Ortho test 1 clinical pearls

ongoing stress reactions only strengthen the memory of pain. Incorporate self-management strategies (mindfulness, relaxation, CBT, graded motor imagery, and sleep management) to address CNS arousal and help modify dysfunctional neuroplasticity changes

true

these things need to be avoided when treating clients with CPRS to not continue to increase the CNS sensitivity.....

bright light, touch, noise, mechanical pressures, and high and low temps

graded motor imagery and mirror therapy might be useful for reducing pain and disability. these techniques assist in correcting the brain's cortical body maps by reducing the incongruence between ___________ and __________

motor commands and sensory feedback

graded motor imagery is a brain-based treatment (top-down), which targets the activation of different brain regions in a graded manner. Treatment consists of 3 different components:

1. rehabilitation of left/right discrimination

2. motor imagery rehearsal

3. mirror therapy

true

the vulnerability of a nerve to chemotherapy is influenced by its length. ____________nerves are more vulnerable than _________ nerves. In general _________ fibers tend to be at a higher risk for anticancer drug toxic effects than __________ fibers

longer; shorter

sensory; motor

while the deficits of CIPN can be sensory, motor, or autonomic, most polyneuropathies are purely ___________

sensory

Pain that originates from skeletal muscles, ligaments, or joints.

somatic pain

pain that results as a direct consequence of a lesion or disease affecting abnormal functioning of the peripheral nervous system (PNS) or central nervous system (CNS)

neuropathic pain

neuropathic pain has been associated with depression more often than somatic pain.

true

__________should be treated only when present; __________should always be treated

disease; illness

pain in an area for longer than 6 months

chronic pain

wounds almost always have more than one color present at a time. Treat the worst stage first; that is progress from treatment of ________to __________ and then treat ________ to ________

black to yellow

yellow to red

if you think your patient's wound is infected what should you do?

have it examined by a physician

ARTERIAL interruption usually produces a _______or________ discoloration of the affected area (pallor)

VENOUS blockage usually produces a congested, ______-________ color

_______________ may indicate chronic venous insufficiency

_________ may indicate loss of outflow of blood from the hand, but may also be an indication of a normal inflammatory phase of wound healing or the presence of infection

white or grayish

purple-blue

dusky blue

redness

early mobilization within a pain-free ROM promotes faster healing of connective tissue, stronger collagen bonds, reduced scar tissue adhesions, and improved collagen fiber orientation

true

strength is related to fiber ________, not fiber type

diameter

clinically, the first goal of dosing exercise is to deliver _________ to the muscles, elicit NO pain, and perform many reps.

Initially, focus on sustaining slow, coordinated movements. Ultimately progress toward a fast/functional speed while maintaining coordination and providing optimal stimulus for regeneration of the specific tissue(s) in lesion

oxygen

exercises dosed at high reps are to improve

vascularization and endurance

avoid pain because pain indicates that the tissue is being irritated. When a tissue is irritated there will be more pain, which leads to muscle guarding, inflammation, and decreased blood flow

true

this joint has the greatest ROM in the body. the ROM is the result of the aggregate movement of a series of articulations that compromise this complex. these articulations work in concert to provide a balance of mobility and stability with the emphasis on MOBILITY

the shoulder

arm and hand involvement often include complaints of pain, paresthesia, and weakness. A strong clue that the plexus is involved is that these symptoms do NOT follow dermatomal or peripheral nerve distributions. Other strong indications that the plexus is involved are intolerance to overhead activities, reports of dropping objects, cramping of the hand intrinsic while writing, walking with a "dead arm," and intolerance of straps across the top of the shoulder

true

______________mobilization exercises should begin as soon as the client is stable usually within the first 3 postoperative days

neutral

When PROM is greater than AROM at the joint, the active limitation is called

lag

When passive limitation of joint motion exists, that limitation is called?

joint contracture

The habit of extending the wrist with ED can be very hard to break once established

True

You should always perform for arm rotation exercises with the elbow on the table

False: this prevents isolated forearm rotation and allows for substitutions with humeral motions

Blocking exercise exert more force than non blocking exercises

True