NPTE 40 Quick Points(common mistakes)

Safety Precautions - MRSA

Gloves, Gown

Safety Precautions- TB-N-95

For TB, follow airborne precautions which require N95 mask only

Safety Precautions- Pneumonia

Follow droplet precautions which require mask when working within 3 feet of patient

Which are the accessories muscles for lateral deviation of TMJ

Lateral pterygoid (ipsilateral muscle) and Medial pterygoid (contralateral muscle) are the main muscle.

Temporalis, Masseter are secondary and act when assistance is needed.

Radioulnar Mobs (Cashier is unable to give cash back)

Distal (Pronation- Anterior glide), Supination- Posterior glide

Proximal- PPP (Proximal Pronation posterior) Opposite roll and slide

In dark, staircase which color tape?

yellow

Leaning during walking- Forward

Quads, Nerves- Femoral N (L2-L4)

Leaning during walking-Backward

G max (Inferior G. nerve)

Leaning during walking-Lateral

G med (Superior G nerve)

Which stage of lymphedema is reversible?

Stage 1

Monofilaments

- 10 gm 5.07 is used for protective sensation, keep perp to the surface

Osgood Schlatter

Boys (12 yrs) Treatment Ice

Jumpers disease

treatment isometrics

Ventral Pon Infarct CVA

Locked In syndrome (Complete basilar artery syndrome)

Pregnancy BP

BP decreases in first trimester, increases in the third

Mann-U Whitney

Nonparametric test designed to test the null hypothesis with two independent samples from the same population.

K-Wallis

non-parametric test for three groups

Odd Ratio

Less than 1: intervention group is better than the control group

V/Q (Ventilation/Perfusion) ratio decreases

Cyanosis- Nail coloration

Flexor tendon repair

Immobilization in flexion, during early rehab: passive flexion and active extension

Extensor tendon repair

Immobilization in extension, during early rehab: active flexion and passive extension

MRI T1 vs X-Ray

MRI- Gold standard

Fracture- X-Ray first. Lung congestion- X Ray first

SpondyloSIS

degeneration of intervertebral discs

SpondyloLYSIS

Scotty Dog, Oblique view

defect in pars interacrticularis or arch of vertebrae

Sway back vs flat back -

Increased Kyphosis (Sway back)

SpondyloLISTHESIS

Lateral view

forward displacement of one vertebra over another

How to Choose Spinal Mobilizations

1. Should you use Central or Unilateral PAs

2. What spine level to Stabilize

3. What spine level to Mobilize

4. What are the Arthrokinematics of the motion

Cardiac rehab phases- MET Phase 1

1-3 METS(No incline),

Cardiac rehab phases- MET Phase 2

4-6 METS (sexual activity),

Cardiac rehab phases- MET Phase 3

6-9 METS (running)

When to use different rollator walkers-Anterior rollator

encourage forward trunk leaning and provide maximum anterior stability.

When to use different rollator walkers- Posterior rollator

encourages trunk extension, shoulder depression, elbow extension and neutral wrist.

Raynaud's disease-

vasospasm of smaller arteries (commonly seen in hand and feet)

What is difference between Ulcerative Colitis and IBS if both of them feels good after passing stool

Symptoms of IBS DO NOT include bleeding or black stools.

Air plethysmography level of accuracy:

The BOD POD is an Air Displacement

Plethysmograph (ADP) that uses whole body densitometry to determine body composition (fat vs. lean). Gold standard to measure body fat

BUN/Creatinine

10:1 normal, more than 20:1 is abnormal, INR normal 0.9-1.1

The Patellar-Pubic Percussion Test

is a form of Osteophony or auscultatory percussion which is used in the assessment of bone integrity by analyzing its vibrations through the use of a stethoscope and bony prominence percussion.

Insulin Shock

take too much insulin causes hypoglycemia

Thomas test positive- Gait deviation

Limited extension in Terminal Stance

Step deformity in Shoulder

AC joint separation

What is the difference between Sulcus test and Step deformity

The PT performs the sulcus test whereas step deformity is visually seen without palpation

What should be the PT response if there are 3 PVC's in a row-

Call emergency.

Legg Perthes disease

Pain worsens with activity and is relieved with rest

Calcific tendonitis

Treatment is Acetic Acid

T4 syndrome

Paresthesias, numbness, or upper extremity pains associated with or without headaches and upper back stiffness.

Correct accessible measurement for the doorway

Doorway - 32 Inches

Correct accessible measurement for the hallway

Hallway - 36 Inches in width, when turning is not required.

Correct accessible measurement for the ramp for wheelchair

Ramp for wheelchair - The minimum ramp grade for a wheelchair ramp is that for every inch of threshold height there is a corresponding 12 in of ramp length (a running slope of 1:12).

Precaution while treating patients with tinea pedis and tinea corporis

Standard precautions. Person-to-person spread can occur if close body contact is frequent.

Persons should be excluded from swimming pools while infected or until treatment initiated

What is selective stretching?

This process of under-stretching some muscles and full stretching of others to improve function.

Ankle strategies

first elicited, to control postural sway, response to small perturbation, contract distal to proximal

Hip strategy

greater force or force through hips/pelvis, hips move opposite head, contract proximal to distal

Stepping strategy

When pushed out of BOS - step to regain new BOS

GERD pts: Precautions-

Sleep with head elevated or in left side lying, and maintain an upright position to avoid reflux and avoid large meals

BP cuff sizes:

cuff is too large: low BP

Cuff is too small: high BP

What is short bowel syndrome?

Short bowel syndrome is a condition in which the body cannot absorb enough fluids and nutrients because part of the small intestine is missing (usually due to prior surgery or illness), or is not working properly.

Pain types- Allodynia

Allodynia: pain from simple touch eg: fibromyalgia, CRPS

Pain types -Hyperesthesia

Hyperesthesia: excessive physical sensation

CTSIB Condition 1

eyes open, fixed support

All sensory systems unaltered

CTSIB Condition 2

Eyes closed, stable surface

Vision absent, Somatosensory unaltered, Vestibular intact

CTSIB Condition 3

Visual surround moves, fixed support (vision inaccuracy)

Vision absent, Somatosensory unaltered, Vestibular intact

CTSIB Condition 4

Eyes Open, moving surface

Vision unaltered, Somatosensory altered, Vestibular intact

CTSIB Condition 5

Eyes closed, moving surface

Vision absent, Somatosensory altered, Vestibular intact

CTSIB Condition 6

Visual conflict with moving surround, moving platform

Vision altered, Somatosensory altered, Vestibular intact

CTSIB Visual Dependent

Instability with conditions 2, 3, 5, 6

CTSIB Vestibular Loss patients

Instability with conditions 5, 6 as maintenance of posture depends on availability of vestibular inputs

CTSIB Somatosensory Dependent

Instability with conditions 4, 5, 6

suface dependent

CTSIB Sensory selection problems

unstable in conditions 3, 4, 5, 6

unable to effectively adapt sensory information to maintain balance

Cognitive Stage of Motor Learning

What to Do phase

Extrinsic feedback > intrinsic

Knowledge of results then knowledge of performance

Feedback after every trial

Blocked practice

Associative Stage of Motor Learning

How to Do phase

Intrinsic feedback

Feedback -summed, bandwidth, fading

Variable and Diminished practice

Automatic Stage of Motor Learning

How to Succeed phase

Scoliosis

Concave side = muscles short and strong

Convex side = muscles stretched and weak; scap/shlder is higher on this side

Gait Kinematics: Sagittal Plane

Flexion/Extension - ROM

Gait Kinematics: Frontal Plane

ABD/ADD = closed chain

Gait Kinematics: Horizontal Plane

Rotation

Wheelchair Width

measure widest part of the hip

ADD 2 inches

Wheelchair Seat Depth

is determined by measuring the patient's posterior buttock, along the lateral thigh to the popliteal fold,

SUBTRACT 2-3 inches

Normal seat depth in an adult size w/c is 16 inches.

Wheelchair Seat Height

ADD 2 inches to leg length measured

Wheelchair Arm Rest

measure from seat platform to below elbow at 90 degrees

ADD 1 inch

Wheelchair Back Height

Measure from seat platform to lower angle of scapula

SUBTRACT 4 inches

Turn 360degrees in wheelchair

60 inches x 60 inches

Turn 90degrees in wheelcair

36 inches

Forward reach in Wheelchair

low reach 15 inches

high reach 48 inches