68W ALC Phase 3 Test 2 LPC

When would you likely see Lhermitte's sign - Answer- Following a whiplash syndrome injury When visualizing back what should you look for for injuries? - Answer- edema, erythema, ecchymosis, battle sign, neuro changes, step offs Primary spinal cord injury - Answer- Results from cord being cut, torn, or crushed or by its blood supply being cut off Secondary Spinal Cord injury - Answer- Caused by secondary effects from injury. Occurs from hypotension, generalized hypoxia, injury to blood vessels, edema, compression of cord from surrounding hemorrhage What are some causes of sciatica? - Answer- Caused by injury to or compression of sciatic nerve. Usually due to intervertebral disk herniation causing compression of nerve roots Special Test for Sciatica - Answer- Straight Leg Raise How much PT can usually manage Sciatica - Answer- 3-4 weeks with medication for px Common exam findings with Sciatica - Answer- Abnormal Posturing < ROM < Muscle strength What is the difference between muscle spasm and cramp? - Answer- Force of the contraction. If it is quick contraction and release of muscle without px it is spasm. Cramp is prolonged with px Special Test for Muscle Strain - Answer- MRI Special Test for muscle spasm - Answer- Blood test Why do you use a blood test for muscle spasms? - Answer- Check Na and other electrolytes for causing factors Number one cause of TBI in combat - Answer- Blast injuries What are the three types of TBIs - Answer- Mild, Moderate, Severe S/Sx Mild TBI - Answer- Transient confusion, Delayed verbal or motor response, Disorientation, Slurred or coherent speech, Any period of LOC What is the most common type of TBI? - Answer- Mild. Dead Man Walking S/Sx Moderate/Severe TBI - Answer- LOC, Personality change, Severe persistent Headache, Repeating N&V, SZ, Inability to awaken, Dilation of both pupils, Slurred speech, Weakness or numbness in extremities, Loss of coordination, Increased confusion, What does MACE stand for? - Answer- Military Acute Concussion Evaluation How often should Neuro testing be performed? - Answer- Semiannually or as mission dictates to ID TBIs What are the five domains of MACE? - Answer- Orientation, Immediate Memory, Neurological Screening, Concentration, Delayed Recall What are the mandated events that require MACE - Answer- 1) Involved in vehicle associated blast event, collision, rollover 2) Within 50 meters of blast 3) Anyone who sustains a direct blow to head 4) Command directed, such as but not limited to repeated exposures What is a Red Flag - Answer- Ominous sign of a worsening condition. Level 2 Evacuation Decision Red Flags - Answer- 1) Any positive answer to MACE items V-VIII 2) Double vision 3) Worsening Headache 4) Cant recognize people; Disorientation to place 5) LOC >5 min 6) Weakness/numbness in arms/legs Level 3 Evacuation Decision Red Flags - Answer- 1) Progressively declining levels of consciousness 2) Pupil asymmetry 3) SZ 4) Repeated Vomitting High Altitude Illness - Answer- Cerebral and Pulmonary Syndromes that can develop in UN-acclimatized persons shorty after ascent to high altitude High Altitude Pulmonary Edema (HAPE) - Answer- acute accumulation of fluid in the alveoli due to rapid ascent in altitude High Altitude Cerebral Edema (HACE) - Answer- acute swelling of brain due to rapid ascent in altitude What are the ways to acclimatize a soldier? - Answer- Staged and Graded Staged Ascent - Answer- Soldiers will rise to a moderate altitude and remain there for 3 days or more before moving any higher. Should use several stops on way up Graded Ascent - Answer- Diffusion - Answer- Flow of gas or liquid from an area of higher concentration to lesser concentration Subjective findings on Dislocated shoulder - Answer- Pain (Severe), Instability, Weakness, Inability to move shoulder, Numbness Objective findings on Dislocated shoulder - Answer- Abnormal appearance, Positive Sulcus Sign, Swelling, Bruising Management of Dislocated shoulder - Answer- 1) Reduction 2) Sling or improvised sling 3) Analgesic; NASAID 4) Pillow placed between 5) Rest and immobilize for NO MORE THAN 5-7 days 6) Strengthen exercising for muscle repair Subjective findings on Rotator Cuff - Answer- Pain and tenderness, Shoulder weakness, Loss of shoulder ROM, Inclination to keep shoulder innactive, Atrophy or thinning of muscles surrounding Objective findings on Rotator Cuff - Answer- Special tests: Drop Arm Exam and Jobes Exam (Supraspinatus Exam) Management and Interventions on Rotator Cuff - Answer- Referral if unable to use arm or shoulder px has lasted more than 1 week. Use of sling Analgesic; NASAID Steroid injection Surgery Therapeutic Interventions on Rotator Cuff - Answer- Rest and limited overhead activites Strengthening Excercises With TBI, it is imperative to focus on what three areas of evaluation? - Answer- Cognitive, Physical, and Behavioral Cognitive Symptoms associated with TBI - Answer- Attention difficulties, concentration problems, memory problems, orientation problems Physical Symptoms R/T TBI - Answer- Headaches, dizziness, insomnia, fatigue, uneven gait, nausea, vomiting, blurred vision, SZ