PEAT #2

Flashcards covering key terms and definitions from the lecture notes on Cardiovascular, Pulmonary, Musculoskeletal, Neuromuscular, Integumentary, Lymphatic, Metabolic, and Genitourinary Systems.

Pulse Oximetry (SpO₂)

Noninvasive measurement of oxygen saturation in arterial blood using infrared light through fingertip/earlobe. Normal range is 95–100%; <90% indicates hypoxemia.

Hypoxemia

A condition where arterial oxygen saturation (SpO₂) falls below 90%.

Capillary refill time

A quick screen for peripheral perfusion, with a normal value of less than 2 seconds.

Normal PaO₂ (Arterial Blood Gases)

The normal partial pressure of oxygen in arterial blood, typically 80–100 mmHg.

Ankle pumps / Heel slides / Quad & glute sets

Exercises that activate the calf pump to improve venous return and reduce DVT risk during bed rest.

Deep breathing / Diaphragmatic breathing

Breathing techniques that enhance venous return via thoracic pressure changes, reducing DVT risk.

Homan’s sign

A physical sign suggestive of deep vein thrombosis (DVT), characterized by calf pain with dorsiflexion of the foot (a red flag necessitating immediate notification of RN/MD).

Absolute exercise contraindications post-MI (acute)

Unstable angina, uncontrolled arrhythmia, severe aortic stenosis, and acute MI within 2 days.

Valsalva maneuver

A breathing technique involving exhalation against a closed airway; it should be avoided post-MI as it increases afterload and heart rate. Patients should be taught to exhale with exertion.

Isometrics (post-MI)

Exercises that should be avoided in the initial post-MI phase (first 2–6 weeks) as they increase afterload and heart rate.

Phase I Cardiac Rehab

Involves gentle AROM, bed mobility, and light walking at 1–2 METs for patients post-MI.

Obstructive Lung Disease (Spirometry)

Characterized by decreased FEV1, normal or decreased FVC, an FEV1/FVC ratio <70%, increased RV, and increased TLC (air trapping). Examples include COPD, asthma, and bronchiectasis.

Restrictive Lung Disease (Spirometry)

Characterized by decreased TLC, VC, and FVC, with a normal or increased FEV1/FVC ratio. Examples include pulmonary fibrosis, scoliosis, and obesity.

Pursed-lip breathing

A breathing technique beneficial for patients with obstructive lung disease to reduce air trapping by prolonging exhalation.

Borg 6–20 RPE Scale

A scale for perceived exertion that correlates with heart rate (RPE × 10 ≈ HR). 9–11 is light, 12–13 is moderate, and 14–17 is vigorous.

Modified Borg 0–10 Scale (Cardiac Rehab)

A scale for perceived exertion, where 0 is nothing and 10 is maximal. The target for cardiac rehab patients is typically 3–5 (moderate).

Six-Minute Walk Test (6MWT)

A functional endurance test for patients with COPD; a distance of <350m is associated with an increased mortality risk.

Peak Expiratory Flow (PEF)

A measurement often used in asthma monitoring to assess airflow.

Postural Drainage (Upper Lobes - Apical)

Positioning where the patient is sitting, leaning back 30 degrees, to drain the apical segments of the upper lobes.

Postural Drainage (Lower Lobes - Posterior Basal)

Positioning where the patient is in Trendelenburg and prone to drain the posterior basal segments of the lower lobes.

Contraindications for Postural Drainage

Increased intracranial pressure, head trauma, hemoptysis, and untreated pneumothorax.

Beta-blockers (e.g., Metoprolol)

Cardiac medications that decrease heart rate and blood pressure, and cause a blunted HR response to exercise. PTAs should monitor RPE and watch for fatigue/dizziness.

ACE inhibitors (e.g., Lisinopril)

Cardiac medications that can cause a dry cough and hypotension as side effects.

Diuretics (e.g., Furosemide)

Cardiac medications that can lead to electrolyte imbalance, causing muscle cramps and arrhythmias.

Anticoagulants (e.g., Warfarin)

Medications that increase bleeding risk; PTAs must exercise caution with manual techniques.

Holter Monitor

A portable device for 24–48 hours of continuous ECG monitoring to detect intermittent arrhythmias.

Echocardiogram

An ultrasound test that assesses heart chamber size, wall motion, and ejection fraction (EF).

BNP test

A blood test used as a marker of the severity of Congestive Heart Failure (CHF).

a-v O₂ difference (Tissue Oxygen Extraction)

The difference in oxygen content between arterial and venous blood, which increases with exercise intensity.

Systole (Heart Valves)

The phase of ventricular contraction where the mitral and tricuspid valves are closed, and the aortic and pulmonic valves are open.

Diastole (Heart Valves)

The phase of ventricular relaxation and filling where the aortic and pulmonic valves are closed, and the mitral and tricuspid valves are open.

Mitral stenosis

A pathological condition where the mitral valve narrows, leading to impaired diastolic filling of the left ventricle.

Inspiratory Muscle Trainer

A device used to improve long-term ventilation by providing threshold loading for inspiratory muscle strengthening.

Normal sinus rhythm

A regular cardiac rhythm with a P wave before every QRS complex, at a rate of 60–100 bpm.

Atrial fibrillation

An irregularly irregular cardiac rhythm with no distinct P waves.

Ventricular tachycardia

A serious cardiac arrhythmia characterized by three or more premature ventricular contractions (PVCs) in a row, with a fast, wide QRS complex.

Ventricular fibrillation

A chaotic and unorganized cardiac rhythm with no distinct QRS complexes, which is a medical emergency (code blue).

Asystole

A cardiac rhythm characterized by a flatline on the ECG, indicating no electrical activity (a code blue emergency).

Peripheral Artery Disease (PAD) Sleeping Position

Patients with PAD often experience pain relief with legs dependent, so they should sleep with the head of the bed elevated and legs neutral or slightly dangling.

Beta-blocker Recommendations for Exercise

Use RPE, not HR, for intensity; ensure adequate warm-up and cool-down due to reduced HR variability; and watch for signs of hypoglycemia masked in diabetic patients.

Stridor

A high-pitched inspiratory breath sound indicating upper airway obstruction, which is a medical emergency.

Crackles (rales)

Breath sounds that can be fine (associated with CHF/pulmonary edema) or coarse (associated with pneumonia).

Wheezes

Expiratory breath sounds indicating airway narrowing, common in conditions like asthma and COPD.

Pleural rub

A grating breath sound heard in patients with pleuritis.

Anterior Cruciate Ligament (ACL) Injury

Injury often caused by valgus + rotation, deceleration, pivoting, or hyperextension. Tests include Lachman, anterior drawer, and pivot shift.

Posterior Cruciate Ligament (PCL) Injury

Injury often caused by a dashboard injury or a fall on a flexed knee. Tests include posterior drawer and sag sign.

Medial Collateral Ligament (MCL) Injury

Injury caused by a valgus force to the knee. Tested with the valgus stress test. Usually non-surgical.

Meniscus Injury

Injury often caused by twisting with a foot planted. Signs include joint line tenderness, swelling, locking, and popping. Tests include McMurray, Thessaly, and Apley.

Osteoarthritis (OA)

A degenerative 'wear-and-tear' condition of cartilage, typically asymmetrical, affecting weight-bearing joints (knee, hip). Morning stiffness is usually <30 min, and pain worsens with use. Associated with Bouchard’s (PIP) and Heberden’s (DIP) nodes.

Rheumatoid Arthritis (RA)

An autoimmune, systemic inflammatory disease, typically bilateral and symmetrical (hands, wrists, feet). Morning stiffness is >1 hr. Can cause deformities like ulnar drift, swan neck, and boutonnière deformities.

Bouchard’s nodes

Bony enlargements of the proximal interphalangeal (PIP) joints, characteristic of osteoarthritis.

Heberden’s nodes

Bony enlargements of the distal interphalangeal (DIP) joints, characteristic of osteoarthritis.

Swan neck deformity

A hand deformity seen in RA, characterized by PIP hyperextension and DIP flexion.

Boutonnière deformity

A hand deformity seen in RA, characterized by PIP flexion and DIP hyperextension.

Ulnar drift

A hand deformity seen in RA, where the metacarpophalangeal (MCP) joints deviate ulnarly.

Patellofemoral Pain Syndrome (PFPS)

Anterior knee pain (movie-goer's knee) worse with stairs, squatting, or prolonged sitting. Causes include maltracking due to weak VMO, tight ITB, increased Q-angle, or pes planus. Tested with Clarke's test.

Dupuytren’s contracture

A condition involving thickening of the palmar fascia, leading to a fixed flexion contracture of the fingers.

Gait Cycle - Stance vs. Swing

The gait cycle consists of approximately 60% stance phase and 40% swing phase.

Gait Deviation: Trendelenburg Gait

A gait deviation caused by weak gluteus medius, resulting in the dropping of the pelvis on the swing leg side.

Gait Deviation: Foot Slap

A gait deviation caused by weak dorsiflexors, where the foot makes an audible slap on the ground during initial contact.

Gait Deviation: Vaulting

A gait deviation where the patient rises up on the toes of the stance limb, often to clear a limb that is too long (e.g., prosthetic) or has difficulty with knee flexion.

Gait Deviation: Antalgic Gait

A gait pattern adopted to avoid pain on weight-bearing, characterized by a shortened stance phase on the painful limb.

Neer Test

A special shoulder test for shoulder impingement syndrome.

Hawkins-Kennedy Test

A special shoulder test for shoulder impingement syndrome.

Drop Arm Test

A special shoulder test to assess for a rotator cuff tear.

Lachman Test

A special knee test for Anterior Cruciate Ligament (ACL) integrity.

Posterior Drawer Test

A special knee test for Posterior Cruciate Ligament (PCL) integrity.

McMurray Test

A special knee test to assess for meniscal tears.

Thompson Test

A special ankle test to assess for an Achilles tendon rupture.

Fracture Healing - Inflammatory Phase

The first phase of fracture healing, lasting approximately 1–7 days.

Fracture Healing - Reparative Phase

The second phase of fracture healing, lasting several weeks, during which soft callus forms, followed by hard callus.

Fracture Healing - Remodeling Phase

The final phase of fracture healing, lasting months to years, where the bone is gradually reshaped and strengthened.

Compartment Syndrome

A painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues against the fascia, often a complication of fractures.

Spondylosis

Degenerative osteoarthritis of the spine.

Spondylolysis

A defect in the pars interarticularis of a vertebra, often appearing as a 'Scottie dog collar' on X-ray.

Spondylolisthesis

A condition where a vertebra slips forward over the vertebra below it, commonly at L5/S1.

Spinal Stenosis

Narrowing of the spinal canal, leading to neurogenic claudication, which is worse with extension and better with flexion.

Disc Herniation

A condition where the nucleus pulposus of an intervertebral disc protrudes, causing radicular pain; flexion should be avoided, especially in acute cases.

Quadruped Positioning (Muscle Activation)

Activates trunk and hip stabilizers, scapular stabilizers (serratus, traps), and core stabilization muscles (multifidus, erector spinae).

Modified Plantigrade

A pre-gait position with hands on an elevated surface, involving weight-bearing through upper and lower extremities, used to improve postural control.

Rancho Los Amigos Cognitive Level 4

Confused-agitated (TBI).

Rancho Los Amigos Cognitive Level 8

Purposeful-appropriate (TBI).

Biceps Reflex

A deep tendon reflex (DTR) primarily associated with nerve roots C5–C6 (musculocutaneous nerve).

Triceps Reflex

A deep tendon reflex (DTR) primarily associated with nerve roots C7–C8 (radial nerve).

Patellar (Knee Jerk) Reflex

A deep tendon reflex (DTR) primarily associated with nerve roots L3–L4 (femoral nerve).

Achilles Reflex

A deep tendon reflex (DTR) primarily associated with nerve roots S1–S2 (tibial nerve).

Carpal Tunnel Release - Reinnervation Phase

Begins sensory re-education, light grip/pinch strengthening, and median nerve glides (after the acute phase of 0–2 weeks).

Motor Learning - Cognitive Stage

The initial stage of motor learning where the patient is understanding the task.

Motor Learning - Autonomous Stage

The final stage of motor learning where the task performance becomes automatic.

Knowledge of Results (KR)

Extrinsic feedback that provides information about the outcome of the movement relative to the goal.

Knowledge of Performance (KP)

Extrinsic feedback that provides information about the quality or nature of the movement itself.

Cranial Nerve I

Olfactory Nerve: Responsible for the sense of smell.

Cranial Nerve II

Optic Nerve: Responsible for vision.

Cranial Nerves III, IV, VI

Oculomotor, Trochlear, and Abducens Nerves: Primarily responsible for eye movement.

Cranial Nerve VII

Facial Nerve: Responsible for facial expression and taste from the anterior tongue.

Cranial Nerve X

Vagus Nerve: Responsible for parasympathetic functions, gag reflex, and swallowing.

Positioning UE post-CVA (Supine)

Scapula protracted, shoulder abducted + external rotation, elbow extended, forearm supinated, wrist neutral, fingers/thumb extended.

Hypotonia (Down Syndrome)

Low muscle tone often seen in individuals with Down Syndrome, accompanied by joint laxity.

Modified Ashworth Scale

A common assessment tool used to measure muscle tone (spasticity).

Radial Nerve Distribution

Innervates the dorsum of the hand and wrist/finger extensors.