Pathology for the Physical Therapist Assistant 1st Edition by Penelope J. Lescher, ISBN-13: 978-0803607866

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Pathology for the Physical Therapist Assistant 1st Edition by Penelope J. Lescher, ISBN-13: 978-0803607866

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• Publisher: ‎ F.A. Davis Company; First Edition (March 2, 2011)
• Language: ‎ English
• 672 pages
• ISBN-10: 0803607865
• ISBN-13: ‎ 978-0803607866

With other texts written at either too high or too low a level, this book meets the needs of PTA students for usable, understandable pathology related to clinical application. Extensively illustrated, this book allows students to more easily comprehend and maintain interest in otherwise complicated pathological processes. The fourteen chapter format effectively fits within a chapter per week course structure, or each chapter may be used as a stand alone module within any course.

Table of Contents:

Front Matter
DEDICATION
PREFACE
ACKNOWLEDGMENTS
REVIEWERS
CHAPTER 1 Inflammation and Healing
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About Normal Cell Anatomy and Physiology?
Normal Cell Anatomy and Physiology
FIGURE 1.1 The cell.
FIGURE 1.2 The cell plasma membrane.
Nucleus
Cytoplasm
Plasma Membrane
Cell Injury
Table 1.1 Cytoplasmic Organelles and Their Functions
Cell Injury—Reversible
FIGURE 1.3 Reversible and irreversible cell injury.
FIGURE 1.4 Sodium pump. Sodium ions (Na+) are higher in concentration in the extracellular spaces than in the cell. Thus, NA+ ions continually try to pass into the cell, together with chlorine ions (CL–), through the process of osmosis. Potassium ions (K+) are higher in concentration inside the cell. The sodium pump is driven by ATPase and shunts Na+ out of the cell to maintain homeostasis.
Cell Injury—Irreversible
FIGURE 1.5 Pyknosis, karyorrhexis, and karyolysis.
NECROSIS
Table 1.2 Causes of Cell Injury
FIGURE 1.6 Gangrene of toes.
Table 1.3 Types of Growth Changes of Cells
Cellular Responses to Damage or Stimuli
ATROPHY
FIGURE 1.7 Abnormal cellular growth patterns: atrophy, hypertrophy, hyperplasia, metaplasia.
HYPERTROPHY
HYPERPLASIA
INVOLUTION AND HYPOPLASIA
METAPLASIA
Why Does the Physical Therapist Assistant Need to Know About Inflammation?
Inflammation
Causes of the Inflammatory Response
CELLS INVOLVED IN THE INFLAMMATORY RESPONSE
Polymorphonucleocytes
Eosinophils
Monocytes and Macrophages
Table 1.4 Cells of Inflammation
FIGURE 1.8 Polymorphonuclear neutrophils.
Platelets
Basophils
Lymphocytes and Plasma Cells
Classification of Inflammation
ACUTE INFLAMMATION
SUBACUTE INFLAMMATION
CHRONIC INFLAMMATION
ACUTE ON CHRONIC INFLAMMATION
Table 1.5 Types of Inflammation
Physical Therapy Treatment for Inflammation
Why Does the Physical Therapist Assistant Need to Know About the Healing Process?
Healing
Hints on the Use of the Guide to Physical Therapist Practice (1-1)
Cells Involved in the Healing Process
MYOFIBROBLASTS
ANGIOBLASTS
FIBROBLASTS
FIGURE 1.9 Granulation tissue in the base of a wound.
Types of Healing
Table 1.6 Types of Collagen
FIGURE 1.10 Healing in skin wounds.
It Happened in the Clinic
Complications of Wound Healing Other Than Delayed Healing
FIGURE 1.11 Keloid Scar.
Special Aspects Regarding Pressure Ulcers
Physical Therapy Intervention for Wounds
Table 1.7 Stages of Pressure Ulcers
GERIATRIC CONSIDERATIONS
FIGURE 1.12 Wound with necrotic tissue.
Bone Healing
FIGURE 1.13 Stages of bone healing.
Ligament Healing
Muscle and Tendon Healing
Why Does the Physical Therapist Assistant Need to Know About Pain?
Pain
Pain Control Theories
Physical Therapy Interventions
Table 1.8 Causes of Chronic Pain
Pain Assessment
FIGURE 1.14 Visual analog scale. Instruction to patient: Mark on the line where your pain is with 0 being no pain and 10 being the highest possible pain.
CASE STUDY 1.1
CASE STUDY 1.2
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 2 Immunopathology, Neoplasia, and Chromosome Abnormalities
LEARNING OBJECTIVES
KEY TERMS
INTRODUCTION
Why Does the Physical Therapist Assistant Need to Know About Immunopathology?
Immunopathology
Cells of the Immune Response
LYMPHOCYTES
Hypersensitivity Reactions
Type I Hypersensitivity
Table 2.1 Hypersensitivity Reactions
Bronchial Asthma
FIGURE 2.1 A person experiencing anaphylactic shock.
Allergic Rhinitis
Anaphylactic Shock (Anaphylaxis)
It Happened in the Clinic
Type II Hypersensitivity
Type III Hypersensitivity
Type IV Hypersensitivity
Vaccination
Effects of Exercise on the Immune Response
Why Does the Physical Therapist Assistant Need to Know About Infection?
Infections
Types of Microorganisms
FIGURE 2.2 Bacteria.
Development of Infection
FIGURE 2.3 Viruses come in many shapes and sizes.
Treatment of Infection
Why Does the Physical Therapist Assistant Need to Know About Neoplasia and Oncology Treatments?
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE 2-1
Neoplasia
Table 2.2 Characteristics of Benign and Malignant Tumors
FIGURE 2.4 Kaposi’s sarcoma.
Carcinogens
Risk Factors for Malignant Tumors
Table 2.3 Some Tumors and Their Locations/Classifications
FIGURE 2.5 Common sites of lymphatic nodes affected by breast cancer.
Box 2.1 Warning Signs for Cancer May Include:
GERIATRIC CONSIDERATIONS
Treatment Interventions for Cancer
Table 2.4 Examples of Chemotherapy Medications With Their Classification
PHYSICAL THERAPY INTERVENTION
It Happened in the Clinic
Why Does the Physical Therapist Assistant Need to Know About Chromosome Abnormalities and Genetic and Hereditary Diseases?
Genetic and Hereditary Chromosome Diseases
The Normal Chromosome
FIGURE 2.6 Normal complement of chromosomes
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE 2-2
Overview of Genetic and Hereditary Chromosome Diseases
Table 2.5 Exogenous Teratogens and Their Possible Effects on the Fetus
FIGURE 2.7 Signs and symptoms of congenital rubella syndrome.
FIGURE 2.8 Signs and symptoms of fetal alcohol syndrome.
Chromosome Abnormalities
FIGURE 2.9 Examples of chromosome abnormalities due to breakage and rearrangement. a) Deletions are loss of a part of a chromosome. b) Translocations occur when part of a chromosome is transferred to another chromosome. c) Inversion occurs when there is a break in two places and the chromosome reconnects in the wrong order. d) Robertsonian translocation occurs when the breakage is close to the centromere of the chromosome. e) A ring chromosome is the result of a breakage in the chromosome and the two ends joining together to form a ring.
DETECTION OF CHROMOSOME ABNORMALITIES
Chromosome Abnormality Conditions
Down Syndrome (Trisomy 21)
FIGURE 2.10 Down syndrome and associated karyotype showing trisomy of chromosome 21.
Fragile X Syndrome
Klinefelter Syndrome (47 X-X-Y syndrome)
Patau Syndrome
FIGURE 2.11 Signs and symptoms of Patau syndrome
Turner Syndrome
Why Does the Physical Therapist Assistant (PTA) Need to Know About Developmental Diseases and Birth Injuries?
Developmental Diseases/Birth Injuries
FIGURE 2.12 Signs and symptoms of Turner’s syndrome
Cerebral Palsy
Erb’s Palsy
Prematurity
Rhesus Disease/Hemolytic Disease of the Newborn
Scoliosis
It Happened in the Clinic
Spina Bifida
FIGURE 2.13 Examples of spina bifida include spina bifida occulta, meningocele, and myelomeningocele.
Why Does the Physical Therapist Assistant Need to Know About Genetically Linked Diseases?
Genetically Linked Diseases
Hemophilia
Muscular Dystrophy
Sickle Cell Disease
Spinal Muscular Atrophy
Tetralogy of Fallot
CASE STUDY 2.1
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 3 Cardiovascular Pathologies
LEARNING OBJECTIVES
KEY TERMS
INTRODUCTION
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Cardiovascular System?
Anatomy and Physiology of the Cardiovascular System
The Heart
FIGURE 3.1 Heart showing internal structures.
FIGURE 3.2 Heart showing major blood vessels.
Neural Control of the Heart
Nerve Conduction System of the Heart
FIGURE 3.3 Electrocardiogram (ECG) showing normal data.
Coronary Circulation
Cardiac Cycle
Heart Sounds
Table 3.1 Normal Heart Sounds
Pulse
Cardiac Output
Table 3.2 Abnormal Heart Sounds
Blood Pressure
Blood Vessels
ARTERIES
FIGURE 3.4 Systemic arteries, anterior view.
VEINS
FIGURE 3.5 Structure and connections of the vessels of the arterial and venous systems.
FIGURE 3.6 Anterior view of the venous system.
CAPILLARIES
Lymphatic System
FIGURE 3.7 Anterior view of lymph vessels and the major groups of lymph nodes.
FIGURE 3.8 Relationship of lymphatic vessels to the cardiovascular system.
Why Does the Physical Therapist Assistant Need to Know About Pathology of the Cardiovascular System?
Hints on the Guide to Physical Therapy Practice
Pathology of the Cardiovascular System
Table 3.3 Normal Adult Heart Values
General Signs and Symptoms of Cardiac Disease
Table 3.4 The Borg Rate of Perceived Exertion Scale
ATRIAL FIBRILLATION
CYANOSIS
DYSPNEA
EDEMA
FATIGUE
HEART BLOCK
INTERMITTENT CLAUDICATION
PAIN
Box 3.1 Routine for Buerger-Allen Exercises
PALPITATIONS
PREMATURE VENTRICULAR CONTRACTIONS
REDUCED EJECTION FRACTION
SYNCOPE
VENTRICULAR FIBRILLATION
Diagnostic Tests Performed for Cardiac Patients
CARDIAC CATHETERIZATION AND ANGIOGRAPHY
ECHOCARDIOGRAPHY
ELECTROCARDIOGRAM
Table 3.5 Characteristics of Electrocardiogram Graph With Associated Activity
HOLTER MONITORING
LABORATORY STUDIES (BLOOD AND URINE)
POSITRON EMISSION TOMOGRAPHY
STRESS TEST
Why Does the Physical Therapist Assistant Need to Know About Disorders and Pathological Conditions of the Heart?
Disorders and Pathological Conditions of the Heart
Angina Pectoris
Aortic Atherosclerosis
Atherosclerosis and Arteriosclerosis
FIGURE 3.9 Atherosclerosis of a vessel
Table 3.6 Risk Factors, Location, and Associated Problems of Atherosclerosis
Cardiac Arrest and Myocardial Infarction
Cardiac Shock, Cardiac Failure, Heart Failure
Cardiomyopathy
Congestive Heart Failure
Table 3.7 Causes and Effects of Congestive Heart Failure
GERIATRIC CONSIDERATIONS
Endocarditis
FIGURE 3.10 Bacterial endocarditis showing splinter hemorrhages in the nail.
Heart Infarct Rupture
Hypertension and Hypertensive Heart Disease
It Happened in the Clinic
Ischemic Heart Disease
Myocarditis
Pericarditis
Rheumatic Heart Disease and Rheumatic Fever
Valve Diseases
Why Does the Physical Therapist Assistant Need to Know About Cardiac Surgeries and Rehabilitation?
Cardiac Surgeries and Cardiac Rehabilitation
Coronary Artery Bypass Graft
Heart Transplant
Open Heart Surgery
Pacemaker Insertion
Percutaneous Transluminal Coronary Artery Angioplasty
Why Does the Physical Therapist Assistant Need to Know About Arterial Diseases?
Arterial Diseases
Arteritis
Cerebrovascular Disease
Patent Ductus Arteriosus
Peripheral Vascular Disease
MAJOR ASPECTS OF PVD FOR THE PTA
Polyarteritis Nodosa
Raynaud’s Disease or Syndrome
FIGURE 3.11 Hands of a patient affected by Raynaud’s disease.
Thromboangiitis Obliterans (Buerger’s Disease)
Why Does the Physical Therapist Assistant Need to Know About Venous Diseases?
Venous Diseases
Thrombophlebitis and Deep Venous Thrombosis
Varicose Veins
Why Does the Physical Therapist Assistant Need to Know About Blood Disorders?
Blood Disorders
Anemias and Other Disorders of Red Blood Cells
Leukemias
Lymphatic Disorders
Hodgkin’s Disease and Hodgkin’s Lymphoma
Lymphangitis and Lymphadenitis
Lymphedema
FIGURE 3.12 Patient with lymphedema of the arm.
Why Does the Physical Therapist Assistant Need to Know About Cardiovascular System Failure?
Cardiovascular System Failure
Hypovolemic Shock and Organ Failure
Physical Therapy Treatment and the Role of the PTA in Cardiac and Circulatory Conditions
Other Considerations
Home Health Physical Therapy
Outpatient Cardiac Rehabilitation
CASE STUDY 3.1
CASE STUDY 3.2
STUDY QUESTIONS
USEFUL WEBSITES
REFERENCES
CHAPTER 4 Respiratory Diseases
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to know About the Anatomy and Physiology of the Respiratory System?
Anatomy and Physiology of the Respiratory System
The Thoracic Cage and Its Contents
FIGURE 4.1 Sagittal section of the head and neck.
FIGURE 4.2 Thoracic cage with contents.
MOVEMENTS OF THE THORAX
THE LUNGS
Table 4.1 Surface Marking for the Respiratory System
FIGURE 4.3 Lobes of the lungs.
Table 4.2 Bronchopulmonary Segments of the Lungs
FIGURE 4.4 Bronchial tree showing bronchial branches to all segments of the lungs.
FIGURE 4.5 Bronchopulmonary segments of lungs: 1) apical (UL), 2) posterior (UL), 3) anterior (UL), 4) right lateral (ML), 4) left superior lingular (UL), 5) right medial (ML), 5) left inferior lingular (UL), 6) right and left superior or apical (LL), 7) right only medial basal (LL) (cardiac), 8) anterior basal (LL), 9) lateral basal (LL), and 10) posterior basal (LL).
Physiology of Ventilation and Respiration
BREATHING PATTERNS
VENTILATION CONTROL
LUNG CAPACITIES AND VOLUMES
Table 4.3 Lung Capacities in the Healthy Adult Male
GASEOUS EXCHANGE AND OXYGEN TRANSPORT
Muscles of Ventilation
DIAPHRAGM
EXTERNAL AND INTERNAL INTERCOSTAL MUSCLES
Why Does the Physical Therapist Assistant Need to Know About Tests for Respiratory Function?
Tests for Respiratory Function
Subjective Findings
Objective Findings
EXCURSION
INTERCOSTAL INDRAWING
BREATH SOUNDS
FIGURE 4.6 Pattern of stethoscope positions for listening to breath sounds.
Lung Function Tests
SPIROMETRY
FIGURE 4.7 Incentive spirometer in use.
FIGURE 4.8 Electronic spirometer.
PEAK EXPIRATORY FLOW
Table 4.4 Four Stages of Classification of Chronic Obstructive Pulmonary Disease (COPD) Related to Spirometry Values
Arterial Blood Gases
FIGURE 4.9 Spirometry flow/volume curves showing normal (A) and abnormal (B and C) forced expiratory volume in 1 second (FEV1) and vital capacity (VC) value.
ACID/BASE BALANCE OF BLOOD
Table 4.5 Normal Levels in Arterial Blood Gas Samples
CHEST RADIOGRAPHS
FIGURE 4.10 Pulse oximeter.
COMPUTED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
PULMONARY ARTERIOGRAPHY OR ANGIOGRAPHY
BRONCHOSCOPY
EXERCISE CAPACITY AND TOLERANCE
HEMATOLOGICAL TESTS
MICROBIOLOGY
Table 4.6 Hematology Interpretation and Normal Values
Table 4.7 Hematology Electrolyte and Lipoprotein Interpretation and Normal Values
Table 4.8 Explanation of the Abbreviations Used for the International System of Units (SI Units).
Why Does the Physical Therapist Assistant Need to Know About Diseases of the Respiratory System?
Diseases of the Respiratory System
General Signs and Symptoms of Pulmonary Diseases
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
COUGH
DYSPNEA
Table 4.9 Types of Sputum, Appearance, and Causes
CYANOSIS
CHEST PAIN
CHEST SHAPE AND REDUCED THORACIC MOBILITY
PULMONARY EDEMA
FIGURE 4.11 Clubbing of fingers.
ATELECTASIS
BRONCHIOLITIS
PNEUMOTHORAX AND PLEURAL EFFUSION
Why Does the Physical Therapist Assistant Need to Know About Pathological Conditions of the Respiratory Tract?
Pathological Conditions of the Respiratory Tract
Lung Abscess
FIGURE 4.12 Bronchiectasis in the lung.
Chronic Bronchitis and Emphysema
Chronic Bronchitis
FIGURE 4.13 Characteristic “pink puffer” and “blue bloater” appearance in chronic obstructive pulmonary disease.
Table 4.10 Clinical Picture of COPD Conditions
It Happened in the Clinic
Emphysema
FIGURE 4.14 Emphysema in the lung.
It Happened in the Clinic
Asthma
Pneumonia
Table 4.11 Clinical Picture of Some Pulmonary Conditions
GERIATRIC CONSIDERATIONS
Cystic Fibrosis
Tuberculosis
Lung Cancer, Benign Lung Tumors, and Malignant Lung Tumors
Pulmonary Infarction
Pneumoconioses
Sarcoidosis
Adult Respiratory Distress Syndrome
Bronchopulmonary Dysplasia in Pediatric Respiratory Distress Syndrome
Pulmonary Surgery
FIGURE 4.15 Thoracotomy incision with related muscles.
Pneumonectomy
FIGURE 4.16 Hand and arm position to support incision after pneumonectomy.
Lobectomy
Hemothorax and Pneumothorax
Post—pulmonary Surgery Complications
Tracheotomy
FIGURE 4.17 Photograph of Pleurovac unit.
Lung Transplant
Classes of Medications Used to Treat Respiratory Diseases
The Role of the PTA in Interventions for Patients With Respiratory Diseases
Specific Physical Therapy Treatment Interventions for Patients With Respiratory Pathologies
POSTURAL DRAINAGE AND AIRWAY CLEARANCE TECHNIQUES
FIGURE 4.18 Position for (A) chest clapping/percussion and (B) vibration of a patient for assisted airway clearance techniques.
FIGURE 4.19 Various bronchopulmonary segment postural drainage positions.
COUGHING AND HUFFING TECHNIQUES
Table 4.12 Contraindications and Precautions of Postural Drainage
BREATHING EXERCISES
FIGURE 4.20 Initial relaxed position for diaphragmatic breathing exercises.
VENTILATORS, LIFE SUPPORT SYSTEMS, AND INTERMITTENT POSITIVE PRESSURE BREATHING
PEDIATRIC CONCERNS AND SPECIAL CONSIDERATIONS
4.1 CASE STUDY
4.2 CASE STUDY
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 5 Degenerative Joint Diseases and Bone Pathologies
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About Normal Joint Structure?
Normal Joint Structure
FIGURE 5.1 A synovial joint.
Why Does the Physical Therapist Assistant Need to Know About the Normal Anatomy and Physiology of Bone?
Normal Anatomy and Physiology of Bone
FIGURE 5.2 Structure of a long bone.
Why Does the Physical Therapist Assistant Need to Know About Degenerative Diseases of the Joints?
Degenerative Diseases of Joints
Hints on the Use of the Guide to Physical Therapist Practice (OA, Gout, and Infective Arthritis)
Osteoarthritis (Osteoarthrosis)
FIGURE 5.3 Effects of osteoarthrosis (OA) in a synovial joint.
Table 5.1 Characteristics of Osteoarthritis (Osteoarthrosis)
Clinical Picture of OA
OA of the Hip
Closed kinetic chain
OA of the Knee
It Happened in the Clinic
OA of the Hands
OA of the feet
FIGURE 5.4 Osteoarthrosis (OA) of the hands.
GERIATRIC CONSIDERATIONS
Spondylosis
Clinical picture and characteristics of spondylosis
Spondylolysis
FIGURE 5.5 A pair of lumbar vertebrae showing the pars interarticularis and related structures.
Spondylolisthesis
FIGURE 5.6 Spondylolisthesis of the lumbosacral spine.
Infective (Septic) Arthritis
Hemophilic Arthritis
Lyme disease
FIGURE 5.7 The bull’s-eye rash of Lyme disease.
Gout
FIGURE 5.8 Gouty tophi in the hand.
Surgical Intervention for Arthritis
ARTHRODESIS
HEMIARTHROPLASTY
MENISCECTOMY
FIGURE 5.9 Hemiarthroplasty of the hip.
OSTEOTOMY
RESECTION ARTHROPLASTY
TOTAL JOINT ARTHROPLASTY
TOTAL HIP ARTHROPLASTY
FIGURE 5.10 Total hip arthroplasty (THA).
TOTAL KNEE ARTHROPLASTY
FIGURE 5.11 Total joint arthroplasty of the knee (TKA).
TOTAL SHOULDER ARTHROPLASTY
FIGURE 5.12 Total joint arthroplasty of the shoulder.
OTHER JOINT ARTHROPLASTY
FIGURE 5.13 Total joint arthroplasty of the elbow.
Why Does the Physical Therapist Assistant Need to Know About Diseases of the Bone?
Diseases of Bone
Hints on the Use of the Guide to Physical Therapist Practice (5-2): Osteoporosis and Paget’s disease
Osteoporosis
FIGURE 5.14 Osteoporotic bone.
GERIATRIC CONSIDERATIONS
Rickets
Osteomalacia
Legg-Calvé-Perthes Disease
Slipped Capital Femoral Epiphysis
Paget’s Disease
FIGURE 5.15 Paget’s disease of bone.
Osteomyelitis
Bone Diseases Associated With Hyperparathyroidism and Hypoparathyroidism
Tuberculosis in the Bone
Syphilis
Gonococcal Arthritis (Disseminated Gonococcal Infection)
HIV/AIDS-Related Arthritic Symptoms
Bone Tumors
Osteosarcoma
Osteoma, Osteoid Osteoma, and Osteoblastoma
Osteochondroma
Giant cell tumor of bone
Ewing’s sarcoma
Fibrous Dysplasia
Multiple Myeloma
Bone Metastases
Cartilage Tumors
Chondroma
Chondrosarcoma
Joint Abnormalities
Genu valgum (Knock-Knee)
Genu Varum (Bow Legs)
FIGURE 5.16 Genu valgum and Genu varum deformities of the knees.
Genetic Bone Abnormalities
Talipes Equinovarus (Clubfoot)
Developmental Dysplasia of the Hip
FIGURE 5.17 Talipes equinovarus (clubfoot).
Torticollis
FIGURE 5.18 Hip spica devices for developmental dysplasia of the hip. (A) Pavlik harness. (B) Hip spica cast.
Achondroplasia
Osteogenesis Imperfecta
Osteopetrosis
Marfan’s Syndrome
5.1 CASE STUDY
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 6 Rheumatoid Arthritis and Related Conditions
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About Rheumatoid Arthritis?
Rheumatoid Arthritis
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Articular (Joint) Pathological Changes
Table 6.1 Comparison of Osteoarthritis and Rheumatoid arthritis
FIGURE 6.1 A rheumatoid arthritis joint showing progressively worsening joint changes.
FIGURE 6.2 One of the signs of rheumatoid arthritis is “spindle finger,” also known as a fusiform-shaped finger, in the proximal interphalangeal joints.
FIGURE 6.3 Boutonnière’s deformity in a hand with rheumatoid arthritis.
FIGURE 6.4 Swan-neck deformity in a hand with rheumatoid arthritis.
FIGURE 6.5 Ulnar drift in a hand with rheumatoid arthritis (Z deformity).
FIGURE 6.6 A foot in a patient with rheumatoid arthritis.
FIGURE 6.7 Toe deformities in RA: claw toe, mallet toe, hammer toe.
FIGURE 6.8 Rheumatoid knees.
Nonarticular (Nonjoint) Pathological Changes
FIGURE 6.9 Rheumatoid nodule in the forearm.
“It Happened in the Clinic”
FIGURE 6.10 X-ray showing severe RA of hand.
FIGURE 6.11 Knee immobilizing splint.
FIGURE 6.12 “Ring” splint for swan-neck and Boutonnière’s deformity.
FIGURE 6.13 Modified “cock-up” splint for rheumatoid arthritis.
Table 6.2 Some Medications Used to Treat Rheumatoid Arthritis With Effects and Side Effects
GERIATRIC CONSIDERATIONS
FIGURE 6.14 Special molded handle cane for use with persons with reduced grip.
PRECAUTIONS, CONTRAINDICATIONS, AND SPECIAL CONSIDERATIONS FOR PT INTERVENTION FOR PATIENTS WITH RA
Why Does the Physical Therapist Assistant Need to Know About Juvenile Rheumatoid Arthritis and Still’s Disease?
Juvenile Rheumatoid Arthritis and Still’s Disease
Table 6.3 Characteristics of Still’s Disease
Why Does the Physical Therapist Assistant Need to Know About The Rheumatoid-Related Inflammatory Joint Pathologies?
Rheumatoid-Related Inflammatory Joint Pathologies
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Ankylosing Spondylitis
FIGURE 6.15 Bamboo spine appearance in ankylosing spondylitis.
FIGURE 6.16 Patient with ankylosing spondylitis showing typical posture.
“It Happened in the Clinic”
FIGURE 6.17 Patient measured with a spondylometer.
“It Happened in the Clinic”
Psoriatic Arthritis
Table 6.4 Types of Psoriatic Arthritis
FIGURE 6.18 Foot in a patient with psoriatic arthritis.
FIGURE 6.19 “Pencil-in-cup” deformity of the distal phalanx.
FIGURE 6.20 Pitting of the finger nail in a patient with psoriatic arthritis.
Reactive Arthritis (Reiter’s Syndrome)
Table 6.5 Comparison of Several Seronegative Polyarticular Arthropathies
GERIATRIC CONSIDERATIONS
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Why Does the Physical Therapist Assistant Need to Know About Connective Tissue Diseases?
Connective Tissue Diseases
Scleroderma
FIGURE 6.21 Hands of a patient with scleroderma.
FIGURE 6.22 The typical facial appearance of a woman with scleroderma.
Table 6.6 Signs and Symptoms of Scleroderma and Systemic Lupus Erythematosus
“It Happened in the Clinic”
Systemic Lupus Erythematosus
FIGURE 6.23 Butterfly rash of systemic lupus erythematosus.
Fibromyalgia
FIGURE 6.24 Location of tender points in fibromyalgia.
Giant Cell Arteritis
Polymyalgia Rheumatica
Myofascial Pain Syndrome
FIGURE 6.25 Infraspinatus trigger point location showing area of referred pain down the arm.
Polyarteritis Nodosa
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Why Does the Physical Therapist Assistant Need to Know About Other Rheumatoid and Connective Tissue—Associated Diseases?
Other Rheumatoid- and Connective Tissue—Associated Diseases
Complex Regional Pain Syndrome
Rheumatic Fever
Sarcoidosis
Sjögren’s Syndrome
Why Does the Physical Therapist Assistant Need to Know About Muscle Diseases?
Muscle Diseases
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Muscular Dystrophy
Myasthenia Gravis
Inflammatory Myopathies
6.1 CASE STUDY
6.2 CASE STUDY
6.3 CASE STUDY
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 7 Neurological Disorders
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Neurological System?
The Anatomy and Physiology of the Neurological System
FIGURE 7.1 The brain. (A) Showing lateral view (external surface). B. Showing medial view of one side of the brain.
Development of the Nervous System in the Fetus
PRIMITIVE REFLEXES
Table 7.1 Primitive Reflexes and Reactions
Table 7.2 Normal Postural Reactions and Other Associated Responses
MOTOR DEVELOPMENT
Table 7.3 Some Major Milestones of Motor Development
The Neuron
FIGURE 7.2 A neuron.
NERVE TRANSMISSION
FIGURE 7.3 A synapse.
Table 7.4 Some of the Neurotransmitters Produced at Synapses
Table 7.5 More Commonly Known Substances That Either Enhance or Depress Synaptic Transmission
MOTOR NEURONS
FIGURE 7.4 Location of motor areas in the cortex of the brain.
Central Nervous System
BLOOD SUPPLY TO THE BRAIN
FIGURE 7.5 Circle of Willis.
CEREBROSPINAL FLUID
BRAINSTEM
Table 7.6 Cranial Nerves
BASAL GANGLIA
DIENCEPHALON
CEREBELLUM
CEREBRUM
Table 7.7 Some Deficits Resulting From Damage to Areas of the Brain
SPINAL CORD
FIGURE 7.6 Cross section of the spinal cord. (A) Main areas of gray and white matter. (B) Ascending (sensory) tracts and descending (motor) tracts. (The descending and ascending tracts travel on both sides of the spinal cord. The figure shows them separately for clarity.)
Table 7.8 Some of the Main Spinal Tracts of the White Matter of the Spinal Cord With Their Functions
FIGURE 7.7 Spinal reflex arc showing the stretch reflex.
VESTIBULAR SYSTEM
LIMBIC SYSTEM
AUTONOMIC NERVOUS SYSTEM
Peripheral Nervous System
Table 7.9 Cutaneous Sensory Receptors
FIGURE 7.8 Cervical plexus.
PERIPHERAL NERVE LESIONS
FIGURE 7.9 Brachial plexus.
FIGURE 7.10 Lumbar plexus.
FIGURE 7.11 Sacral plexus.
Table 7.10 Cervical and Thoracic Peripheral Nerves, Nerve Root Derivation, and Muscle and Other Innervations
FIGURE 7.12 (A) Anterior view and (B) posterior view of dermatomes.
Table 7.11 Lumbar and Sacral Peripheral Nerves, Nerve Root Derivation, and Muscle and Other Innervations
Testing for the Neurological System
CT SCAN
DERMATOMES
DEEP TENDON REFLEXES
ELECTRODIAGNOSTIC TESTING: ELECTROMYOGRAPHY AND NERVE CONDUCTION STUDIES
GLASGOW COMA SCALE
MAGNETIC RESONANCE IMAGING (MRI)
MUSCLE STRENGTH TESTING
MYOTOMES
NEURAL TENSION TESTING/NERVE STRETCHING
Table 7.12 Manual Muscle Testing Grades
Table 7.13 The Spinal Nerve Root Supply to Groups of Muscles
PALPATION
POSTTRAUMATIC AMNESIA SCALES
RANCHO LOS AMIGOS LEVELS OF COGNITIVE FUNCTIONING
FIGURE 7.13 A selection of goniometers.
RANGE OF MOTION
FIGURE 7.14 An inclinometer.
SOME SPECIFIC PERIPHERAL NERVE TESTS
TWO-POINT DISCRIMINATION
VERTEBRAL ARTERY TEST FOR CERVICAL SPINE
Physical Therapy Treatment for People With Neurological Conditions
Adverse Mechanical/Neural Tension
Alexander Technique
Brunnstrom Approach
Constraint-Induced Movement Therapy
Craniosacral Therapy
Feldenkrais Method
Myofascial Release
Neurodevelopmental Therapy/Bobath Techniques
Proprioceptive Neuromuscular Facilitation
Sensory Integration
Tai Chi Chuan in Rehabilitation
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Neurological System?
Neurological Disorders
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Neurological Conditions Resulting From Deficits in the Development of the Nervous System or Birth Injury
Anencephaly
Arnold-Chiari Malformation/ Chiari Malformation
Autism Spectrum Disorder
Cerebral Palsy
Fetal Alcohol Spectrum Disorders
“It Happened in the Clinic”
Holoprosencephaly
Common Neurological Disorders
Alzheimer’s Disease (Also See Dementia—Non-Alzheimer’s)
Table 7.14 The Stages of Alzheimer’s Disease
“It Happened in the Clinic”
Amyotrophic Lateral Sclerosis
Cerebrovascular Accident and Transient Ischemic Attack
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
GERIATRIC CONSIDERATIONS
Creutzfeldt-Jacob Disease
Dementia—Non-Alzheimer’s (Lewy Body, Senile Dementia, Vascular Dementia)
Epilepsy, Seizure Disorder, and Epileptic Syndromes
Guillain Barré Syndrome and Acute Inflammatory Demyelinating Neuropathy
Huntington’s Disease
Multiple Sclerosis
“It Happened in the Clinic”
Near-Drowning/Drowning With Partial or Full Recovery
Neuropathy, Peripheral Neuropathy and Polyneuropathy
Parkinson’s Disease
Table 7.15 The Staging of Parkinson’s Disease Using the Hoehn and Yahr Scale
“It Happened in the Clinic”
Post-Polio Syndrome
Spinal Cord Injury
Traumatic Brain Injury and Head Injury
FIGURE 7.15 Coup and countercoup head injury
CASE STUDY 7.1
CASE STUDY 7.2
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 8 Burns and Skin Conditions
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of Skin?
Anatomy And Physiology of the Skin
Table 8.1 Protective Functions of the Skin
FIGURE 8.1 Cross-section of the skin.
Table 8.2 Layers of the Epidermis of the Skin and Skin Appendages of the Epidermis With Their Characteristics
FIGURE 8.2 Various nerve endings in the skin.
Table 8.3 Types of Sensory Nerve Endings in Dermis and Epidermis of the Skin and Their Function
Why Does the Physical Therapist Assistant Need to Know About Skin Conditions and Diseases?
Skin Conditions and Diseases
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Table 8.4 Types of Skin Lesions
FIGURE 8.3 Appearance of various skin lesions. (1) macule: flat with a clear outline; (2) papule: small lump with a solid feel; (3) nodule: firm and elevated above the surface of the skin, extends deeply into the layers of the skin; (4) vesicle or blister: usually fluid filled with a thin covering of skin; (5) pustule: area filled with pus or exudates raised above the level of the surrounding skin; (6) plaque: scaly skin lesion; (7) fissure: a crack in tissue which may extend deeply into the dermal layer of the skin; (8). ulcer: an open cavity in tissue of varying depth.
Thermal Injuries
Burns
FIGURE 8.4 Depths of skin involved in various types of burn shown by shaded areas. (1) Depth of skin involved in a superficial burn. (2) Depth of skin involved in a superficial partial-thickness burn. (3) Depth of skin involved in a deep partial-thickness burn. (4) Depth of skin involved in a full-thickness burn.
FIGURE 8.5 Keloid or hypertrophic scarring. (Top) Collagen forms in a disorganized way in the hypertrophic or keloid scar. (Bottom) Appearance when pressure is applied to a healing wound the collagen fibers form in an organized way.
Table 8.5 Burn Wound Zones
Table 8.6 Rule of Nines Values for Adult and Infant/Small Child
PTA PRECAUTIONS FOR PATIENTS WITH BURNS
GERIATRIC CONSIDERATIONS
Cold Injuries
Immersion Foot or “Trench Foot”
Frostbite
Hypothermia
Infectious Diseases of the Skin
BACTERIAL INFECTIONS OF THE SKIN
Boils and Carbuncles
FIGURE 8.6 Diagram of a furuncle and carbuncle. The furuncle and carbuncle are caused by bacterial infection of the hair follicles. The pus-filled carbuncle is shown with several “heads.”
Cellulitis
FIGURE 8.7 Cellulitis in the foot.
Impetigo
FUNGAL INFECTIONS OF THE SKIN
Candidiasis
Tinea
VIRAL INFECTIONS OF THE SKIN
Herpes simplex
Herpes Zoster
FIGURE 8.8 Herpes zoster on the anterolateral trunk showing the typical vesicles.
“It Happened in the Clinic”
Wart and Verruca
VECTOR-BORNE (INSECT BORNE) SKIN INFECTIONS
Scabies
Pediculosis (Lice)
FIGURE 8.9 A human head louse (pediculus humanus capitis) and a nit (egg case) attached to a hair shaft.
OTHER SKIN CONDITIONS
Acne vulgaris
Eczema, Dermatitis, and Urticaria
FIGURE 8.10 Seborrheic dermatitis of the forehead and eyebrows.
Psoriasis
FIGURE 8.11 Typical bright red scaly plaque of psoriasis.
Neoplasms of the Skin
FIGURE 8.12 Basal cell carcinoma.
Squamous Cell Carcinoma
FIGURE 8.13 Squamous cell carcinoma.
Malignant Melanoma
FIGURE 8.14 Comparison of a mole and a malignant melanoma. (Left) The mole or nevus has smooth edges with a raised left, may be red or brown in color or have no color. (Right) The malignant melanoma is an irregular shape. Tends to be larger than a nevus and is dark red to bluish black in color. Note: This is not a definitive description of malignant melanoma and a variety of shapes, sizes, and colorations are possible. Carcinoma does not always follow a subscribed pattern.
FIGURE 8.15 Malignant melanoma.
FIGURE 8.16 Kaposi’s sarcoma on a foot.
Kaposi’s Sarcoma
SKIN ULCERATIONS
Table 8.7 Characteristics of Arterial and Venous Ulcers
Arterial, Ischemic, and Diabetic Ulcers
FIGURE 8.17 Ulceration secondary to arterial insufficiency.
Venous Stasis Ulcers
FIGURE 8.18 Venous stasis ulcer over medial malleolus.
Table 8.8 Differences in Treatment for Arterial and Venous Ulcers
Pressure (Decubitus) Ulcers
FIGURE 8.19 Decubitus (pressure) ulcer.
8.1 CASE STUDY
8.2 CASE STUDY
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 9 Endocrine, Metabolic, and Nutritional Disorders
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does The Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Endocrine System?
Anatomy and Physiology of the Endocrine System
Why Does the Physical Therapist Assistant Need to Know About Diseases and Disorders of the Endocrine System?
Table 9.1 Hormones Produced by Specific Endocrine Glands and Their Effects
Endocrine System Diseases and Disorders
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Pituitary Diseases
Pituitary hypofunction
Hyperpituitarism
FIGURE 9.1 The face of a woman affected with acromegaly showing a thickened appearance of the tissues of the cheeks, chin, and forehead.
Thyroid Diseases
Hyperthyroidism
FIGURE 9.2 A patient with Grave’s disease showing the typical goiter and exophthalmos, with wide open eyes, staring, or protrusion of the eyeball.
Table 9.2 Some Thyroid Function Tests
Hypothyroidism
FIGURE 9.3 Comparison of hypothyroidism and hyperthyroidism
Hypoparathyroidism
Adrenal Cortex Diseases
Addison’s Disease, Adrenocortical Hypofunction, Hypocortisolism, and Adrenal Insufficiency
Cushing’s Syndrome and Cushing’s Disease
FIGURE 9.4 Comparison of adrenocortical hyperfunction (Cushing’s syndrome) and hypofunction (Addison’s disease).
Conn Syndrome
Congenital Adrenal Hyperplasia/ Adrenogenital Syndrome
Adrenal Medulla Diseases
Neuroblastomas and Pheochromocytomas
Why Does the Physical Therapist Assistant Need to Know About Diabetes Mellitus?
Diabetes Mellitus
Table 9.3 Prevalence of Diabetes Mellitus (DM) in the United States, 2007
Table 9.4 Factors Affecting Glucose Levels of the Blood in Patients With Diabetes Mellitus
FIGURE 9.5 The long-term complications and effects of diabetes.
Table 9.5 Common complications of diabetes mellitus
“It happened in the clinic”
PHYSICAL THERAPY ADVICE FOR THE PATIENT WITH DIABETES MELLITUS
PRECAUTIONS FOR THE PHYSICAL THERAPIST ASSISTANT WHEN TREATING PATIENTS WITH DM
Diabetic Neuropathy
GERIATRIC CONSIDERATIONS
Diabetic Coma
Why Does the Physical Therapist Assistant Need to Know About Metabolic Diseases and Disorders?
Table 9.6 Symptoms of Hyperglycemia and Hypoglycemia
Metabolic Disorders
Balance of Acids and Bases
Table 9.7 Signs and Symptoms Associated With Electrolyte and Fluid Imbalance
Phenylketonuria
Wilson’s Disease
Why Does the Physical Therapist Assistant Need to Know About Nutritional Disorders?
Nutritional Disorders
Overweight and Obesity
Complications From Obesity
Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Table 9.8 Dietary Daily Intake Recommendations of Vitamins and Minerals
Table 9.9 Vitamin Functions and Deficiencies
Mineral Deficiencies
Inflammatory Bowel Disease
CASE STUDY 9.1
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 10 Infectious Diseases
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About Hepatitis?
Hepatitis
Hepatitis A
Hepatitis B (HBV)
Hepatitis C (HCV)
Hepatitis D, E and G
Alcoholic Hepatitis
Why Does the Physical Therapist Assistant Need to Know About HIV/AIDS?
Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
FIGURE 10.1 Thrush in the mouth.
It Happened in the Clinic
Why Does the Physical Therapist Assistant Need to Know About Sexually Transmitted Diseases?
Sexually Transmitted Diseases
Chancroid
Chlamydia
Cytomegalovirus
Gonorrhea
Human Papillomavirus
Syphilis
FIGURE 10.2 Syphilis infection showing a chancre on the proximal penile shaft.
GERIATRIC CONSIDERATIONS
Why Does the Physical Therapist Assistant Need to Know About Nosocomial Infections?
Nosocomial Infections
Complications of Nosocomial Infections
MEDICAL INTERVENTION
Why Does the Physical Therapist Assistant Need to Know About Vector- and Animal-Borne Infectious Diseases?
Insect (Vector)- and Animal-Borne Infectious Diseases
Dengue Fever and Dengue Hemorrhagic Fever
Hantaviruses
Malaria
Plague
Rabies
Rocky Mountain Spotted Fever
Typhus
West Nile Virus or West Nile Encephalitis
FIGURE 10.3 The Aedes japonicas mosquito, one of the mosquitoes responsible for the transmission of the West Nile virus.
Yellow Fever
Why Does the Physical Therapist Assistant Need to Know About Infectious Disease Immunity?
Preventable Infectious Diseases for Which Health Care Workers Are Required to Have Immunity
Diphtheria
Table 10.1 Diseases Caused by Gram-Negative and Gram-Positive Bacteria
Mumps
Pertussis (Whooping Cough)
Poliomyelitis and Post-Polio Syndrome
Rubella (German Measles)
FIGURE 10.4 A young boy with the maculopapular rash characteristic of rubella (German measles).
Rubeola (Measles)
Tetanus
Varicella (Chickenpox)
Why Does the Physical Therapist Assistant Need to Know About Other Infectious Diseases?
Other Infectious Diseases
Anthrax
Botulism
Infectious Mononucleosis
Influenza (Flu)
Legionellosis/Legionnaire’s Disease
Meningitis
Toxic Shock Syndrome
Variola (Smallpox)
10.1 CASE STUDY
STUDY QUESTIONS
Useful Web Sites
REFERENCES
CHAPTER 11 Female and Male Reproductive System Conditions
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Female Reproductive System?
Anatomy and Physiology of the Female Reproductive System
FIGURE 11.1 The bony pelvis.
FIGURE 11.2 Contents of the female pelvis.
FIGURE 11.3 Female external genitalia shown in anterior view of the perineum.
FIGURE 11.4 The urogenital and anal triangles of the pelvic floor musculature.
FIGURE 11.5 Mammary gland shown in midsagittal section.
Table 11.1 Hormones Affecting the Reproductive System
Why Does the Physical Therapist Assistant Need to Know About Diseases and Conditions of the Female Reproductive System?
Diseases and Conditions of the Female Reproductive System
HINTS ON USE OF THE GUIDE TO PHYSICAL THERAPIST PRACTICE
Dyspareunia
Endometriosis
Infertility
Menstrual Cycle Problems
Premenstrual Syndrome
Carcinomas of the Female Reproductive System
Carcinoma of the Cervix
Table 11.2 Staging of Carcinoma of the Cervix
Table 11.3 Some Diagnostic Tests Used for Detection of Cervical Carcinoma
Carcinoma and Nonmalignant Tumors of the Ovaries
Table 11.4 Types of Benign Ovarian Cysts
Carcinoma of the Uterus (Endometrial Carcinoma)
Table 11.5 Staging of Endometrial Carcinoma
Carcinoma of the Vulva
Leiomyoma of the Uterus (Fibroids)
Pelvic Floor Incompetence and Weakness
Pelvic Inflammatory Disease
Uterine prolapse
Intrauterine Devices and Their Significance in Physical Therapy Intervention
Diseases of the Breast
Benign fibroadenoma
Breast carcinoma
GERIATRIC CONSIDERATIONS
Table 11.6 Types of Surgery for Breast Carcinoma
Fibrocystic Disease
FIGURE 11.6 Fibrocystic changes in the breast. Nodules may be palpated and calcifications may occur that show up on mammography.
Why Does the Physical Therapist Assistant Need to Know About Pregnancy?
Pregnancy
Lactation
Monitoring of the Fetus During Pregnancy
“It Happened in the Clinic”
Precautions and Contraindications for PT Intervention During Pregnancy
Pregnancy-Related Conditions
Ectopic Pregnancy
Gestational diabetes
Low Back Pain in Pregnancy
Placenta Accreta
Placenta Previa
Postdate Pregnancy
Preeclampsia
Premature Birth
Rh Incompatability
Spontaneous Abortion and Miscarriage
Labor
STAGES OF LABOR
FIGURE 11.7 The stages of labor: (A) During the first stage of labor, the fetal head is in the effacement position and the cervix starts to dilate. (B) As the second stage of labor begins, the baby’s head turns and progresses down the birth canal. (C) During the later part of the second stage of labor, the membranes rupture and the baby’s head “crowns.” (D) As the second stage of labor ends, the baby’s head emerges. (E) During birth, the baby’s head turns sideways and the shoulders rotate to enable the baby to exit the birth canal.
PHYSICAL THERAPY INTERVENTION FOR THE NEW MOTHER
Complications of Labor
Breech Delivery
Table 11.7 Types of Breech Presentation
FIGURE 11.8 Types of breech presentations. (A) Frank breech in which the buttocks are presented to the cervix and the legs are extended. (B) Complete or full breech in which the buttocks are presented to the cervix and the legs are crossed. (C) Single footling breech in which one leg exits the birth canal first and the other leg is flexed within the uterus.
Caesarean Section Delivery
FIGURE 11.9 Commonly used episiotomy incisions.
Episiotomy
Forceps-Assisted Delivery
Multiple Births
Postpartum Issues and Problems
Muscle Tone, Ligamentous Laxity, and Injuries
Pelvic Joint Injuries
Postpartum Depression and Psychosis
Why Does the Physical Therapist Assistant Need to Know About Menopause?
Menopause
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Male Reproductive System?
Male Reproductive Anatomy
FIGURE 11.10 Contents of the male pelvis.
FIGURE 11.11 The structure of a mature sperm cell.
FIGURE 11.12 Midsagittal section of a testis.
Why Does the Physical Therapist Assistant Need to Know About Diseases of the Male Reproductive System?
Diseases of the Male Reproductive System
Congenital Abnormalities
Erectile Dysfunction
Infertility in the Male
Prostate Diseases
Benign Prostatic Hyperplasia
FIGURE 11.13 Cross sections of the prostate showing (A) normal prostate, (B) benign prostatic hyperplasia, and (C) carcinoma of prostate.
Prostate Cancer
Prostatitis
Testicular Diseases
Epididymitis
Orchitis
Testicular Carcinoma
Carcinoma of the Penis
11.1 CASE STUDY
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 12 Diseases of the Digestive and Urinary Systems
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Digestive System?
Anatomy and Physiology of the Digestive System
FIGURE 12.1 Anterior view of the stomach sectioned to show layers of muscle.
FIGURE 12.2 Internal lining of the small intestine showing villi.
FIGURE 12.3 The digestive organs in anterior view.
Table 12.1 Enzymes and Secretions That Aid in Digestion
Diagnostic Medical Tests for Digestive System Diseases
BARIUM TESTS
BLOOD, FLUID, AND TISSUE TESTS
COLONOSCOPY AND SIGMOIDOSCOPY
DIGITAL RECTAL EXAM
ENDOSCOPY
ESOPHAGEAL PH MONITORING AND ESOPHAGEAL ACIDITY TESTING
LAPAROSCOPIC EXPLORATORY SURGERY
RADIOGRAPHIC AND IMAGING TESTS
Why Does the Physical Therapist Assistant Need to Know About Diseases of the Digestive System?
Diseases of the Digestive System
Hints on use of the Guide to Physical Therapist Practice
Diseases of the Esophagus
Esophageal Cancer
GASTROESOPHAGEAL REFLUX DISEASE
Diseases of the Mouth and Pharynx
Carcinoma of the Mouth and Oral Carcinoma
Temporomandibular Joint Dysfunction as a Result of Periodontal Disease
Diseases of the Stomach
Carcinoma of the Stomach
Gastritis and Peptic Ulcer Disease
FIGURE 12.4 Diagram of some common locations of esophageal, gastric, and duodenal ulcers.
Gastroenteritis
Diseases of the Small Intestine
Appendicitis
FIGURE 12.5 Position of McBurney’s point in appendicitis.
Celiac Sprue (small intestine malabsorption)
Ileus and Small Intestinal Obstruction
Whipple’s Disease
Diseases of the Large Bowel and Large Intestine
Colorectal Carcinoma
Diverticula Disease of the Colon
Table 12.2 Types of Surgical Procedures Used for the Treatment of Colorectal Cancer
Hemorrhoids
Inflammatory Bowel Disease (Crohn’s Disease and Ulcerative Colitis)
Intestinal Polyps
Irritable Bowel Syndrome
Peritonitis
Rectal Prolapse
Diseases of the Liver and Gallbladder
Cholelithiasis and Choledocholithiasis
Cirrhosis of the Liver
CARCINOMA OF THE GALLBLADDER
Liver Diseases and Conditions Caused by Drugs, Medications, and Toxins
Carcinoma of the Liver—Primary
Diseases of the Pancreas
Acute and Chronic Pancreatitis
Carcinoma of the Pancreas
Why Does the Physical Therapist Assistant Need to Know About the Anatomy and Physiology of the Urinary System?
The Anatomy and Physiology of the Urinary System
FIGURE 12.6 Anterior view of the urinary system.
FIGURE 12.7 The kidney showing internal structure.
Diagnostic Tests and Procedures for the Urinary Tract
BLOOD TESTS
Table 12.3 Normal and Abnormal Constituents and Characteristics of Urine
CATHETERIZATION OF THE BLADDER
CYSTOSCOPY
RADIOLOGICAL TESTS
RENAL BIOPSY (KIDNEY BIOPSY)
RENAL DIALYSIS
URINALYSIS
URINE CULTURE AND SENSITIVITY (C & S)
Terms Associated With Urinary Disease
DIURETIC MEDICATIONS
NEUROGENIC BLADDER
RENAL TRANSPLANT
Why Does the PTA Need to Know About Urinary Tract Diseases?
Diseases of the Urinary Tract
Table 12.4 General Characteristic Signs and Symptoms of Urinary Tract Diseases and Conditions
Diseases of the Bladder
“It Happened in the Clinic”
Bladder Cancer
Cystitis
Diseases of the Kidney
Glomerulonephritis
FIGURE 12.8 A nephron.
Kidney Stones
FIGURE 12.9 Diagram of various locations of calculi (stones) in the urinary tract.
Nephrosclerosis
Pyelonephritis
FIGURE 12.10 Kidney of a patient with chronic pyelonephritis compared with a normal-sized kidney with some scarring.
Renal Carcinoma
Renal Cystic Disease
Renal Failure—Acute and Chronic
Wilms’ Tumor
MEDICAL INTERVENTION
CASE STUDY 12.1
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 13 Intensive Care
LEARNING OBJECTIVES
KEY TERMS
Introduction
Why Does the Physical Therapist Assistant Need to Know About the Intensive Care Unit?
The Intensive Care Unit
Table 13.1 Normal Laboratory Values of Blood, Plasma, and Serum
Table 13.2 Normal Laboratory Values of Urine
Table 13.3 Normal Laboratory Hematological Values
General Precautions and Recommendations for Treating Patients in the ICU
Equipment Used in the ICU
ARTERIAL LINES AND INTRA-ARTERIAL LINES
BLOOD PRESSURE
ELECTROCARDIOGRAM MONITOR
INTRACRANIAL PRESSURE MONITOR
FIGURE 13.1 An electrocardiogram monitor.
INTRAVENOUS INFUSION (IV)
LOWER EXTREMITY COMPRESSION DEVICES
FIGURE 13.2 A lower extremity compression device.
MECHANICAL VENTILATORS
OXYGEN
POSTSURGICAL DRAINS
FIGURE 13.3 A Hemovac.
PULSE OXIMETER
FIGURE 13.4 A pulse oximeter.
SUCTIONING DEVICES
URINARY CATHETERS
FIGURE 13.5 A catheter tube and bag.
What Causes a Patient to Be Placed in the ICU?
Physical Therapy Interventions Used for Patients With Specific Diagnoses on the ICU
Burns
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
Cerebrovascular Accident (CVA)
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
End-Stage Renal Failure
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
Myocardial Infarction
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
Near-Drowning
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
Table 13.4 Glasgow Coma Scale
Surgery—Cardiac, Orthopedic, and Major Internal Surgery
Trauma—Treat the Essential First
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
Traumatic Brain Injury
PRECAUTIONS AND CONSIDERATIONS FOR PHYSICAL THERAPY INTERVENTION
Prevention of Pressure Ulcers
Legal and Ethical Issues
Pediatric Intensive Care Unit
CASE STUDY 13.1
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
CHAPTER 14 The Geriatric Patient
LEARNING OBJECTIVES
KEY TERMS
Introduction
Overview of Geriatrics
Why Does the Physical Therapist Assistant Need to Know About Geriatrics and the Effects of Aging?
Physiological Effects of Aging
Effects of Age on the Skin
False Assumptions About the Elderly
Psychological Effects of Aging
Why Does the Physical Therapist Assistant Need to Know About Specific Diseases Prevalent in the Elderly Population?
Specific Diseases Prevalent in the Elderly Population
Anatomy and Physiology of the Eye
FIGURE 14.1 The internal structures of the eye.
Pathological Conditions of the Eye
Cataracts
Detached Retina/Retinal Detachment
Glaucoma
Macular Degeneration
FIGURE 14.2 Amsler grid, for the detection of eye disorders, especially age-related macular degeneration. This image depicts a normal eye.
FIGURE 14.3 Amsler grid as it would appear to someone with age-related macular degeneration.
IMPLICATIONS OF VISION LOSS AND LOW VISION FOR PHYSICAL THERAPY INTERVENTION
Anatomy and Physiology of the Ear
Pathological Conditions of the Ear
FIGURE 14.4 The internal structures of the ear.
Acoustic Neuroma
Benign Paroxysmal Positional Vertigo
Labyrinthitis and Vestibular Neuritis
Ménière’s Disease
Otosclerosis
IMPLICATIONS OF HEARING LOSS FOR PHYSICAL THERAPY INTERVENTION
Other Conditions or Disorders Related to Aging
Amputation
Arthritis
Balance Problems, Falls, and Immobility
Bowel and Bladder Dysfunction
Dementia
Diabetes Mellitus
Malnutrition
Parkinson’s Disease
Pressure Ulcers
Terminal Illness
Special Issues Related to Geriatric Patients
Elder Abuse
RESTRAINTS AND RESTRAINT ALTERNATIVES
CASE STUDY 14.1
STUDY QUESTIONS
USEFUL WEB SITES
REFERENCES
Back Matter
GLOSSARY

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