SysTx - Conditions - Final OP PDF

RESPIRATORY VENOUS...

RESPIRATORY VENOUS ARTERIAL ← CARDIOVASCULAR 🫀 PRIMARY HEADACHES CONDITION THROMBOANGIITIS OBLITERANS / BUERGER'S PREGNANCY HEADACHES EMPHYSEMA CHRONIC BRONCHITIS SINUSITIS DEEP VEIN THROMBOSIS VARICOSE VEINS RAYNAUD'S D + P PAD / ARTERIOSCLEROSIS HYPERTENSION TENSION = muscle contraction-type DISEASE headache (associated with TrPs + Hypertension = the elevation of blood pressure above myofascial pain syndromes) normal range for a prolonged period of time Stay Neutral + Profesional ; be mindful of vocabulary Thrombophlebitis = inflammation + swelling of a vein Raynaud's = peripheral vascular vasomotor disorder No default "congratulations" bilateral inflammation (acute or chronic) of the (superficial or deep) that leads to formation of a thrombus which affects the blood vessels outside the heart + Thromboangiitis Obliterans (Buerger's Disease) "That sounds like a big change, how are you feeling about this?" diffuse, dull or vice-like pain thorax SYSTOLIC / DIASTOLIC SECONDARY HEADACHES paranasal sinuses = type of vasculitis with inflammatory lesions of NORMAL: 40 years SINUS = due to sinus inflammation frequent urination pain in face, forehead, maxilla, between eyes low back pain, referral pain from uterine ligaments MIGRAINE = HA disorder of recurrent, (only 50% of those with DVT experience pain) (ethmoid) pain/pressure in affected sinus constipation moderate to severe headaches; sx vary by nasal drip/congestion 😪 nasal discharge, post-nasal drip and/or relaxin (loosening CT) individual throbbing, deep pain aggravated by certain positions nasal congestion asymptomatic until complications develop progesterone (relaxing smooth muscle) unilateral dyspnea dyspnea localized redness + warmth start dull ache, progress to pulsating, SYMPTOMS coughing coughing fever is common cord-like swelling along the course of the vein Tissue Fragility variable depending on blood vessels affected SOB twisted, enlarged + bulging of veins (bluish + lumpy), (can take years or decades for complications/symptoms to develop) pubic symphysis pain pounding resolved condition = skin may develop brownish running down all or part of leg accompanied with variety of other ACUTE = pain, often severe, usually infection varicose veins pigmentation along affected vein some asymptomatic, some dull achy pain, weak symptoms (nausea, vomiting, sensitivity to CHRONIC = dully, achy, vague leg cramps WITHDRAWAL = due to stopping the use of a may be feverish (especially after long periods of standing or walking) light, sound, more) compression syndromes (TOS, CTS) substance the body has become accustomed to restless legs or legs are so uncomfortable that a person lots more aura or visual disturbances possible has difficulty standing on both feet at once (drugs, stimulants, caffeine, pain-killers) triggers ETHMOID Episodic + Segmental Symptoms Most Common to Trimester begin early AM when blood levels of substance feeling of fatigue in legs, walking may be difficult 4-72 hours worse with coughing straining, lying back (come + go intermittently over time, appear at different, Risk Factors for HTN 1st Trimester are lower possible swelling around ankles better with head upright asymmetrical locations) PRIMARY SYMPTOM = sense of weakness or muscular "tiredness" (new client presentation = take BP reading before tx): morning sickness throbbing pain burning or itchy skin on the legs 3 PHASES "blue bloater" MAXILLARY bilateral, progressive intermittent claudication usually present in + 45 years of age bilateral "pink puffer" leg cramps (especially calf muscles) at night 🌙 temporary pallor and cyanosis of the digits 1st SYMPTOM often: intermittent claudication in arch of foot Prodromal : autonomic symptoms, mood, productive cough worse with head upright + bending forward muscles men > women (until menopause then =) 2nd Trimester DIFFERENTIATING prolonged expiration pain at rest skin over leg may be variable, shiny bluish-brown (usually fingers) or palm of hand pain + weakness relieved by rest possible aura-visual cyanosis better reclined pain at rest diabetes Edema SYMPTOMS barrel chest pain worsens with movement extremity skin tissue integrity loss edema pain at rest may indicated more severe involvement digital clubbing FRONTAL trophic changes to skin obesity Hypertension REBOUND = due to overuse + reliance on thin weight pain worsens with elevation possible muscle atrophy, brittle nails, cyanosis cold sensitivity Attack : unilateral, throbbing, sensitivity to weight retention worse with reclining pale, pallour skin, especially upon elevation lifestyle factors (smoking, diet, stress, sedentary) medications rubor (redness of skin from dilated capillaries under skin) light/noise/others, nausea, vomiting, need better with head upright may develop gangrene pregnancy (esp. 1st trimester) 3rd Trimester cyanosis to hide from stimuli in dark quiet SPHENOID trophic changes to skin from chronic ischemia family hx/hx of predisposing cause of HTN Gestational Diabetes worse with lying back + bending forward arterial occlusion in the arms is much less common than legs Ketoacidosis Postdromal : fatigue, exhaustion, sore, goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? goals of treatment? sluggish, flaring pain with movement, may goals of treatment? willingness + goals + accessibility for ALWAYS ASK willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? willingness + goals + accessibility for homecare? be followed by Tension HA willingness + goals + accessibility for homecare? homecare? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? usual + affected ADLs? general health? trimester? LEVEL 2 (Tx + Type of HA) family history? first pregnancy? health of pregnancy? location? do you have a fever? diagnosed, cleared of DVT? history of pregnancy? complications? LEVEL 1 (Rule Out 🎌) quality? has this been diagnosed? family history of pregnancy? diagnosed? last Dr. visit? meds? onset? onset? does this affect vision or hearing? any medical intervention? diagnosed? stable? managed? HA now? referral? diagnosed? cleared of DVT? primary or secondary? If secondary, what history of systemic conditions that = fetal risk or complications risks? (Advanced Emphysema = need Dr. approval) diagnosed? last Dr. visit? meds? diagnosed by doctor? where is it? symptoms? current BP? is this usual or unusual for you? FIDs of HA? present symptoms? calf cramp? underlying condition? diagnosed by a physician? medications? severity? when/what aggravates it? severity? severe CB = need Dr. approval history of sinusitis? how long? how long have they had them? had massage before? new HA in young/old/pregnant? onset, 1st onset? what are your triggers? treatment plan? medication? how do you manage? what do you do when you do you know which lobes? calf cramping? stage 3 + 4 = Dr approval of massage? physician? midwife? location? recent cold/flu? recent surgery or injury/trauma? frequency of attacks? pain/cramping during activity? is it predictable? (usually legs) experience it? mucous, what color is it? where do you feel pain? recent surgery or immobilization? regular Dr visits? medications? treatment plan? consent to reach out to other HCP + collaborate? intense pain w/ sudden onset? underlying conditions? KEY HISTORY Qs recent immobilization? treatment + medication? pain/cramping predictably with feet elevation other HCP, treatment plan? other HCP, treatment plan? have you noticed which position makes the pregnant or post-partum? Dr prescribed changes to sleep position? Dr? other HCP + TX plans? pregnant/postpartum? are you currently having an attack? underlying CV condition? (ie. HTN, Heart Disease history) cardiac health? other respiratory conditions? cardiac conditions? other respiratory conditions? congestion worse? lying back, sitting up, health history? respiratory conditions? present symptoms? backache? hip pain? leg cramps? meds? stress levels? is the skin cracked, thin or ulcerated? (also HBP? is it managed? other underlying conditions? other underlying conditions? leaning forward? heart conditions? clotting disorder? history of heart disease? ADLs? affected ADLs? trauma? triggers? history of clotting disorder, cancer, cardiac observe) other underlying health conditions? (ie. diabetes) other conditions? risk factors? current symptoms? priority for treatment? (may be neurological? TOS? CTS? true or pseudo sciatic? fever? relieves? failure/disease, stroke, diabetes? is the physician aware of any risk of thrombus recent dental work or trauma to the face? unrelated to HTN) underlying health conditions? dental work? formation or gangrene? nasal discharge? colour? Communicate that massage cannot get rid of the varicose BP? take reading veins, but can help with the pain LEVEL 3 ( Contributing Factors) sleep, work, family hx, activity level what have you heard about pregnancy massage? have you noticed any positions are better or worse for your comfort? presentation of risk factors (new client presentation = take BP reading before tx) fatigue/laboured breathing Preeclampsia/Eclampsia New HA (especially >50 or child or pregnancy) headache during exercise NEW, severe HA in pregnancy Severe px that comes on suddenly intermittent claudication Immediate Referral: Warning Symptoms HBP Recent head injury chest pain vaginal bleeding (especially first 24 weeks) Edema (unusual to pregnancy, unilateral, fever HA worsens over time (especially following history of heart attack/heart disease severe continuous abdominal pain face, hands) head injury) sudden changes in patient condition history of DVT or PE client unwilling to make changes to health breaking of water before 34 weeks fever 🤒 primary or secondary HA + fever periods of dyspnea recent surgery unknown health status pre-eclampsia signs: Aneurysm underlying health concerns if secondary HA + nausea &/or vomiting cardio issues (CHF or Pulmonary HTN) *if present, good idea to start asking CV Condition pregnancy + postpartum pain on activity-predicable onset, stops when activity stops (intermittent claudication) congestive heart failure (need to speak with Dr) - NEW severe HA, change in vision debilitating, sudden, severe, explosive facial trauma current attack HA + mental confusion, seizures, mood pain predictably on elevation, relieved on dependent position (legs down) new or intense HA in pregnancy - HBP no predictable pattern (out of no where) Red Flag Qs medication: coumadin or heparin skin/tissue integrity (a major concern for arterial swings, or neurological sx's RED FLAGS lack of circulation to extremities-skin integrity, diminished pulses - swelling/edema (unusual: central, face, hands, fingers, unilateral) Respiratory Infections intense, severe swelling that affects vision + recent prolonged immobilization insufficiency) HA + numbness on one side of face/head long term, unmanaged hypertension WHEN TO REFER TO DR pain on upper right abdomen Temporal Arteritis Advanced Emphysema = Dr approval needed + conservative position (side-lying or semi- hearing burn patients (may have muscles atrophy, nails brittle, fingertip HA that is unusual ; doesn't fit the usual S&S of diabetes (or any other comorbidities) undiagnosed HTN elderly (most commonly) skin thicken) the person folwers) recent trauma to LE or pelvis Stage 3 or 4 HTN: wait 10-15 mins + retake BP (maintaining Referral within 24 Hours: Warning Symptoms unilateral ongoing symptoms triggers: cold, stress, emotions, other HA occurring after physical activity, straining blood in spututm = no postural drainage history of clotting disorder, cancer, cardiac failure or disease, stroke, diabetes calm environment, continue with history) temperature of 38.5ºC + throbbing, temple, red, swollen or coughing Osteoporosis = no tapotement (unless symptoms such as HA, anxiety, nosebleed → refer frequency of urination + pain with urination New HA w/ hx of cancer, heart disease for immediate Dr referral) absence of fetal movement for 24 hours Meningitis New HA w/ pregnancy, HIV If still elevated on 2nd measurement refer immediate excessive vomiting to point of no food/fluids can be retained fever HA + clear fluid or blood coming out of ears medical attention, especially if diastolic +120 excessive itching stiff neck (+ve Koernig's) (medical emergency) sharp shooting pain during neck FLX *Call 911 if patient is experiencing SOB, chest pain, difficulty speaking, etc no techniques that ↑ work of the heart avoid deep massage to low back, sacrum, abdomen in 1st Trimester no prolonged elevation of legs no local massage or ROM to affected limb no deep, specific techniques over varicosities or no prolonged, repetitive, broad, full body strokes modify → (due to greater risk of miscarriage) long physical examination no exhausting patient with overtreatment or prolonged application of painful technique (especially fever 🤒 dystrophic tissue short segmental massage CId if sudden change in BP = refer to midwife or physician important with with severe emphysema) no heat distal or immediately proximal no local massage to painful varicosities that are no cold hydrotherapy on affected tissue no fully body lymphatic drainage if they have gestational diabetes = ensure they have eaten prior to prone usually not tolerated severe emphysema = NO SUPINE or PRONE facial trauma sensitve to touch deep techniques avoided on affected tissue if in no systemic/extreme hydro treatment strokes toward the head no rib springing or joint play to ribs with hypermobility or history of subluxation if DVT is diagnosed, need Dr approval for massage no local massage 24 hours after medical treatment of poor health if they have heartburn = > 2hours after meal before massage deep pressure CIs no postural drainage with severe hemoptysis, severe pulmonary edema, CHF, PE, severe HBP or LBP, intense, severe swelling affecting vision + saline injections, after surgery + until approved by no work on compromised skin/tissue no cold hydrotherapy on affected tissue no aggressive treatment that could ↑ BP (no painful or avoid systemic hot hydro (increasine maternal internal temp) TrP Release (gentle mm stripping instead) recent MI , recent neurosurgery stimulating techniques) hearing if DVT is suspected, immediate medical referral physician no elevation of affected limb deep techniques avoided on affected tissue if in poor health aggressive tx techniques no postural drainage directly after eating no techniques that ↑ risk of local tissue damage (ie. x-fiber no massage over varicosity to affected legs if there is no compression of arteries no work on compromised skin/tissue mindful of ↑ risk of blood clotting during pregnancy heat on head or shoulders no tapotement over bony prominences, floating ribs, breast tissue