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Lateral Epicondylitis (Tennis Elbow) Presentation (Gold)
-pain along the lateral elbow especially over the lateral epicondyle that
sometimes radiates into the dorsum of the hand.
-pain will increase with wrist flexion with elbow extension, resisted wrist
extension, and resisted radial deviation.
-pt may have difficulty holding or gripping objects and insufficient forearm
functional strength.
Lateral Epicondylitis (Tennis Elbow) Treatment (Gold)
-initiate stretching and strengthening (elbow, wrist, hand)
-all exercise must remain pain-free
-E-stim, iontophoresis (dexamethasone), cryotherapy
Ranchos Los Amigos Level 1: No Response
Patient appears to be in a deep sleep and is completely unresponsive to any
stimuli
Ranchos Los Amigos Level 2: Generalized Response
-patient reacts inconsistently and non-purposefully to stimuli in a non-specific
manner
-responses are limited and often the same regardless of stimulus presented
-responses may be physiological changes, gross body movements, and/or
vocalization
,Ranchos Los Amigos Level 3: Localized Response
-patient reacts specifically, but inconsistently to stimuli
-responses are directly related to the type of stimulus presented
-may follow simple commands such as closing the eyes or squeezing the hand in
an inconsistent, delayed manner
Ranchos Los Amigos Level 4: Confused-Agitated
-patient is in a heightened state of activity
-behavior is bizarre and non-purposeful relative to the immediate environment
-does not discriminate among persons or objects; is unable to cooperate directly
with treatment efforts
-verbalizations frequently are incoherent and/or inappropriate to the
environment; confabulation may be present
-gross attention to environment is very brief; selective attention is often
nonexistent
-patient lacks short and long-term recall
Ranchos Los Amigos Level 5: Confused-Inappropriate
-patient is able to respond to simple commands fairly consistently, however,
with increased complexity of commands or lack of any external structure the
responses are non-purposeful, random, or fragmented
-demonstrates gross attention to the environment, but is highly distractible and
lacks the ability to focus attention on a specific task
-with structure, may be able to converse on a social automatic level for short
periods of time
-verbalization is often inappropriate and confabulatory
-memory is severely impaired; often shows inappropriate use of objects; may
perform previously learned tasks with structure but is unable to to learn new
information
,Ranchos Los Amigos Level 6: Confused-Appropriate
-patient shows goal-directed behavior, but is dependent on external input or
direction
-follows simple directions consistently and shows carryover for relearned
tasks such as self-care
-responses may be incorrect due to memory problems, but they are appropriate
to the situation.
-past memories show more depth and detail than recent memory
Ranchos Los Amigos Level 7: Automatic-Appropriate
-patient appears appropriate and oriented within the hospital and home setting
-goes through daily routine automatically, but frequently robot-like
-patient shows minimal to no confusion and has shallow recall of activities
-shows carryover for new learning, but at a decreased rate
-with structure is able to initiate social or recreational activities; judgment
remains impaired
Ranchos Los Amigos Level 8: Purposeful-Appropriate
-patient is able to recall and integrate past and recent events and is aware of and
responsive to environment
-shows carryover for new learning and needs no supervision once activities are
learned
-may continue to show a decreased ability relative to premorbid abilities,
abstract reasoning, tolerance for stress, and judgment in emergencies or unusual
circumstances
Glasgow Coma Scale
-a neurological assessment tool used initially after injury to determine arousal
and cerebral cortex function
, GCS: 8>
severe brain injury or coma
GCS: 9-12
moderate brain injuries
GCS: 13-15
mild brain injuries
anterograde amnesia
inability to form new memories
post-traumatic amnesia
-time between the injury and when the patient is able to recall recent events
-patient does not recall the injury or events up until this point of recovery
retrograde amnesia
-inability to remember events prior to the injury
-may progressively decrease with recovery
Traumatic brain injury
a blow to the head or a penetrating head injury that damages the brain