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When would a therapist wear a glove or finger cot?
- Therapist has an open sore or cut
- Ct has a rash, cut, abrasion, infection that would allow the transmission of fluids
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What do you do if there's blood on the floor?
- Wear gloves
- Clean with 10% bleach solution
- Surround spill then mop up working inward to avoid splashes
- Soak mop in bleach afterwards
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What do you do with contaminated linens?
- Roll them away
- Double bag them separate from other linens
- Mark bag "contaminated with body fluids"
- Launder at high temperature
- Wash table with strong disinfectant
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Posterior shoulder exercise
- Place right arm across your torso and with the left hand grasp the right elbow from underneath. Apply a gentle pull to the right elbow.
- You should feel a stretch in the back of the right shoulder
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Pectoral stretch (the "door frame')
- Place your right palm on a door frame with your shoulder abducted to 90 degrees. With bent knee, lung forward with your right leg. Lean your torso into the lunge without moving your right arm.
- You should feel the stretch across your right pectoral region
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Forearm flexors and extensors stretch
With elbow extended, bring your right arm out in front of you (shoulder flext to 90 degrees) with palms facing the floor (forearm pronation). With the left hand, grasp the back (dorsal) of your right wrist. Apply a gengle pull downward on the right wrist. You should feel a stretch of the forearm extensors and possibly right elbow.
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Quad stretch
Facing a wall, place left palm against the wall at shoulder level. Fully flex your right knee, grabbing the dorsal side of your right foot with your right hand. Pull your right heel toward your butt, applying a gentle stretch to the right quad group.
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What is the purpose of regular self care exercises?
- They warm-up and warm-down the therapist's muscles, helping to prevent the build-up of toxins and break hypertonic holding patterns.
- They don't replace regular massage as part of a self-care plan.
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Uses of the resting position
- Entering the ct's personal boundary
- Prevents activation of sympathetic nervous system
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Correct angle of arms
45-60 degrees
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Correct angle of hands and wrists
120-130
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Protect neck and shoulders by
- keeping neck in line with spine
- keeping shoulders relaxed and down
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Absolute contraindications (general)
- Fever of 101.5 or higher
- First or worst headache
- Unstable hypertension
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Absolute contraindications for local conditions
- Acute flare-up of RA or other inflammatory conditions
- DVT
- Local contagious skin conditions
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Uses of stroking
- Accustom the ct to the therapist's touch
- Promote relaxation
- Used as a transition and closure
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Therapeutic effects of stroking
- Decreases sympathetic nervous system
- Reflexive effect on circulation
- If vigorous, can stimulate nerve endings
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Contraindications of stroking
- Open wounds
- Contagious skin conditions
- Gross edema
- Severe varicose veins
- Hyperesthesia
- Very hairy
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Uses for effleurage
- Prepare the tissue for deeper techniques- warming the tissue
- Provide continuity between techniques
- Mobilize waste products for increased absorption after more specific work
- Pain relief and to promote relaxation
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Therapeutic effects of effleurage
- Increase in blood and lymph flow- mechanical effect of deeper pressure is used and reflexive effect if less pressure
- Improves mobility of superficial soft tissue, increason ROM
- Decreases sympathetic nervous system firing and in turn reduces pain and hypertonicity
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Contraindications of effleurage
- Distal to injury site
- Chronic edema in the lower limb if related to a heart condition
- Contagious skin condition
- Varicose veins
- Edema in the limbs caused by a thrombus
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Uses of petrissage
- Deeper warming of the tissue
- Resolve chronic edema
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Effects of petrissage
- Increase local circulation, promoting increased nutrition and removal of waste products
- Breaks up adhesions with the tissue, improving ROM
- Reduces muscle hypertonicity
- Relieves pain
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Contraindications for petrissage
- Acute muscle tears (hear pop or snap)
- Acutely inflamed joints
- Contagious skin conditions
- Varicose veins
- Severely atrophied muscles
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Proximal - Distal - Proximal
On extremities, work on proximal limb first
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Peripheral - Central - Peripheral
Work around the problem area first
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Fifth Principle
Treat the antagonist
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Bony landmark for the back
PSIS
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Bony landmark for posterior leg
Lateral border of the sacrum
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Bony landmark for the anterior leg
ASIS
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Bony landmark for the arm
Ipsilateral clavicle and GH jt
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Bony landmark for the neck
Bilateral clavicles
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Bony landmark for the chest
Base of the manubrium
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Direct shaking
Grasp muscle belly and sweep back and forth
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Indirect shaking
Grasp distal limb and swing back and forth
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Rocking
Create a rtythmic wave in the ct's body or limb
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Effects of tractioning
- Improves joint action
- Decreases tone in surrounding muscles
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Three body mobilization techniques
Rocking, shaking and tractioning
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Contraindications of tractioning
- Acute injury
- Unhealed fractures
- Ruptured ligaments
- RA
- Peripheral nerve lesions
- Hypermobile joints
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Bony landmarks for abdomen
Xiphoid process and ASIS
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Direction to work abdomen
clockwise
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Cortisol
Stress hormone that can be reduced by massage
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