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Medical Exercise Training Exam

  1. 1. Please list the six keys to medical exercise program design.
    • 1.) Clear understanding of anatomy and pathology
    • 2.) Immediately recognize contraindicated exercises and activities
    • 3.) Assess key areas using key techniques
    • 4.) Incorporate indicated exercises and activities into the program
    • 5. Understand progression guidelines and functional goals leading to a positive outcome.
    • 6. Use a protocol-based approach
  2. 2. Please describe how each of the six keys may impact the outcome of the MET client.
    Anatomy and Pathology dictate the program design

    Developing a program w/o anatomy understanding is shooting in the dark

    The program should target specific situations based on the anatomy

    • blood glucose
    • improved endurance
    • increases in strength/flexibility

    measurable differences ex. the client could only transport by walker/wheelchair, can now transport by cane/light walking
  3. What are the four joints that make up the shoulder complex?
    • -Gleno humeral joint (subacromonial space)
    • -Acromio-clavicular joint
    • -Sterno-clavicular joint
    • -Scapulothoracic joint (stability)
  4. How many degrees of freedom or movement are found in the shoulder?
    There are 3 degrees of mobility in the shoulder

    • - Flex and extend
    • -Abduction and Adduction
    • -Internal and external rotation

    All of these come from the glenohumeral  joint
  5. What are the muscle components of the rotator cuff?
    Suprasinatus, infraspinatus, subscapularis, Teres Minor
  6. What muscles in the shoulder are part of the C5 myotome?
    Deltoid
  7. What cutaneous areas are part of the C6 dermatome?
    Trapezius muscle, postero lateral deltoid, humerus,  radial forearm/thumb
  8. What does cutaneous mean?
    relating to or affecting the skin.
  9. What are the three ligaments damaged with the anterior shoulder dislocation?
    • Glenohumeral ligament
    • Coracoacromial ligament
    • coracohumeral ligament
  10. What structures are found in the sub-acromial space?
    • Tendon of biceps muscle
    • subacromial bursa
    • rotator cuff
  11. Ask Festus about this one

    1. Please list the common conditions effecting each joint:

    a. Gleno-humeral joint

    b. Acromio-clavicular joint

    c. Scapulo-thoracic joint

    d. Sterno-clavicular joint
    Gleno humeral joint- Rotator cuff tear, subacrimonial bursitis

    Acromio-clavicular joint- Arthritis, fracture/separation

    Scapulo-thoracic joint- Snapping scapula syndrome, scapulothoracic bursitis

    Sterno-clavicular joint- Osteoarthritis, clavicle fracture
  12. Please identify the structures impinged in the sub-acromial space with impingement syndrome.
    Superspinatus tendon, rotator cuff tendon, subacrimonial bursa
  13. Please identify the conditions that present with similar symptoms to gleno-humeral impingement.
    AC joint issues
  14. Does bicipital tendinitis usually effect the proximal or distal attachment of the biceps?
    Distal, because it is closer to the elbow.
  15. What condition is usually involved with pain in the AC joint with heavy lifting and repeated overhead activities?
    Bone spur or osteophyte.
  16. What subjective comment will your client make indicating he or she is ready to begin overhead or deltoid activities?
    They can sleep on their shoulder side at night
  17. What is the ratio of rotato cuff to deltoid exercise during medical exercise training for shoulder impingement or rotator cuff tear?
    1:2 Deltoid/Pectoralis to Rotator Cuff/post shoulder guide
  18. Please explain the concept of the "primer set" and when it is used.
    Deltoid and pectoralis work/rotator cuff post shoulder

    • -1 set interior/exterior rotation prior to deltoid
    • -1 set post shoulder girdle prior to pectoralis
  19. What is the medical term for opening the glenohumeral joint during the pendulum exercise?
    sub-acrimonial distraction
  20. Please list the eight carpal bones.
    • Scaphoid
    • lunate
    • triquetrum
    • pisiform
    • trapezium
    • trapezoid
    • capitate
    • hamate
  21. Please list all the muscles that flex the wrist.
    flexor carpi radialis, and flexor carpi ulnaris.
  22. Please list all the muscles that extend the wrist.
    Extensor carpi radialis longus together with extensor carpi radialis brevis
  23. What is the membrane that attaches to the ulna and radius?
    interosseous membrane
  24. Identify the ligament under which the median nerve passes to enter the hand.
    Transverse carpal ligament
  25. What is the term used collectively for the ligaments along the medial aspect of the elbow?
    The deltoid ligament
  26. What are the layman’s terms for medial and lateral epicondylitis?
    • Medial Epicondylitis- Golfers elbow
    • Lateral Epicondylitis- Tennis elbow
  27. Please list the medical exercise training (MET) criteria for medial epicondylitis.
    Thorough medical history, control inflamation, repitition, increase strength and function, maintain or improve tissue pliability, ergonomic assessment, protocol based approach
  28. Please list the MET criteria for lateral epicondylitis.
    • Medical clearance
    • Minimal swelling and pain
    • Full hand motion function
    • Sensation intact
  29. Numbness and tingling in the IV and V digits of the hand would indicate involvement of what nerve?
    Ulna nerve
  30. Please list the MET goals and criteria for carpal tunnel syndrome?
    • Fair grip and wrist strength
    • minimal pain (<4 on pain scale)
    • Medical clearance, if required, wear brace/splint

    • Goals: Impose and maintain wrist and hand, strengthen forearms sup/pro
    • stretch anterior shoulder girdle/strengthen post girdle
  31. Please explain how thoracic outlet syndrome may cause carpal tunnel like symptoms.
    Pectoralis may get tight and cause compression on thoracic outlet or inlet area producing carpal like symptoms
  32. Please list the hand structures are innervated by the median nerve?
    Thumb, index, middle finger, and lateral aspect of the ring finger
  33. Why is lower extremity motor control an important MET criteria for the lumbar client?
    It could be a sign that there is a disc involved
  34. Please describe the symptoms associated with lateral stenosis and central stenosis.
    • LS: Unilateral leg pain
    • CS: Bilateral leg pain that goes away when sitting
  35. Why does lumbar extension reduce the sciatica associated with lumbar disc herniation?
    It pushes nuclear material forward and away from the nerve root
  36. Which results in higher disc pressure - sitting or supine lying? Please explain why.
    Why does lumbar extension reduce the sciatica associated with lumbar disc herniation?
  37. What are the three essential components of a MET program for lumbar disc herniation?
    • Spinal stabilization
    • LE strengthening
    • Cardiovascular training
  38. What is the common mechanism of injury with a spondylolisthesis?
    • Extreme and/or forced extension
    • motor vehicle accident
  39. What is the common mechanism of injury with a lumbar disc herniation?
    Occupation/weight
  40. How and why does extreme lumbar extension effect spondylolisthesis?
    The spine is already severely extended, this will aggravate the spinal cord, extension moves vertebral segment forward
  41. What is the MET criteria for spondylolisthesis?
    • Recruit abdominals
    • Limit spinal extension
    • Emphasize spinal stability with ADLs
  42. Please list five conditions that cause sciatica.
    • Spinal stenosis
    • disc herniation
    • SI joint problems
  43. What are the indications for a lumbar laminectomy?
    Disc herniation leads to compression of nerve root against the lamina.
  44. Please describe the procedure(s) involved with the lumbar laminectomy.
    Remove a portion of the lamina (decompression) cutoff horizontal disc, solder the cutoff area so it doesn't herniate again.
  45. Please list the MET criteria for the laminectomy client.
    • Full LE motor control function
    • full bowel and bladder control
    • Medical clearance
    • Slippage less than 5mm
    • Pain <4 on pain scale
  46. 4. What are the indications for a spinal fusion?
    Laminectomy, disc herniation, degenerated disc, bulging disc, thinning disc, disc degeneration
  47. Please describe the surgical procedure(s) involved with the spinal fusion?
    A screw is drilled into the vertebral body, or a fusion cage is screwed  b/w 2 vertebral segments with bone grafts
  48. Please summarize the MET management of spinal fusion client.
    Immobilize for 1st 2-4 weeks, muscle activation of trunk musclature, introduction to neutral spine, increase functional capacity, improve overall leg strength, emphasize spinal stabilization
  49. Please explain the pathology associated with ankylosing spondylolitis.
    Degenerative spinal fusion, loss of spinal curvature ((usually in European males), currently no effective treatment
  50. Please explain the exercise management of scoliosis.
    Look at the Cs not the S's... STRETCH! The concave strengthen the convex, start with the lower C, rinse and repeat
  51. Please list the possible conditions that may cause piriformis syndrome type symptoms.
    Lumbar or sacrum issues,  injuries from car accidents, pregnant women
  52. Please list the MET goals for the piriformis client.
    • Clear the pelvis first
    • stretch the piriformis
    • improve spinal stability
    • look for asymmetrical activities or postures
  53. Please explain the connection between the deterioration of the ligamentum teres and the loss of proprioception with hip osteoarthritis?
    As the ligamentum teres deteriorates, there is less proprioception
  54. Please list three hip assessment procedures used to assess the arthritic hip.
    • Pain scale
    • Faber/PatricksTest
    • Thomas Test
    • Hip ROM Testing
    • Hip Muscle Strength Testing
    • Harris Hip Scale
    • Tineth Gait
    • Balance Scale
  55. Please explain how hip arthritis increases hip instability.
    Deterioration of the bone leads to diminishing ability to move stable properly,  leading to increased hip instability
  56. Please discuss common reasons for hip replacement in clients under age 55.
    Trauma or organic disorder
  57. Please explain how avascular necrosis may develop after fracture of the femoral neck.
    Lack of blood flow due to decrease of blood flow because of age
  58. Please list and explain the contraindicated movements after hip replacement.
    Adduction across midline, internal rotation
  59. Please list three key exercises for the total hip replacement client.
    • Increase glute strength, overall leg strength, functional capacity,
    • improve balance and gait
  60. Please list and explain the advantages of hip resurfacing compared to hip replacement.
    • Ligament structures stay intact
    • Minimal bone loss
    • Greater functionality
    • less morbidity
  61. Which hip assessment procedure assesses the hip flexor, knee extensors and IT band flexibility?
    Thomas Test
  62. Please explain the positioning of the client to perform the Thomas Test.
    Ischial tuberosity  on the edge of the table, bring the opposite knee of the leg you are testing to chest, let client lie on back and let their other leg relax
  63. What does Faber’s Test assess and which condition is it best used to evaluate?
    Hip capsule ROM flexibility and early-stage arthritis
  64. A positive Trendelenburg Sign indicates weakness in which muscle?
    Gluteus medius
  65. Would you perform the Ober Test on a client with greater trochanteric bursitis?
    Yes
  66. A local internist refers a 59 year-old female with a history of a right total hip replacement 2 years ago due to a motor vehicle accident. The client gained 35 pounds since the surgery. She completed physical therapy and walks with no assistive devices or limp. She reports limited endurance. The physician finds no medical concerns with her and gives you medical clearance to begin the exercise program.

     

    1. Please explain the Rom limitations for the THR client.

     

    2. Please explain the hip resurfacing procedure.

     

    3. Please outline the exercise program for this client for weeks 1 and 3.

     

    4. Please explain any contraindicated exercise for this client.
    Please explain the Rom limitations for the THR client.- No bending of the hip more than 90 degrees, twisting the leg or crossing the leg

    2. Please explain the hip re-surfacing procedure. The femoral head is shaved down and capped. This is a good option because ligaments stay intact, there is minimal bone loss, greater functionality, less morbidity

    3. Please outline the exercise program for this client for weeks 1 and 3.- Exercises will be focused on glute strength, overall leg strength, functional capacity, and to improve balance and gait.

    4. Please explain any contraindicated exercise for this client. Adduction across the midline, internal rotation.
  67. Please identify the two joints of the knee and list at least one pathology which occurs in each.
    Tibio femoral- meniscus tears, mcl damage, cruciate damage

    patello femoral- patella femoral syndrome, Chondromalacia
  68. Please indicate the percentage of knee stability provided by the ACL, MCL and LCL.
    • ACL-84-88%
    • MCL-4-6%
    • LCL-1%
  69. Please explain the vascularity of the knee menisci.
    Menisci damage is the beginning of arthritic changes in the knee
  70. What is the usual mechanism of injury associated with the ACL rupture?
    Knee extension, rotary force in the knee
  71. What is the usual mechanism of injury associated with the PCL rupture?
    Knee flexion
  72. Please explain the retro patella contact points as the knee moves from 0 degrees to 135 degrees of flexion.
    When the knee is  at 90 degrees, the superior aspect of the patella is in contact with the underlying femoral groove. at 45 degrees,  the contact point moves down closer to full extension. This translates to an even lower contact point
  73. Please explain how Q-angle is measured and acceptable values for males and females.
    • Male: 10-12 degrees
    • Female: 15-18 degrees
  74. Please explain the Q-angle differences in genu valgus and genu varus.
    • Q angle > foramen = valgus deformity
    • genu varum- bowed legs
    • genu valgum- knock knees
    • genu recuvatum- back knee
  75. Please explain the screw home mechanism in the knee.
    Tibia to femoral condyle tibia rotation is known as screw home mechanism
  76. Please explain the pathology associated with the ACL rupture.
    Rotary force in relative extension or planted foot. You will hear a pop or loud snap, swelling within the first 2 -4 hours, blood in joint fluid, knee instability
  77. Why is reconstruction of the ACL important in the athlete and physically active client?
    Vitally  important in stabilizing the knee in cutting, changing direction, athletic and physical activities. It also prevents the tibia from sliding under the femur.
  78. Please explain the “Terrible Triad” of the knee.
    MCL, ACL, and PCL all sustain damage
  79. Please list the two common grafts used to reconstruct the ACL. Please discuss the pros and cons of each graft.
    Patella tendon graft- 110% stringer than original ACL joint, cons: rehab intensive (need rehab within 1st week of surgery)

    Hamstring graft- Can wait for a week before starting rehab. Cons: not as strong as patella graft
  80. Why is vastus medialis recruitment so important with knee swelling and quad atrophy? 
    Quad atrophy leads to more ineffectiveness to vastus medialis, also helps to prevent patella femoral syndrome
  81. Why is reconstruction of the PCL so difficult?
    It is in the back of the knee.  There are nerves in that area, tears usually happen on the edge of the tibial plateau.
  82. Which knee movements should be avoided respectively for the MCL and LCL sprain?
    Limit full knee extension
  83. Please explain the difference in a patella tendon and quadriceps tendon rupture.
    In a patella tendon rupture, the kneecap will be elevated, in a quad tendon rupture, the kneecap will be slightly lower
  84. Please explain the three primary factors leading to patella-femoral syndrome.
    • 1. Overuse
    • 2. Muscle imbalance or weakness
    • 3. injury
  85. Please explain how an increased Q-angle may result in patella-femoral syndrome.
    The wider the q angle, the more the patella tracks laterally
  86. Please discuss how a meniscus tear may result in the need for a total knee replacement.
    Any damage to the meniscus will lead to arthritic changes.  This could lead to  osteoarthritis and a total knee replacement
  87. What is the primary indication for total knee replacement?
    Destruction of joint cartilage
  88. Why is the maximal amount of knee flexion normally seen following knee replacement?
    The normal function is 100 degrees of flexion. The goal should be to get back as close as possible to the original
  89. Please explain what the anterior drawer test assesses and when it should be used.
    ACL integrity, should be used after a possible injury
  90. Please explain what the Lachman’s test assesses and when it should be used?
    ACL integrity. IT SHOULD NEVER BE USED!
  91. Please explain the difference between tibial and femoral leg length discrepancy.
    In tibial leg length discrepancy, one of the tibias is higher than the other, in femoral, one of the femurs is protruding more than the other.
  92. What would you observe with the Thomas test to indicate hip flexor tightness.
    IT band, hip flexor, sartorius, and rectus femoris
  93. What would you observe to indicate IT Band tightness with the Ober Test?
    If the leg drops down below the table
  94. How many degrees of freedom are available in the ankle joint?
    6
  95. Please describe the ankle mortis
    The distal tibia and fibula articular form the ankle mortis. Also contains the body of the talus  bone
  96. Please identify the ligaments along the lateral aspect of the ankle.
    • Anterior talo-fibular ligament
    • calcaneo fibular ligament
    • posterior talo-fibular ligament
  97. Please identify the ligaments along the medial aspect of the ankle.
    Deltoid ligament
  98. Please identify the muscles that evert the foot.
    Peroneous longus, brevis tertius
  99. Please identify the nerves of the foot.
    • Medial plantar nerve
    • lateral plantar nerve
    • medial calcaneal nerve
  100. Please identify the most common fracture site in the ankle.
    Lateral malleous
  101. Please identify the two ligaments most often damaged in ankle sprains.
    Anterior talofibular ligament and calcanea fibular ligament
  102. Please identify the MET criteria for the ankle fracture client.
    Restore and  or maintain ROM/flexibility, strengthen ankle evertors, invertors, plantar flexors, dorsiflexors, improve leg strength, manage swelling and weight bearing
  103. Please identify the assessment procedure used to assess ankle ligament instability.
    • Assess:
    • strength and ROM
    • swelling
    • gait and balance
    • functional capacity
    • tissue tolerance level
  104. Please describe the typical client affected by the Achilles tendon rupture.
    Middle aged men
  105. Please list three essential exercises used to manage the ankle sprain.
    • Seated calf raises
    • Standing calf raises
    • Stretching ROM activities
  106. Please describe the indications and use of the Anterior Drawer Test.
    Assess the anterior talofibular ligament integrity. You are looking for an endpoint when pulling the heel
  107. Please describe the indications and use of the Thompson’s Test.
    Assess achiles tendon integrity. You are looking for the foot to plantar flex when squeezing the calf.
  108. Please describe the indications and use of the Homan’s Sign.
    Assess for thrombophlebitis. Indicators are pain along the posterior aspect of the calf during dorsiflexion of the ankle
  109. What ligaments does the Anterior Drawer Test assess?
    Anterior Talo Fib ligament
  110. Please describe the condition thrombophlebitis.
    Blood clot along the calf
  111. Please list the medical complications associated with diabetes.
    • Stroke
    • Kidney dysfunction
    • Cardiovascular disease
    • Neuropathy
    • Amputation
  112. Please list the risk factors that may lead to diabetes.
    • Central obesity
    • Hypertension
    • High triglycerides
    • Low hdl
  113. Please explain the pathology associated with diabetes and the differences in Type I and Type II diabetes.
    Type 1- Lack of insulin production, onset usually by age 20

    Type 2- Lifestyle consequences, onset usually after age 30. 90% are type 2

    there is usually a family history, and sedentary lifestyle
  114. Please list some of the major symptoms associated with diabetes.
    Blurred vision, smell of acetone in breath, nausea, vomiting, abdominal pain, polyuria, glycosuria, polydipsia, polyphagia, lethargy, stupor, hyperventilation
  115. Please list and briefly explain the common medical management options for diabetes.
    Oral hypoglycemics, insulin, diet, exercise, surgery for complications
  116. Please provide a profile of the typical diabetes clients. Please include physical characteristics.
    • Central obesity
    • High blood pressure
    • insulin resistance
    • High triglycerides
    • low hdl
  117. Please explain the term “neuropathy” as it relates to diabetes.
    Diabetes can damage nerves. Usually want clients to wear socks because diabetes affects feet in particular
  118. Please list the medical exercise training criteria for the diabetes client.
    • Medical clearance from doctor
    • Ability to self monitor blood glucose
    • Acceptable blood pressure values
    • Blood glucose values 90-240mg/dl
    • -Check with MD for values
  119. Please outline the medical exercise training guidelines for diabetes.
    Check blood glucose, have a snack or juice available, engage large muscle groups, long duration, low intensity
  120. Please list exercise precautions for the diabetes client.
    • Long warmup with client
    • Use RPE scale
    • Check feet periodically for blisters
    • check blood glucose before exercise
    • Avoid blood glucose levels below 100 mg/dl to start exercise
    • Don't exercise during peak insulin
    • Don't exercise injection sites
  121. Please list the medical complications associated with hypertension.
    • Kidney dysfunction
    • cardiovascular disease
    • cerebrovascular accident
    • heart attack
    • CHF
  122. Age
    Race
    Family Hx
    Obese
    Lack of activity
    Tobacco use
    Too much salt
    Low potassium
    Too much alcohol
    Stress
    Chronic conditions
    pregnancy
    • Age
    • Race
    • Family Hx
    • Obese
    • Lack of activity
    • Tobacco use
    • Too much salt
    • Low potassium
    • Too much alcohol
    • Stress
    • Chronic conditions
    • pregnancy
  123. Please explain the differences between essential and secondary hypertension.
    Essential- The cause is not known

    Secondary- Pregnancy
  124. Please list the major complications associated with hypertension.
    • Confusion
    • headache
    • convulsion
    • elevated sugar levels
    • hypertensive retinopathy
    • myocardial infarction
    • CHF
    • Chronic renal failure
  125. Please explain why hypertension may cause left ventricular cardiomyopathy.
    Overworked heart, this area is where tension is higher
  126. Please list and discuss common medical management options for hypertension.
    • diuretics
    • beta blockers
    • calcium channel blockers
    • ACE inhibitors
    • Diet
    • Exercise
    • Stress management
  127. Please list the exercise precautions for hypertension.
    • Long warmup with exercise
    • Use RPE scale
    • Check BP before session 160/100 or less
    • Establish safe BP levels via communication with MS
    • If BP is 220/110 terminate session
    • greater than 20 point drop in SBP terminate
  128. Please list and explain the medical exercise training criteria for the hypertension client.
    • Maintain safe BP levels
    • Establish independent exercise program
    • Establish ability to self monitor, manage BP w/ exercise maintain or lose weight
    • improve cardiovascular capacity
    • Follow appropriate diet
  129. Please outline the medical exercise training guidelines for hypertension.
    • Begin with BP check
    • low intensity and long duration
    • Should not exceed 10-15 reps
    • Duration-30-45 minutes (rest 60 sec.)
    • Light resistance with high reps
    • 10-12 exercises maximum
    • Use rate of perceived scale
  130. Please explain the differences between systolic and diastolic blood pressure.
    Systolic is the top number and amount of pressure on arteries when heart is beating. Diastolic is the number on the bottom and describes pressure on the arteries when the heart is resting in between heartbeats
  131. Why is the hip the most stable joint in the body? Answer the question using the concept of joint occurring from the "inside out".
    Joint stability- Thefemoral head is lined with the assantaganum & cartilagefor a tight fit, bony congruency more stable than the shoulder.

    2.) Ligament Structures- Ligaments connect hip to femur (nice, thick, layered)

    3.) 2 layers of muscle structures
  132. What are the key assessment components of the post rehab assessment?
    • Understand A&P of area
    • Get a good MedHX
    • Think and assess function
    • Select appropriate activities
    • LISTEN! Client will tell you what is wrong and what needs attention.
  133. Please explain the role of the medical exercise professional.
    Utilize exercise as sole modality to manage medical conditions
  134. Please explain the scope of practice of the medical exercise professional.
    • Fitness assessments
    • strength training
    • flexibility training
    • cardio training
    • functional conditioning
    • speciality training (yoga, pilates etc.)
    • Aquatic exercise
    • Weight reduction
    • Wellness/Fitness Education
    • Group Training
  135. Describe red flags clients might have
    • Radiating pain
    • numbness/tingling
    • loss of range of motion
    • loss of function
    • swelling
    • night pain
    • chest pain
    • shortness of breath
    • open wounds
    • abnormal vital signs
  136. Please define "medical exercise training" or MET.
    The development & implementation of safe and effective exercise and conditioning programs for clients with medical conditions

    -Utilization of exercise as the sole modality to manage medical conditions.
  137. Please explain the involvement of the key anatomical structures associated with shoulder dislocation.
    The humeral head is out of fossa, glenohumeral ligaments, the sprained rotator cuff may be traumatized, glenoid labrum may be damaged, and weakness and instability may persist.
  138. Please describe the changes in the shoulder capsule that occur with a frozen shoulder.
    Loss of capsular flexibility, degeneration of synovial membrane, loss of synovial fold and fluid usually occurs in middle-aged females, Coracoracrimonial (CA) ligament thickening
  139. Why is the rotator cuff strengthening so important with medical exercise training for frozen shoulder?
    The longer they've had frozen shoulder, the less likely they have strength in the shoulder
  140. Which ligament is the key stabilizer of the glenohumeral ligaments?
    interior glenohumeral ligaments
  141. Please describe the role of the gleno-humeral ligaments and glenoid labrum in shoulder stability.
    gleno humeral ligaments especially the interior gleno humeral ligaments are essential for shoulder stabiliity. The glenoid labrum increases the the size of the glenoid, keeping stability
  142. Please list three key exercises to incorporate into the medical exercise training program for the shoulder dislocation client.
    • Push ups at various angles
    • Limited ROM with flyes and chest press
    • Interior/Exterior rubbing tube exercise
  143. Please list the indications (reasons) for a total shoulder replacement (TSR).
    • Humeral head or neck fracture
    • Development of avascular necrosis
    • Arthritic changes that limit function
    • Glenoid fossa/labrum damage
    • Loss of ROM, pain and limited function
  144. What is the most crucial factor in functional recovery after TSR?
    Integrity of rotator cuff and amount of strength it can handle
  145. What are the signs and symptoms associated with the cervical spine disc herniation?
    Raddiating pain, loss of sensation, weakeness,
  146. Please list the MET criteria for the cervical spine herniation client.
    No radiating pain,(<4 on pain scale) no numbness or tingling, full UE motor function, No headaches, clearance from MD/DC/RPT
  147. What is a cervical radiculopathy?
    Nerve root compression or some type of condition/distribution of pain down the arm from the cervical spine
  148. Please explain the importance of cervical nerve roots in upper extremity pain patterns.
    Cervical nerve roots move more down to other parts of the upper extremities C5medial nerve, C6 innervation to the periscapular nerve, C7 thoracic
  149. Please summarize the MET management of the cervical spine herniation client.
    • Manage/Control inflamation,
    • limit c spine ROM
    • decompress segment
    • restore/maintain upper extremity strength
    • possible surgical intervention
  150. Please summarize the medical management of the cervical spine herniation client.
    • Avoid excessive cervical flexion
    • Increase Cspine stability/strength
    • Teach decompression C-spine
  151. Please list the assessment procedures for the cervical spine disc herniation client.
    • C spine ROM
    • Muscle (tests) biceps, delts, thumb extension, upper traps and other associated muscles
Author
shorunke86
ID
364553
Card Set
Medical Exercise Training Exam
Description
Updated

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