Exam 3- Acute Care and Ambulatory Aids

What swelling is contained by the joint capsules

Joint effusion

Describe joint effusion

Feels like water ballon and moves when palpated then returns

Swelling in interstitial space (outside the joint space)

Edema

Describe edema

Press on tissue with I finger and dent (pit) remains

What does compression do physiology

Decrease edema and bleeding

How do you wrap for external compression

Distal to proximal, wrap tighter distal than you do proximal to promote fluid flow away form injury

What is a horseshoe (U) or J shaped felt pad held in place with an elastic wrap that increase the compression

Buttress

Should you feel throbbing after wrapping an injury

No

Examples of internal compression on lymph vessels and veins

Muscle contraction

ROM, pumping ankles, alphabet, isometrics

External compression pushes?

Fluid toward the heart and arterial blood into the extremity

Intermittent compression can be used for

Acute or chronic edema

-mechanical devise that inflates to compress part

What is the most common compression

Intermittent sequential graded compression

What is intermittent sequential graded compression

Inflated for minutes than deflated then repeated for hours per day

Intermittent compression can be combined with

Cooling

What helps lymph flow

Elevation because of gravity

What helps significantly reduce edema

Elevation above the level of the heart

What does dependent elevation mean

Any position below the level of the heart

Taping and bracing is good for

Acute support

Athletic tape stretches in how long

20-30 minutes

Bracing may inhibit?

Muscle action

-hamstring inhibition with knee bracing

What support or assist when patient is unable to walk or bear weight on one extremity

Ambulatory aids

_____________ is better than ________________ when structural and functional integrity of joint is not severely compromised

Weight bearing is better than non-weight bearing

Positioning and footwear for fitting crutches

Low heeled shoes

Stand with tall posture

Feet close together

Where should the crutch tip be when fitting crutches

6 inches form outer margin of shoe

2 inches in front of shoe

Where should the arm brace be when fitting crutches

1-2 inches below anterior axillary fold

Where should the hand brace be when fitting crutches

Elbow flexed to 30 degrees

Improper fit of crutches may cause

Lumbar/pelvic subluxation

Low back strain

Hip strain

What is pressure on axillary nerves and vessels

Crutch palsy

Crutch palsy may cause

Temporary or permanent numbness in the hands

Non weight bearing with crutches

Tripod gait

Partial weigh bearing with crutches

Tripod or 4 point gait

Tripod gait of crutches

Tips move 12-15 inches forward

Pull underarm brace firmly against torso

Swing both legs between crutches

Step onto unaffected foot

Swing to gait of tripod gait

Bring foot to the crutches

-easier, less coordination

Swing through gait of tripod gait

Foot lands in front of crutches

Faster, more coordination

Another name for tripod gait for partial weight bearing

Four point gait

Affected leg and crutches move forward together

Tripod gait for partial weight bearing (Four-point gait)

Describe four point gait

Swing though with body and unaffected limb

Two options for crutches going up and down stairs

Tripod gait

Handrail gait

What is the preferred and safer option for crutches going on stairs

Handrail

Handrail gait for crutches on stairs

Both crutches under one arm

-away for railing

-crutches remain on affected side if possible

What gait should you use if there is no handrail or curbs with crutches on the stairs

Tripod

Describe how to walk up or down stairs with crutches

"The good go up, the bad go down"

-good foot goes up first walking up the stairs and the bad foot goes first when going down the stairs

Cane length

Superior aspect of greater trochanter of femur

Cane is used on__________ side of involvement

Opposite

The cane moves with with ________ side

Involved side