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list 3 tissue responses to cellular stress:
- it adapts to stress
- it becomes injured, but recovers
- it dies
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list the 3 stages of GAS (general adaption syndrome) of pathology:
- alarm stage: fight or flight stage
- resistance stage: maintain homeostasis and/or athletes pleatue
- exhaustion stage: increased risk of injury ex: shin splints, tendonitis, overuse injuries
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tissues organize, grow, and gain strenght along lines of stress is known as:
wolff's law
any intervention applied to the body must be at an appropriate intensity for the proper duration to evoke the needed physiologic response
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the means of applying various forms of energy to a pt to have a desired effect on the healing environment is called:
list 3 types of energy forms:
therapeutic modalities
- energy forms can be:
- mechanical: massage, strectching, ultrasound (sound to heat)
- electromagnetic: diathermy, light, e-stim
-
describe the philosophy for modalities
- examination is preformed to identify pts stage of healing (acuity), impairments, fxnal limitations
- tissue healing is predictable (helps determine return to play)
- treatment addresses your findings
- try to manipulate the healing process, phyiscal and fxnal properties to improve fxn
- here enters modalitites as one mean to do so
-
list the 4 general effects of therapeutic modalities
- modify inflammation and healing
- relieve pain
- alter collagen extensibility and flexibility
- modify muscle tone (after surgery, loss of muscle tone)
-
the transfer of energy to increase or decrease tissue temperature is called:
list 5 methods of energy transfer:
thermal agents
- methods of energy transfer:
- conversion: transfer of one energy to another
- convection: circulating air (ex: whirlpool)
- radiation: sun rays absorbed
- evaporation: sweat leaving the body
- differing agents have differing depths of penetration and conductivity (hot pack vs ultrasound)
- hotpack is less than 5 cm
- ultrasound is more than 5 cm
-
list 2 means for increasing tissue temperature for physiological response:
list a mean for decreasing tissue temperature for physiological response:
- increasing temperature
- superficial: hot pack, infrared-lamps, parafin
- decreasing temperature:cryotherapy
-
list 4 mechanical agents:
what is the fxn of mechanical agents:
- sound
- compression: sequential compression, ace wrap, game ready
- water: hydrotherapy
- traction
fxn: may increase or decrease pressure in the body
-
list 3 electromagnetic agents:
- electromagnetic radiation: SWD (short wave diathermy)
- light: UV, phototherapy, laser
- electrical current: TENS (transcutaneous electrical nerve stimulation), NMES (neuromuscluar electrical stimulation)
- -application of electromagnetic energy in form of radiation or electrical current
- -variation and modulation of energy changes effects and depth of penetration
-
describe contraindications:
describe precautions:
- contraindications:conditions that render a treatment improper or undesirable
- absolute vs. relative
- precautiontreatment performed with special care and consideration
- vary according to modality
- considerations: physiologic effects & distribution of energy (review box 3-1)
-
list 9 contraindications and precautions to consider:
- pregnancy
- malignancy: cancer or hx of
- pacemaker
- impaired sensation: potential danger of burns, ect.
- impaired mentation (ability to communicate)
- metal implants: burning, warming the plates, or joint cement
- allergies
- high blood pressure
- stents
-
list 4 descriptors of epithelial tissues:
- skin lining of vessels and organs
- high potential to regenerate
- provides barrier that prevents substances from entering or leaving
- critical component w/ application of many modalities
-
list 5 descriptors of adipose tissue:
- fat cells
- protects structures
- high water content
- insulator: barrier for heat and cold
- can affect the application of many modalities
-
list 5 descriptors of connective tissue:
list 4 types:
- support cells
- provides strenght, support, nutirition and defense for other tissues
- fibroblasts, chondrocytes, myofibroblasts, and adipocytes
- collegen (11 types - some reports of up to 28 types)
- restricts ROM (scar tissue)
-
list the description of muscle tissue:
list 3 types:
list 2 fibers:
- ability to shorten and enlongate
- types: cardiac, smooth, skeletal
- type I muscle fiber: endurance
- type II muscle fiber: fast twitch, more mitochondria, fatiuges easily
- voluntary vs involuntary recreuitment patterns
- satillite cells mimic muscle (scar tissue) when torn
-
describe nervous tissue:
list the pathway of nervous tissue:
- sensory receptors
- ability to carry impulses toward (afferent) or away (efferent) a central structure
- pathwaydendrite
- body
- axon
- synaptic cleft
-
list and describe the 5 types of afferent nervous tissue:
Ia:
Ib:
II:
III:
IV:
- Ia (A Alpha): muscle spindle
- Ib (A Alpha): GTO
- II (A Beta): touch/pressure, secondary muscle (fastest) carries hot, cold, touch to spine
- III (A Delta): temperature, sharp pain (faster)
- IV (C): temperature, dull pain
-
describe the 3 types of efferent nervous tissues:
A- Alpha:
A - Gamma:
A Beta:
- A-Alpha: skeletal muscle
- A-Gamma: muscle spindle
- A-Beta: muscle and muscle spindle
-
describe the propagation of nerve impulses:
resting potential:
action potential:
myelination:
- resting potential: + outside, - inside
- action potential: - outside, + inside
- all or none
- refractory peroid
- unmyelinated
- myelinated: schwan cells, nodes of Ranvier, faster, more efficient - saltatory conduction
-
list 6 chemical neurotransmitters that cross the synaptic cleft:
- acetylcholine
- dopamine
- epinephrine
- norepinephrine
- serotonin
- substance P ( Table 1-4)
synapses can be excitatory or inhibitory
-
define the following legal considerations....
licensure:
certification:
registration:
exemption:
- licensure: most restrictive form of regulation. establishes scope of practice, miminal education standards, and protects titles
- certification: a state based certification test. defines scope of practice, does not protect titles
- registration: minimal prerequisites. registered professionals may use titles
- exemption: performs skills and roles of another profession without infringment
-
define the following terms:
negligence:
omission:
commission:
- negligence: (form of legal tort) departing from a standard of care
- omission: fail to do things properly
- commission: fail to do what is right
-
list 4 legal considerations for the facility:
- GFI: ground fault intrupptor
- whirlpool swithces and line of site (to watch/observe)
- properly insprection and calibration
- flooring issues
-
list 7 possible observations to include in the objective portion of a soap note:
- temperature
- color
- gait
- posture
- edema
- weight bearing
- atrophy
-
list 5 possible considerations of pain to include in the objective portion of a soap note:
- rating
- best
- worst
- changes
- qualitiy
-
List 6 things that are the purpose of medical records:
- communication tool among health care providers
- document tx and/or rehab progression
- assist in continuity of care
- Provides basis for future tx
- serves as legal document to show that reasonable care was provided
- provides database for research
-
List 6 types of medical records:
- Medical hx
- pre-participation physical exam
- Informed consent forms
- Injury reports
- referral forms
- SOAP Notes
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