PT11 FINALS

not included: history of PT & anatomical terminology

anorexia (anorexia nervosa)

loss of appetite

Eupnea

normal, effortless breathing

12-20 mins

normal breathing (eupnea)

tachypnea

increase breathing rate

bradypnea

abnormally slow breathing

orthopnea

difficulty breathing in positions other than upright sitting and standing

Pyrexia

raised body temperature; fever.

Valsalva Maneuver

forcible exhalation against a closed glottis, resulting in increased intrathoracic pressure

strain

deformation of materials in response to stress

- can cause lengthening/shortening of the structure

stress

internal load produced in a structure by an EXTERNAL LOAD

arthrokinematics

articular motion occurring between adjacent joint surfaces

Osteokinematics

movement occurring between two bones; involves rotatory motion of around an axis

Dysdiadochokinesia

inability to perform rapid alternating movements

Dysmetria

The inability to judge distance of the range of a movement and the force of muscular activity.

- finger to nose exam

hemiballismus

sudden, jerky, forceful, flailing involuntary movements on one side of the body

tremor

Involuntary oscillatory movement resulting from alternate contractions of opposing muscle groups

Chorea

Involuntary, rapid, irregular, jerky movements involving multiple joints; most apparent in upper extremity

- feature of Huntington's disease

Asthenia

the body lacks or has lost strength (whole/any of its parts)

Athetosis

bizarre, slow, twisting, writhing movement, resembling a snake or WORMLIKE MOVEMENTS

- feature of CEREBRAL PALSY

Nystagmus

rhythmic, oscillatory movement of the eyes

Akinesia

inability to initiate movement

- seen in the late stages of parkinsonism

Jendrassik maneuver

Method used to facilitate eliciting the deep tendon

reflexes of the lower extremities; the patient hooks

together the fingers of the hands and attempts to

pull them apart. While the pressure is maintained,

the reflex is tested.

Rigidity

stiffness; inability to bend or be bent (joint)

- difficult to move ALL through the range

Spasticity

increased muscle tone or contraction and stiff, awkward movements (faster: difficulty)

Tone

(muscle)

- the resistance of muscles to passive elongation or stretch

decerebrate

extension rigidity

Decorticate

flexion rigidity

Hypotonia

decreased muscle tone

Hypertonia

increased muscle tone

Normotonia

Normal tone or tension of muscle

stages of stroke recovery

1. Flaccidity

2. Spasticity

3. Recovery

hemiplegia

paralysis of one side of the body

Diplegia

legs affected more than arms (paralysis)

Quadriplegia

whole body paralysis

Spastic Gait

a stiff, foot-dragging walk caused by one-sided, long-term, muscle contraction; seen with cerebral palsy, head trauma, or brain tumor

3 types of nystagmus

1. horizontal

2. vertical

3. torsional

inspiration

expansion

expiration

depression

increased intracranial pressure

pressure in bradypnea

increased blood and intrathoracic pressure

pressure in Valsalva maneuver

general asthenia

occurs in chronic wasting diseases; adrenal gland

sedentary lifestyle

cause of asthenia

athetoid movements

movements related to athetosis

choreiform movements

movements related to chorea

characteristics of anorexia nervosa

1. low weight

2. fear of gaining weight

3. strong desire to be thin

Acute Care

Short-term hospital treatment for short-term illnesses or health problems.

Primary Care

Basic or first-level healthcare provided by primary care physicians.

Secondary Care

Specialized care provided by medical specialists who do not have first contact with patients.

Tertiary Care

Highly specialized, technologically based medical services provided by highly specialized physicians in a hospital setting.

Subacute Care

Intermediate level of healthcare for medically fragile patients who are too ill to be cared for at home.

Ambulatory Care

Outpatient care provided by physicians, physician assistants, nurse practitioners, PTs, etc.; less costly than inpatient care and favored by managed-care plans

Skilled Nursing Facility

Extended care facility providing continuous nursing, rehabilitation, and other healthcare services on a daily basis.

Acute Rehabilitation Hospital

Provides rehabilitation, social, and vocational services to disabled individuals to facilitate their return to maximal functional capacity.

Chronic Care Facility

• Long-term care facility providing services to patients with permanent or residual disability caused by a nonreversible pathological health condition.

• Provides services to patients for 60 days or more; may require specialized care or rehabilitation

Custodial Care Facility

Patient care that is not medically required but necessary for patients unable to care for themselves.

What are the criteria for patient eligibility in home health care?

• homebound

• health risk when leaving home

• requires skilled care from either nurse, PT, OT, or ST

• has physician certification

• has potential for progress

• more than housekeeping deficits

average and usual length of stay in an acute care hospital

30 and 7 days

makes the PT’s role in patient and family education and in discharge planning increasingly important

rapid discharge for next level of care

Who provides acute care in a hospital?

physicians, physician assistants (PAs), nurses, physical therapists (PTs), and other healthcare professionals

What is the role of the PCP in primary care?

gatekeeper to other subspecialists, including PT

How does the PT support primary care teams?

examination, evaluation, diagnosis, and prevention of musculoskeletal and neuromuscular disorders

What does secondary care often require?

Inpatient hospitalization or ambulatory same-day surgery

Role of PT in tertiary care

responds to requests for consultation made by other healthcare practitioners

Difference between subacute care and SNF

PT, OT, ST services are at a higher level than what is offered in an SNF on a regular basis

Difference between transitional care unit and SNF

A transitional care unit is a short-term care facility (less than 21 days) for complex patients transitioning from the hospital to home, or from one care setting and to another. A skilled nursing facility is a long-term care facility that provides nursing and rehabilitation services for patients who require continuous chronic care.

Medicaid requirements for SNFs

• 7 days of skilled nursing and 5 days of skilled therapy weekly

• 24-hour nursing coverage

• availability of PT, OT, and ST

Who delivers daily care in Custodial Care Facilities?

nonmedical support staff

percent of hospice care required by Medicare and Medicaid to be provided at home

80%

Hospice team

nurses, social workers, chaplain, volunteers, and physicians (PT and OT are optional)

Types of HHAs

• governmental

• voluntary

• private (nonprofit or for profit)

Major goal of PT in the school system

Help the child function in the school setting

Settings for private practice

vary from sports physical therapy and orthopedic clinics, rehabilitation agencies, and occupational health

Rehabilitation

refers to the development of a person to the fullest physical, psychological, social, vocational, avocational, educational potential consistent with his/her physiological, anatomical, and environmental limitations; holistic development

Physical Medicine

branch of medicine concerned with the diagnosis and treatment of physical disorders

Rehabilitation Medicine

associated with the diagnosis and treatment of functional disorders

disease

abnormal condition affecting the body

disorder

functional abnormality or disturbance

Physiotherapist/Physical Therapist

• assesses and manages mobility (including the use of walking aids if required)

• improves balance and assists with regaining strength and control of arms, legs, and body

• focuses on the lower extremities

Physical Therapy Director

• physical therapist by profession, with educational qualifications and prior experience in the field of PT; accepted additional administrative responsibilities

• establishes guidelines and procedures that delineate the functions and responsibilities of all levels of physical therapy personnel

• ensure objectives and are efficiently and effectively achieved within framework and in accordance with safe physical therapist practice

• interprets administrative policies; liaison between line staff and administration

• fosters professional growth of the staff

Staff Physical Therapist

• assists patients; assess, evaluate, and treat holistically

• Commission on Accreditation in Physical Therapy Education (CAPTE) — establish and apply standards to assure quality and continuous improvement in entry-level preparation of physical therapists and physical therapist assistants

• require license to practice

Physical Therapist Registered Philippines (PTRP)

Philippine title for PTs

Registered Physical Therapist (RPT)

US title for PTs

Doctor of Physical Therapy (DPT)

doctorate students

goniometer

a device used to measure a joint’s range of motion (ROM)

Physical Therapist Assistant (PTA)

• works under the supervision of a licensed physical therapist

• teaches patients/clients exercise for mobility, strength, and coordination

• trains them for activities such as walking with aids (crutches, canes, walkers) and the use of adjunctive interventions (additional management)

• may modify an intervention only in accordance with changes in patient status and within the established plan of care developed by the physical therapist

• typically has an associates degree from an accredited PTA program; licensed, certified, or registered in most states

Physical/Occupational Therapy Aide

• support personnel who may be involved in support services

• receive on-the-job training under the on-site direction and supervision of a PT or PTA

• duties are limited to methods and techniques that do not require clinical decision making or problem solving by a PT or PTA

Physical Therapy and Physical Therapy Assistant Student

• can perform duties commensurate with education level

• the PT clinical instructor (CI) is responsible for all actions and duties of the aforementioned students

Physical Therapy Volunteer

• member of community with interest to assist in departmental activities

  • taking phone messages

  • basic nonclinical/secretarial duties

• cannot provide or setup patient treatment, transfer patients, clean whirlpools, or maintain equipment

Home Health Aide

• provides health-related services to the elderly, disabled, and ill in their homes

• include performing housekeeping tasks, assisting with ambulation (term for walking) or transfers, and promoting personal hygiene

• registered nurse, physical therapist, or social worker provide instructions

Occupational Therapist

• aims to help the patient to become as independent as possible in all daily occupations (eating, showering & dressing, cooking, shopping, driving, leisure activities, work, and hand & upper limb function)

• focuses on the upper extremities

Certified Occupational Therapist Assistant (COTA)

• works under the direction of an occupational therapist

• rehabilitative activities and exercises outlined in an established treatment plan

Rehabilitation Consultant/Physiatrist

• is a doctor who specializes in rehabilitation

• assists with planning the rehabilitation (assess and identify issues)

Certified Orthotist (CO)

• design, fabricate, and fit orthoses (braces, splints, collars, corsets) for patients with disabling conditions of the limbs and spine

• must complete examination by the American Orthotist and Prosthetic Association

orthosis

focuses on alignments

prosthesis

focuses on replacements

Certified Prosthetist (CP)

• designs, fabricates, and fits prostheses for patients with partial or total absence of a limb

• same examination as the CO

Respiratory Therapist

• evaluate, treat, and care for patients with breathing disorders; usually employed in hospitals

• performs bronchial drainage techniques, measuring lung capacities, administering oxygen and aerosols, and analyzing oxygen and carbon dioxide concentrations

• require license to practice

Respiratory Therapy Technician Certified (CRRT)

• holds an associates degree from a 2-year training program accredited by the Committee in Allied Health Education and Accreditation

• passed a national exam to become registered

• administers respiratory therapy as prescribed and supervised by a physician

  • pulmonary function tests

  • treatments consisting of oxygen delivery, aerosols, and nebulizers

  • maintenance of all respiratory equipment

• treatment is still from an RT

Primary Care Physician

• usually an internist, general practitioner or a family medicine physician that provides primary care services and manages routine healthcare needs

• provides authorization for referrals

Social Worker

• offers clients and families support as well as liaising with other services

• assists in paperwork and financial matters