| a psychosocial approach to explaining health-related behavior. Created to explain the failure of people to participate in programs to prevent or to detect disease. | Health Belief Model (HBM) |
| a state of complete physical, mental, and social well-being and not merely an absence of disease or infirmity. | health |
| a state of being that incorporates all facets and dimensions of human existence, including physical health, emotional health, spirituality, and social connectivity. | wellness |
| sickness or deviation from a healthy state; the perception and response of the person to not being well. | illness |
| a biologic or psychologic alteration that results in a malfunction of a body organ or system. | disease |
| role of physical therapy professionals play in health promotion: | • Enhance function,
• Improve overall fitness,
• Address comorbidities and prevent additional onsets. |
| goals of Healthy People 2020: | o Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
o Achieve health equity, eliminate disparities, and improve the health of all groups.
o Create social and physical environments that promote good health for all.
o Promote quality of life, healthy development, and healthy behaviors across all life stages. |
| goals of Healthy People 2030: | o Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death.
o Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
o Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all.
o Promote healthy development, healthy behaviors, and well-being across all life stages.
o Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all. |
| achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.” Health inequities are reflected in differences in length of life; quality of life; rates of disease, disability, and death; severity of disease; and access to treatment. | health equity |
| preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. | health disparities |
| healthcare that is preventative | proactive healthcare |
| healthcare that is rehabilitating | reactive healthcare |
| six dimensions of wellness: | • Emotional,
• Occupational,
• Physical,
• Social,
• Intellectual,
• Spiritual |
| awareness and acceptance of one’s feelings; understanding personal limitations; stress management. | emotional dimension of wellness |
| work satisfaction; positive attitude toward work; meaningful work; aligned with personal values. | occupational dimension of wellness |
| personal responsibility for physical activity; mindful awareness of fitness needs and nutrition; purposeful avoidance of issues that negatively affect physical health; regular doctor visits. | physical dimension of wellness |
| personal contribution to a community; mindful care of relationships. | social dimension of wellness |
| problem-solving, creativity, continuous learning; curiosity. | intellectual dimension of wellness |
| personal quest for meaning and purpose of life; awareness of natural forces. | spiritual dimension of wellness |
| 5 common social determinants of health: | • Access to quality healthcare,
• Access to quality education,
• Social and community context,
• Economic stability,
• Neighborhood environment |
| 3 key modifiable personal health behaviors: | • Enhance self-awareness and knowledge of healthy habits.
• Change behaviors that interfere with good health.
• Create environments that support good health practices. |
| learning occurs within a social context with a dynamic and reciprocal interaction between cognitive processes, environment, and behavior. | Social Cognitive Theory (SCT) |
| 6 constructs of the Social Cognitive Theory: | • Reciprocal determinism,
• Behavioral capability,
• Observational learning,
• Reinforcements,
• Expectations,
• Self-efficacy |
| person/environment/behavior. Each one is affected by the others. | reciprocal determination construct of SCT |
| must know what to perform and how to do it in order to make a change. | behavioral capability construct of SCT |
| ability to witness and observe others and reproduce results. | observational learning construct of SCT |
| internal or external responses that affect the likelihood to continue the behavior. | reinforcements construct of SCT |
| anticipated consequences from one’s behavior | expectations construct of SCT |
| self-confidence in ability to adapt and change behaviors. | self-efficacy construct of SCT |
| a psychosocial approach to explaining health-related behavior. Created to explain the failure of people to participate in programs to prevent or to detect disease. | Health Belief Model (HBM) |
| 6 constructs of the Health Belief Model: | • Perceived susceptibility,
• Perceived severity,
• Perceived benefits,
• Perceived barriers,
• Cues to action,
• Self-efficacy |
| belief about getting a disease or condition. | perceived susceptibility |
| belief about the seriousness of the condition, or leaving it untreated and its consequences. | perceived severity |
| beliefs about the positive outcomes associated with a behavior in response to a real or perceived threat. | perceived benefits |
| a person’s estimation of the level of challenge of social, personal, environmental, and economic obstacles to a specified behavior or their desired goal status on that behavior | perceived barriers |
| events, people, or things that trigger people to change behavior. | cues to action |
| People at different stages of change will be motivated by different message content. | Transtheoretical Model (TTM) of behavioral change. |
| 5 constructs of the Transtheoretical Model: | • Precontemplation,
• Contemplation,
• Preparation,
• Action,
• Maintenance |
| no intention of making any changes within the next 6 months. | precontemplation |
| intend to make changes within the next 6 months. | contemplation |
| has begun to take steps toward making the desired change in behavior and plans to make the changes within the next 30 days. | preparation |
| has changed the behavior for less than 6 months. | action |
| has changed the behavior for more than 6 months | maintenance |
| 5 layers of the Social Ecological Model: | • Individual,
• Interpersonal,
• Organizational,
• Community,
• Public policy |
| concerned with an individual’s knowledge and skills. | individual |
| has to do with a person’s relationships with other people. | interpersonal |
| has the opportunity to reach more people in different sectors of the community. | organizational |
| the culmination of the various organizations in an area. | community |
| the governing bodies in charge of the prevention effort. | public policy |
| health promotion efforts designed to identify risk factors and prevent a target problem or condition in an individual or in a community/population as risk. | primary prevention |
| early diagnosis and reduction of functional decline and the severity or duration of existing disease and chronic conditions and sequelae to enhance activity and participation. | secondary prevention |
| use of rehabilitation to decrease the degree or limit the progression of disability and improve function in individuals with chronic conditions or irreversible diseases. | tertiary prevention |
| any effort taken to allow an individual, group, or community to achieve awareness of – and empowerment to pursue – prevention and wellness. | health promotion |
| a way to educate individuals for them to acquire functional health knowledge; strengthens attitudes, beliefs, and practice skills needed to adopt and maintain healthy behaviors throughout their lives. | health education |
| minimal motion control of neck | soft collar |
| has mandibular and occipital extensions and a rigid anterior strut. Used for ligamentous and minor fractures. | philadelphia collar |
| maximum orthotic control of the neck, noninvasive appliance that has a rigid plastic posterior section extending from the head to the midtrunk, superior portion held in place by a forehead band. | Minerva collar |
| a circular band of metal that is fixed to the skull by four screws. Uprights connect the halo to a thoracic vest. The most restrictive neck brace. | halo collar |
| corset brace that tightens around the lumbar region. | lumbar corset |
| moldable insert; warm and press against patient’s back in proper alignment; fits into a protective sleeve and corset. | lumbar warm and form brace |
| Lumbar/sacral flexion-extension-lateral control | LS FEL brace |
| hard plastic brace, molded to pt’s contours. Overlapping “shells” that close together like a clamshell with velcro and latched straps. | Oyster shell TLSO brace |
| limits hip adduction, good for chronic hip dislocations, especially post-THA. | hip spica brace |
| brace put around the knee to keep the knee from flexing. | knee immobilizer |
| soft brace worn to compress knee, allows flexion and extension. | soft-form knee brace |
| brace with a hinge that only allows pt to bend their knee to certain degrees. | hinged knee brace |
| customized splint to maintain neutral position and open hand position to prevent abnormal tone after a stroke or brain injury. | cock-up wrist splint |
| used after a sprain or minor fracture/ORIF of humerus; maintains support of the arm, but less supportive than the abduction pillow. | standard arm sling |
| used for major surgeries like total shoulder replacement or rotator cuff repair. Keeps your arm in abduction while protecting it with a pillow. | shoulder abduction pillow |
| used after stroke or brain injury if subluxation of shoulder is a risk due to low tone. Allows use of hand for functional activities. | hemi-sling |
| orthotic that helps with ankle and foot control | Standard AFO – Ankle-Foot orthotic, |
| orthotic that promotes free ankle movements | Dynamic AFO |
| used with pts with more extensive paralysis/paresis or limb deformity. Consist of a shoe, foundation, ankle control, foot control, knee control, and superstructure. | KAFO – knee-ankle-foot orthotic |
| same as KAFO, but a pelvic band and hip joints are added. Prevents hip abduction, adduction, and rotation. | HKAFO – hip-knee-ankle-foot orthotic |
| same as HKAFO with an added lumbosacral orthosis. | THKAFO – trunk-hip-knee-ankle-foot orthotic |
| used when prolonged bed rest to avoid heel sores and foot drop; minimally effective. Purpose is to keep ankle at 90 degrees. | L'Nard splint |
| for medial arch support, positioned at the medial border of the insole. | scaphoid pad |
| convex component that may be incorporated in an insert or may be a resilient domed piece glued to the inner sole so its apex is under the metatarsal shafts. It transfers stress from the metatarsal heads to the metatarsal shafts, so it reduces plantar pressure. | metatarsal pad |
| orthotic that alters alignment of the rearfoot | heel wedge |
| intended for flexible pes valgus. The anterior border extends forward on the medial side to augment the effect of the medial wedge in supporting longitudinal arch. | thomas heel |
| heel strike of one foot to the next heel strike of the same foot. | gait cycle |
| constitutes 60% of the gait cycle and is the interval in which the foot is in contact with the ground. | stance phase |
| constitutes 40% of the gait cycle and occurs when the limb is not in contact with the ground. | swing phase |
| when both limbs are in contact with the ground. | double support phase |
| number of steps taken in a given period of time. | step cadence |
| the distance from the point of heel strike of one extremity to the point of heel strike of the opposite extremity. | step length |
| distance covered during gait cycle. | stride length |
| Effects of COG with normal gait: | undergoes a natural rise and fall of about 2 inches when walking. Undergoes a natural lateral shift of 1 ¾ inches when walking. |
| Effects of pelvis with normal gait: | must rotate about 4 degrees bilaterally with normal gait with help of IR/ER of hip. Must tilt with help of abd/add of hip. |
| Effects of hip with normal gait: | has high output of energy. Hip flexes with gait. |
| Effects of knee with normal gait: | must flex to absorb energy of the gait and allow swing through. Has high input over energy, but low output. |
| Effects of ankle with normal gait: | must adjust to DF for heel strike and PF for toe off. Has a high output of energy. |
| weakness of anterior tibialis; foot slaps ground due to no eccentric control. | foot slap |
| leg length discrepancy, heel cord contracture, heel pain. | lack of heel strike/toes first |
| lack of DF; toes never clear ground due to lack/weakness of anterior tibialis. | toe drag |
| weakness in quads, flexion contracture, muscle guarding with knee pain, leg length discrepancy | Excessive knee flexion |
| knee hyperextension due to lack of joint stability; locked into hyperextension by ligamental and bony support | Genu recurvatum |
| used with foot drop to try to avoid toe drag. | Excessive hip flexion (steppage) |
| weak iliopsoas, weak anterior tibialis; circumducts rather than forward advancement. | Hip circumduction |
| weak hamstrings, weak anterior tibialis, fused or braced knee. | hip hiking |
| excessive trunk lateral flexion to compensate for weak glute meds on stance side, and prevent pelvic drop on swing through side; or protect a painful hip. | Trendelenburg |
| protective of painful area, shortened step length; uneven cadence; may coincide with additional abnormal patterns. | antalgic |
| unsteadiness due to lack of control of proprioception | ataxic |
| repetitive tip toe pattern for patients with Parkinson’s Disease. Uncontrollable gait, comes to an abrupt halt at an object. | festinating |
| circumduction of hip for momentum to advance the flaccid extremity. | hemiplegic |
| flexed knees and trunk, shuffling gait (with occasional festination). | Parkinsonian |
| leg crosses midline during swing through. | scissor |
| plantar flexion of the stance foot to help opposite leg clear the floor; leg length discrepancies or amputees. | vaulting |
| Cerebral Palsy “controlled fall” pattern. (40-50% of patients with CP) Typically with hip add, hip IR, hip flexion, knee flexion, PF. Momentum and velocity maintain upright posture with gait. | Spastic diplegia |
| effects of rhythmic auditory stimulation and music therapy on patients with gait deviations: | • Can be used to elicit rhythmical step patterns and cues.
• Can be used to relax fear of falling prior to or during treatment.
• Can be used as stimulating or inhibiting cue |
| theory behind the use of loco-mat training and body-weight supported treadmill interventions to improve gait deviation: | Used for spinal cord injuries. These re-train neuromuscular coordination, but it depends on the level of damage. |
| brace down the anterior lower leg, with a rigid plate that extends the normal length of the foot. Allows increased stance time. The socket helps to protect the metatarsals | Partial foot prosthesis |
| Due to the nature of the amputation, the limb may be asymmetrical. Can have medial flap to allow better donning/doffing. Must be secured after donned. | Syme’s prosthesis |
| uses a central metal shank covered with soft plastic or foam rubber “skin-like” substance. More natural appearance. Easier to adjust. Most commonly used as final prosthesis. | endoskeleton |
| “crustacean” shell. Made of hard, shiny plastic. Obvious external hardware at knee joint. Most durable cover, but least cosmetic. Most commonly used as training leg prior to final prosthesis. | exoskeleton |
| concave surfaces that allow decreased pressure over bony areas. | reliefs |
| convex surfaces that allow increased pressure to more tolerant areas, such as muscle, tendon, and less prominent bony areas | buildups |
| lower posterior and medial shelf for ischial tuberosity and gluteals, higher lateral and anterior wall to direct forces to the posterior. | Quadrilateral socket design in TFA prosthetics |
| narrower med/lat borders, weight is shifted to med/lat sides and distal limb instead of ischial tuberosity | Ischial containment design in TFA prosthetics |
| type of TTA or TFA supension for prosthetic limbs: removes all air molecules between liner, limb and socket. Allows consistent shape of limb, good for wound healing, decreases shearing forces of movement, assists proprioception | vacuum suspension |
| type of TTA or TFA supension for prosthetic limbs: leather strap that surrounds the distal thigh. | cuff |
| type of TTA or TFA supension for prosthetic limbs: leather or flexible plastic attachment that laces up the thigh. Can be problematic due to pressure atrophy. | corset |
| type of TTA or TFA supension for prosthetic limbs: liner has pin attachment that locks into place on prosthesis. | distal pins |
| type of TTA or TFA supension for prosthetic limbs: medial and lateral edges extend above the femoral epicondyles; also uses removable medial wedge. | Supracondylar brim |
| type of TTA or TFA supension for prosthetic limbs: extends anteriorly above patella. Good for short transtibial amputations. | Supercondylar/suprapatellar brim |
| excision of any part of one or more toes. | Partial toe |
| disarticulation at the metatarsal phalangeal joint. | Toe disarticulation |
| resection of the 3rd, 4th, 5th metatarsals and digits (a ray is a metatarsal and its associated phalanges). | Partial foot/ray resection |
| amputation through the midsection of all metatarsals. | Transmetatarsal |
| more than 50% of tibial length. | Long transtibial |
| between 20% and 50% tibial length. | Transtibial |
| less than 20% of tibial length. | Short transtibial |
| amputation through the knee joint; femur intact. | Knee disarticulation |
| more than 60% of femoral length. | long transfemoral |
| between 35% and 60% of femoral length. | transfemoral |
| less than 35% of femoral length. | short transfemoral |
| amputation through hip joint; pelvis intact. | Hip disarticulation |
| resection of part of the pelvis. | Hemipelvectomy |
| amputation both lower limbs and pelvis below L4-L5 level. | Hemicorporectomy |
| scar location that leaves a scar line anteriorly across the limb. | Posterior flap |
| Scar location that leaves a horizontal scar at midline of the limb. | Equal flap technique |
| two leading causes of amputation: | • PVD,
• Trauma |
| leading cause for LE amputations, especially when coupled with smoking and diabetes. | PVD – peripheral vascular disease |
| second most common cause of amputations, most commonly from MVA or gunshot/military | trauma |
| a bundle of nerve tissue. Painful if compressed. Must sufficiently pad the area. | neuroma |
| cramping, squeezing, shooting/burning pain in an area that no longer exists. | phantom pain |
| tingling, burning, itching, pressure or numbness in an area that no longer exists. | phantom sensations |
| mechanism of compression for postoperative dressing choices: plaster casting molded to keep limb in desired shaped. Not removable. | rigid |
| mechanism of compression for postoperative dressing choices: plaster or plastic that can be removed to check healing/signs of infection/wounds. | removable rigid |
| mechanism of compression for postoperative dressing choices: Unna boot style. Provides medicinal protection against infection, not as much support as rigid. | semi-rigid |
| mechanism of compression for postoperative dressing choices: elastic wraps or shrinker sock | soft |
| acute care bed exercises for post-surgical amputations: TTA | QS, GS, Abd, SLR, knee to chest |
| acute care bed exercises for post-surgical amputations: TFA | QS, GS, SLR, Abd |
| What is this? | central line |
| What is this? | Chest tube drain |
| What is this? | CPAP mask |
| What is this? | Foley catheter bag |
| what is this? | nasal cannula |
| what is this? | non-rebreather mask |
| what is this? | oxymizer |
| what is this? | venturi mask |
| what is this? | BIPAP mask |
| what is this? | Passy-Muir valve |
| What is this? | G-tube |
| what is this? | incentive spirometer |
| what is this? | intermittent compression pump |
| what is this? | PICC line |
| What is this? | TED hose |
| what is this? | NG-tube |
| typical length of stay for a TKA | 3-5 days |
| typical length of stay for a THA | 1 week |
| typical length of stay for spinal surgeries | 2-5 days |
| when pt’s medical condition continues to require 24 hour monitoring and is severe enough to require acute interventions beyond the normal length of stay. | Long term acute |
| when pt is stable, but can’t go home yet. Typical pt: lives alone, no family to care for them at home; requires assistance with ADL’s. | Subacute rehab |
| pt’s must qualify, typical pt’s: complex stroke, brain injury, amputation, spinal cord injury, Guillain Barre, etc. Usually right after surgery | Acute rehab |
| normal hemoglobin levels: | males: 14-18 g/dL,
females: 12-16 g/dL |
| normal prothrombin time levels: | 11-16 seconds |
| normal partial thromboblastin time: | clot time 30-45 seconds |
| normal INR levels: | 2-3, 1 is normal blood without medicines. |
| normal PH in blood: | 7.35-7.45 |
| high potassium; Fairly rare…? (some link to Addison’s Disease, ACE inhibitors, blood transfusions). | hyperkalemia |
| low potassium; Caused by diarrhea/vomiting, GI drains | hypokalemia |
| high sodium; Caused by excessive sodium resulting from decreased water intake (hypovolemia) &/or high sodium diet, excessive vomiting, CHF, ARF/CRI, Cushing’s Syndrome, diabetes. | hypernatremia |
| low sodium; Caused by diuretic use, burns/wound drainage, CHF, cirrhosis, ARF/CRI. | hyponatremia |
| increased volume of fluid/blood; associated with CHF, kidney failure due to imbalanced water and sodium output. | hypervolemia |
| decreased volume of fluid/blood; Can be caused from hemorrhaging or dehydration | hypovolemia |
| Caused by a deficit of HCO₃-; common with chronic diarrhea, sepsis, trauma shock, DKA, and renal failure. | metabolic acidosis |
| Caused by severe vomiting, excessive antacid usage, diuretics, hypokalemia | metabolic alkalosis |
| Commonly caused by Chronic Obstructive Pulmonary Disease (COPD), thoracic trauma, drug overdose | respiratory acidosis |
| Commonly caused by pain, fever, hyperthyroidism, meningitis, brain tumor, psychogenic | respiratory alkalosis |
| outer tough, fibrous layer of dense, irregular connective tissue in the heart. | Parietal pericardium |
| inner thin layer of the heart. Provides lubrication between the two layers, and allows heart to expand and contract. | Visceral pericardium |
| pumps oxygenated blood to the body. | left ventricle |
| pumps blood low in oxygen to the lungs. | right ventricle |
| receives oxygen-rich blood from the lungs and pumps it to the left ventricle. | left atria |
| receives oxygen-poor blood from the body and pumps it to the right ventricle. | right atria |
| what are the atrioventricular valves? | o AV valves,
o Tricuspid,
o Mitral (bicuspid) |
| separate the atria from the ventricles on each side of the heart and prevent backflow of blood from the ventricles into the atria during systole. | AV valves |
| to control the flow of blood from your heart’s top chamber (right atrium) to the bottom chamber (right ventricle). | Tricuspid valve |
| allows blood to flow from the left ventricle to the aorta and prevents blood from flowing backward. | mitral (bicuspid) valve |
