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\usepackage{lastpage}           % Needed for total page number
\usepackage{seqsplit}           % Splits long words.
%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
\usepackage{wasysym}            % Symbols
%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{Bre (Bmazelle)}
\pdfinfo{
  /Title (npte.pdf)
  /Creator (Cheatography)
  /Author (Bre (Bmazelle))
  /Subject (NPTE Cheat Sheet)
}

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% Header and Footer
\pagestyle{fancy}
\fancyhead{} % Set header to blank
\fancyfoot{} % Set footer to blank
\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
    }
\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{NPTE Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Bre (Bmazelle)} via \textcolor{DarkBackground}{\uline{cheatography.com/138467/cs/29155/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Bre (Bmazelle) \\
  \uline{cheatography.com/bmazelle} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 29th September, 2021.\\
   Updated 29th September, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
  \SetRowColor{white}
  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

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% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.


\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Neuro dysfunction patterns by injury}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Frontal lobe}}: contralateral weakness, personality changes/ antisocial behavior, broca's aphasia, delayed or poor initiation.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Parietal Lobe}}: constructional apraxia and anosognosia, Wernicke's aphasia, homonymous visual defects, impaired language comprehension.} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Occipital Lobe}}: variety of visual deficits (homonymous hemianopsia, visual agnosia, cortical blindness), impaired extra-ocular muscle movement} \tn 
% Row Count 9 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Temporal Lobe}}: hearing impairments, memory and learning deficits, wernicke's aphasia, antisocial behaviors} \tn 
% Row Count 12 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Cerebellum}}: Ataxia, lack of trunck and extremity coordination, intention tremors, balance deficits, dysdiadochokinesia, dysmetria} \tn 
% Row Count 15 (+ 3)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Basal Ganglia}}: bradykinesia and akinesia, resting tremors, rigidity, athetosis, chorea,} \tn 
% Row Count 17 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Thalamus}}: thalamic pain syndrome, altered relay of sensory information} \tn 
% Row Count 19 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Hypothalamus}}: altered basic homeostasis of body functions, poor autonomic nervous system function, altered function of anterior pituitary gland (ADH secretion and reproduction)} \tn 
% Row Count 23 (+ 4)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{brainstem}}: Altered consciousness, contralateral hemiparesis or hemiplegia, cranial nerve palsy, altered respiratory patterns, attention deficits.} \tn 
% Row Count 26 (+ 3)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Right hemisphere}}: left sided sensory and motor deficits, unable to understand nonverbal communication, difficulty in sustaining movements, poor hand eye coordination and kinesthetic awareness, quick and impulsive, overestimation of abilities.} \tn 
% Row Count 31 (+ 5)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Neuro dysfunction patterns by injury (cont)}}  \tn
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Left hemisphere}}: right sided sensory and motor deficits, difficulty understanding and producing language, difficulty sequencing movements, poor logical and rational thought, slow cautious anxious, self depreciating.} \tn 
% Row Count 5 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.8718 cm} x{11.3982 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Functions of the brain}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Frontal Lobe}} & primary motor cortex responsible for voluntary movements on contralateral side. Broca's area (motor components of speech), cognition, judgement, attention, abstract thinking and emotional control \tn 
% Row Count 8 (+ 8)
% Row 1
\SetRowColor{white}
{\bf{Parietal lobe}} & primary sensory cortex integrates sensation from contralateral side of body, short term memory, perception of touch, proprioception pain, and temp sensations \tn 
% Row Count 15 (+ 7)
% Row 2
\SetRowColor{LightBackground}
{\bf{Temporal lobe}} & Primary auditory cortex, associative auditory cortex, wernicke's area (comprhension of spoken word), long term memory, visual perception, primary visual cortex \tn 
% Row Count 22 (+ 7)
% Row 3
\SetRowColor{white}
{\bf{Occipital lobe}} & visual association cortex (processes visual info and applies meaning) \tn 
% Row Count 25 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{Medulla oblongata}} & contains centers for vital sign functioning of the cardiac, respiratory, and vasomotor centers,. maintains consciousness and arousal \tn 
% Row Count 31 (+ 6)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.8718 cm} x{11.3982 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Functions of the brain (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
{\bf{Hypothalamus}} & critical for maintaing homeostasis. controls primitive drivesrelated to age, agression, emotion, thirst, hunger, sleep wake cycle. Damage to this area can cause problems with temp, water, and behavioral regulation. \tn 
% Row Count 9 (+ 9)
% Row 6
\SetRowColor{white}
{\bf{Basal ganglia}} & regulates posture and muscle tone \tn 
% Row Count 11 (+ 2)
% Row 7
\SetRowColor{LightBackground}
{\bf{cerebellum}} & maintains posture and voluntary muscle movement control \tn 
% Row Count 14 (+ 3)
% Row 8
\SetRowColor{white}
{\bf{Brainstem}} & contains cranial nerve nuclei, damage damage can lead to variety of cranial nerve dysfunctions \tn 
% Row Count 18 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.1169 cm} x{9.1531 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{gait deviations seen w/ stroke}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{{\emph{Hip}}}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Retraction & Increased trunk and LE muscle tone \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Hiking & Inadequate hip and knee flexion, increased tone in trunk and LE \tn 
% Row Count 6 (+ 3)
% Row 3
\SetRowColor{white}
Circumduction & Increased extensor tone, inadequate hip and knee flex, increased PF  in ankle or footdrop \tn 
% Row Count 11 (+ 5)
% Row 4
\SetRowColor{LightBackground}
Inadequate hip flexion & Increased extensor tone, flaccid LE \tn 
% Row Count 13 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{{\bf{{\emph{Knee}}}}} \tn 
% Row Count 14 (+ 1)
% Row 6
\SetRowColor{LightBackground}
decreased knee flexion during swing & Increased LE extensor tone, weak hip flex \tn 
% Row Count 16 (+ 2)
% Row 7
\SetRowColor{white}
excessive flex during stance & weakness or flaccidity in LE, increased flex tone in the LE \tn 
% Row Count 19 (+ 3)
% Row 8
\SetRowColor{LightBackground}
hyper extension during stance & hip retraction, increased extensor tone in LE, weakness in hamstrings, quads, gluteus maximus \tn 
% Row Count 24 (+ 5)
% Row 9
\SetRowColor{white}
Instability during stance & increased LE flex tone , flaccidity or weakness of extensor muscles. \tn 
% Row Count 28 (+ 4)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{{\emph{Ankle}}}}} \tn 
% Row Count 29 (+ 1)
% Row 11
\SetRowColor{white}
footdrop & increased ext tone, flaccidity \tn 
% Row Count 31 (+ 2)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.1169 cm} x{9.1531 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{gait deviations seen w/ stroke (cont)}}  \tn
% Row 12
\SetRowColor{LightBackground}
ankle \seqsplit{inversion/eversion} & increased tone in specific muscle groups, flaccidity \tn 
% Row Count 3 (+ 3)
% Row 13
\SetRowColor{white}
toe clawing & increased flexor tone in toe muscles. \tn 
% Row Count 5 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Neuro cranial nerves}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{1:olfactory} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{2=optic} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{3=oculomotor} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{4= trochlear} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{5=trigeminal} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{} \tn 
% Row Count 5 (+ 0)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{6=Abducens} \tn 
% Row Count 6 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{7=facial} \tn 
% Row Count 7 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{} \tn 
% Row Count 7 (+ 0)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{8=vestibulocochlear} \tn 
% Row Count 8 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{9=glossopharyngeal} \tn 
% Row Count 9 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{} \tn 
% Row Count 9 (+ 0)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{10=vagus} \tn 
% Row Count 10 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{} \tn 
% Row Count 10 (+ 0)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{11=spinal accessory} \tn 
% Row Count 11 (+ 1)
% Row 15
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{12=hypoglossal} \tn 
% Row Count 12 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{PNF techniques for facilitation}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/bmazelle_1632078345_PNF techniques for facilitation.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.687 cm} x{3.374 cm} x{11.809 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{PNF Pattern}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{17.67cm}}{{\bf{{\emph{UE}}}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
D1F & \seqsplit{flex-add-ER} & "close your hand, turn, pull arm across face" \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
D1E & \seqsplit{ext-abd-IR} & open your hand, turn and push your arm down and out \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
D2F & \seqsplit{Flex-abd-ER} & open hand, turn, lft your arm up and out \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
D2E & \seqsplit{ext-add-IR} & close hand, turn, pull arm down across body \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{3}{x{17.67cm}}{{\bf{{\emph{LE}}}}} \tn 
% Row Count 10 (+ 1)
% Row 6
\SetRowColor{LightBackground}
D1F & \seqsplit{flex-add-ER} & bring foot up, turn, and pull leg up and across your body \tn 
% Row Count 13 (+ 3)
% Row 7
\SetRowColor{white}
D1E & \seqsplit{ext-abd-IR} & push foot down, turn, push leg down and out \tn 
% Row Count 15 (+ 2)
% Row 8
\SetRowColor{LightBackground}
D2F & \seqsplit{Flex-abd-ER} & lift foot up, turn and lift leg up and out \tn 
% Row Count 17 (+ 2)
% Row 9
\SetRowColor{white}
D2E & \seqsplit{ext-add-IR} & push foot down, turn, and pull leg down and in. \tn 
% Row Count 19 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{17.67cm}}{108}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{3.5427 cm} x{6.5793 cm} x{6.748 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{UMN VS. LMN lesions}}  \tn
% Row 0
\SetRowColor{LightBackground}
 & {\bf{UMN}} & {\bf{LMN}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\seqsplit{Location} & CNS & PNS \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{structures} \seqsplit{involved} & Cortex, brainstem, corticospinal tracts, spinal cord & SC: anterior horn cell, spinal roots, peripheral nerves \{\{nl\}\} CN: cranial nerves \tn 
% Row Count 8 (+ 6)
% Row 3
\SetRowColor{white}
\seqsplit{Disorders} & stroke, TBI, SCI & Polio, guillan-Barre, PNI, peripheral neuropathy, radiculopathy \tn 
% Row Count 12 (+ 4)
% Row 4
\SetRowColor{LightBackground}
tone & hypertonia, velocity dependent & decreased or absent, hypotonia, flaccid \tn 
% Row Count 15 (+ 3)
% Row 5
\SetRowColor{white}
\seqsplit{Involuntary} \seqsplit{movements} & flexor or extensor muscle spasms & with denervation: fasciculations \tn 
% Row Count 18 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\seqsplit{strength} & stroke: paraparesis, \{\{nl\}\} corticospinal \seqsplit{lesions:contralateral} if above decussation in medulla, \{\{nl\}\}Spinal cord lesions: BL loss below level of lesion & Limited distribution: segmental or focal pattern, root innervated pattern. \tn 
% Row Count 29 (+ 11)
% Row 7
\SetRowColor{white}
Muscle bulk & disuse atrophy & neurogenic atrophy \tn 
% Row Count 31 (+ 2)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{3.5427 cm} x{6.5793 cm} x{6.748 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{UMN VS. LMN lesions (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
\seqsplit{Voluntary} \seqsplit{movement} & impaired or absent: dyssentric patterns, obligatory synergies & weak or absent if nerve interrupted \tn 
% Row Count 5 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Neuro  muscle tone abnormalities}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Hypertonia}}}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Decorticate rigidity}}: always an UMN lesion, sustained flexor posturing in the UE, sustained extensor posturing in the LE, Diencephalon lesion, sign of severe impairment} \tn 
% Row Count 5 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Decerebrate}}: always an UMNL, sustained ext posturing in the UE \& LE, Brainstem lesion, sign of severe impairment} \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Rigidity}}: Always an UMNL, resistance to passive stretch in agonist \& antagonist, Basal ganglia lesion} \tn 
% Row Count 11 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Cogwheel rigidity}}: ratchet-like response to quick passive movement; \seqsplit{catches/releases/catches.}} \tn 
% Row Count 13 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Leadpipe rigidity}}: constant rigidity \{\{nl\}\} .} \tn 
% Row Count 14 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Hypotonia}}}}} \tn 
% Row Count 15 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Flaccidity}}: LMNL, Cerebellar lesion, following spinal or cerebral shock, resolves or changes into spasticity.\{\{nl\}\}.} \tn 
% Row Count 18 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Ashworth Scale}}}}\{\{nl\}\} 0: No increased tone. \{\{nl\}\}1 or 1+: slight increase in tone. \{\{nl\}\} 2: moderate increase in tone. \{\{nl\}\}3: PROM is difficult. \{\{nl\}\} 4: affected joints are non-moveable (ankylosed)} \tn 
% Row Count 23 (+ 5)
% Row 9
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Deep tendon reflexes commonly tested}}}}\{\{nl\}\}Biceps: C5-C6\{\{nl\}\} Brachioradialis: C5-C6 \{\{nl\}\}Triceps: C7-C8\{\{nl\}\} Quadriceps: L2-L4 \{\{nl\}\} Hamstrings: L5-S3 \{\{nl\}\} Achilles: S1-S2} \tn 
% Row Count 27 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{glasgow coma scale}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/bmazelle_1632068817_gcs-new4[2].jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal ligaments, muscles, bones.}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Ligaments:}} primarily type one collagen types and very strong in scars, generally hypovascular contain mechanoreceptors which contribute to proprioception, free nerve endings which contribute to pain perception. There are varying intrinsic differences within ligaments leading to varying approaches for rehab: extra-articular ligaments heal in an organized and predictable manner while intraarticular ligaments do not heal spontaneously or in a predictable manner.  \newline % Row Count 10 (+ 10)
{\emph{Ligament sprains:}} 1-3 degree a few lig fibers - all are torn, caused by excessive load or stretch. pain with stretching (1 \& 2), decreased ROM,  \newline % Row Count 13 (+ 3)
{\bf{Muscle}}: Primarily made of loose, irregular connective tissue which makes the tissue more pliable and extensible, high vascularization and water content lead to faster healing times, easiest tissue to mobilize following trauma or period of immobilization. \newline % Row Count 19 (+ 6)
{\emph{Strain:}} muscle fibers torn caused by excessive load or stretch to muscle. Weakness, muscle spasms, swelling, disability, pain with isometric contraction, stretches,  \newline % Row Count 23 (+ 4)
{\bf{Bone}}: composed of two basic layers: strong, intense outer layer- contributes to its strength, softer, mesh inner layer- stores marrow, covered with periosteum- provides blood to the bone, constantly remodeling- wolf's law ( bone remodels based upon needs placed upon it)  \newline % Row Count 29 (+ 6)
{\emph{Fracture types: }} \newline % Row Count 30 (+ 1)
} \tn 
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal ligaments, muscles, bones. (cont)}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{ A.) complete: the bone is fx all the way through. Will require immobilization, may require ORIF through surgical intervention using screws, pins, plates to secure bone ends \newline % Row Count 4 (+ 4)
B.) Incomplete: disrupted integrity of bone. fragments are still somewhat connected. will require immobilization which depends on where it is and WB/NWB status \newline % Row Count 8 (+ 4)
C.) Stress fx: fine hairline fx occurring w/ little to no soft tissue damage. best seen on x ray 3-4 weeks after incident \newline % Row Count 11 (+ 3)
D) Open fx: bone protrudes out of skin. Requires open reduction, possibly internal fixation.  \newline % Row Count 13 (+ 2)
E) Greenstick fx: bone is bent and partially fx. typically happens to children because their bones are more flexible.% Row Count 16 (+ 3)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal Kinesiology and body mechanics}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Concave- convex rule: If the moving surface is convex, the glide will be in the opposite direction the bone moves. If the moving surface is concave, the glide will be in the same direction as the bone.  \newline % Row Count 5 (+ 5)
End Feels:  \newline % Row Count 6 (+ 1)
{\bf{normal end feels:}}  \newline % Row Count 7 (+ 1)
{\bf{Soft}}: soft tissue approximation \newline % Row Count 8 (+ 1)
{\bf{Firm}}: capsular and ligamentous stretching  \newline % Row Count 9 (+ 1)
{\bf{Hard}}: bone meets \newline % Row Count 10 (+ 1)
{\bf{ Abnormal end feels:}} \newline % Row Count 11 (+ 1)
{\bf{Boggy: }}edema, joint swelling  \newline % Row Count 12 (+ 1)
{\bf{Firm w/ decreased elasticity: }}fibrosis of soft tissue \newline % Row Count 14 (+ 2)
{\bf{Rubbery: }} muscle spasm \newline % Row Count 15 (+ 1)
{\bf{Empty:}} loose, then very hard, associated with pt muscle guarding to avoid pain  \newline % Row Count 17 (+ 2)
{\bf{Hypermobility: }} end feel later than opposite joint \newline % Row Count 19 (+ 2)
Joint 	{\bf{Close-pack position}} 	{\emph{loose-pack}} \newline % Row Count 20 (+ 1)
Facet (spine)	{\bf{Extension}} 	{\emph{Midway between flex \& extension}} \newline % Row Count 22 (+ 2)
Temporomandibular	{\bf{Clenched teeth}}	{\emph{Mouth slightly open}} \newline % Row Count 24 (+ 2)
GHJ 	{\bf{Abd \& ER}}	{\emph{55-70° Horiz Add, rotated so forearm is in transverse plane}} \newline % Row Count 26 (+ 2)
Acromioclavicular 	{\bf{Arm abducted to 90°}} 	{\emph{Arm resting by side, shoulder girdle in physiological position.}}  \newline % Row Count 29 (+ 3)
Ulnohumeral 	{\bf{Extension}} 	{\emph{70° elbow flex, 10° supination}}  \newline % Row Count 31 (+ 2)
} \tn 
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal Kinesiology and body mechanics (cont)}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Radiohumeral 	 {\bf{Elbow flex 90° forearm sup 5°}} 	{\emph{Full ext \& supination}}  \newline % Row Count 2 (+ 2)
Prox radioulnar	{\bf{5° supination}} 	{\emph{70° elbow flex 35° supination}} \newline % Row Count 4 (+ 2)
Dis radioulnar	{\bf{5° supination}} 	{\emph{10° supination}}  \newline % Row Count 6 (+ 2)
Radiocarpal 	{\bf{Ext with radial deviation}} 	{\emph{between flex- ext (straight line can pass through 3rd metacarpal \& radius) c  slight ulnar deviation}} \newline % Row Count 9 (+ 3)
Hip	{\bf{Full ext, IR \& abd}}	{\emph{30° flex, 30° abduction, \& slight ER}} \newline % Row Count 11 (+ 2)
Knee	{\bf{Full ext, \& ER of the tibia}} 	{\emph{25° flexion}} \newline % Row Count 13 (+ 2)
Talocrural 	{\bf{Max DF}} 	{\emph{10° PF, midway between inv \& ev.}} \newline % Row Count 15 (+ 2)
Common muscle substitutions:  \newline % Row Count 16 (+ 1)
{\emph{scapular stabilizers to initiate shoulder mvmt when shoulder abd are weak}} \newline % Row Count 18 (+ 2)
{\emph{lat trunk muscles or tensor fascia latae when hip abd are weak}}% Row Count 20 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{musculoskeletal joint mobilizations}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{joint mobilization indications: pain, hypomobility, muscle spasm and guarding, functional ROM limitation} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Joint mobilization contra: hypermobility, pregnancy, malignancy, unhealed fx, bone disease, effusion, inflammation, blood thinners} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{mob grades:\{\{nl\}\}grade 1: Small amp oscillation at beginning of range. \{\{nl\}\}grade 2: Large amp pushing into tissue resistance just short of joint caps. \{\{nl\}\} grade 3: Large amp stretches joint caps \{\{nl\}\} grade 4: Small amp high velocity manipulation past end of passive range} \tn 
% Row Count 12 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Special tests for musculoskeletal conditions}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{GHJ	 {\bf{Anterior instability }}	{\emph{apprehension test: assessment of anticipated pain when subject maintained 90 degrees Abd and ER of shoulder. }}} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Posterior and inferior instability}} 	{\emph{Jerk test: sudden jerk applied to shoulder in 90° flexion and IR (humeral head subluxes off the back of the glenoid)}} {\emph{Sulcus sign: an indentation occurs inferior to the acromion as distal distraction is applied to the humerus.}}} \tn 
% Row Count 9 (+ 6)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Subacromial impingement }}	{\emph{Hawkins- kennedy: passive 90° flex and IR reproduce pain}} {\emph{Neer's: Passive IR and full abd reproduce pain }} {\emph{Empty can: shoulder placed at 90° abd 30°horiz add, pain c resistance }}} \tn 
% Row Count 14 (+ 5)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Rotator cuff pathology }}	{\emph{Drop arm: unable to slowly lower arm passively abducted to 120°}} {\emph{Lag signs: pt unable to maintain IR/ ER}}} \tn 
% Row Count 17 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{ACJ}}	{\emph{H add: localized pain occurring during H add p/arom.}} 	{\bf{SLAP}}	{\emph{active compression: painful pop oc click in 90° flex, 10-15° add and full IR when downward force is applied }} {\emph{Biceps load 2: apprehension when asked to flex biceps against resistance at 120° abd. }}} \tn 
% Row Count 23 (+ 6)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Thoracic outlet syndrome }}	{\emph{Adson's: radial pulse diminish when arm is extended and ER, pt head rotated toward arm. }} *Roos: radial pulse diminishes when arm placed in 90° abd, slight H add, elbow flex to 90°, open and close fist for 3 mins.} \tn 
% Row Count 28 (+ 5)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\emph{ Elbow 	{\bf{Ligament instability }}	}}Varus/valgus stress: laxity noticed as varus and valgus stress applied to elbow in 20-0° flex{\emph{ }}Biceps rupture: Distal bunching of muscle noted and complete loss of function. *} \tn 
% Row Count 33 (+ 5)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Special tests for musculoskeletal conditions (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Neuro dys}}	{\emph{Flex: pain at the medial epicondyle of elbow, numbness and tingling in ulnar nerve distribution. Reproduced when pt hold c max elbow flex and wrist ext 1 min. Indicates cubital tunnel syndrome. }}} \tn 
% Row Count 5 (+ 5)
% Row 8
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Wrist \& hand  	{\bf{De Quervain's tenosynovitis (tendonitis of abductor pollicis longus or extensor pollicis brevis) }}	{\emph{eichoff's: pain reproduced when thumb is flexed across palm while moving into ulnar deviation. }} {\emph{Finkelstein: pain reproduced when wrist and thumb are pulled into ulnar deviation with distraction force. }}} \tn 
% Row Count 12 (+ 7)
% Row 9
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Neuro dys}}	{\emph{Phalen's (wrist flexion): tingling and paresthesia reproduced during max wrist flex and hold together for 1 min, indicates carpal tunnel compression of medial nerve. }} {\emph{Tinel sign: tingling and paresthesia are reproduced when tapping over carpal tunnel area compressing medial nerve. }} {\emph{2-pt discrimination: asses ability to detect 2 pts of contact at once on palm. }}} \tn 
% Row Count 20 (+ 8)
% Row 10
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Hip  	{\bf{DJD}}	{\emph{Scour/grind: P! when compressive force is applied to femur, hip 90° flex, knee max √}}} \tn 
% Row Count 23 (+ 3)
% Row 11
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Dys, mob restriction }}	{\emph{Patrick (faber): involved leg is unable to assume relaxed posture, P! symptoms c hip √, abd, ER, foot placed proximal to knee in supine }}} \tn 
% Row Count 27 (+ 4)
% Row 12
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Muscle length, strength involvement }}	{\emph{Thomas test: supine slingle leg hip and knee max √ , if opp limb flexes, indicates tightness of psoas major. }} {\emph{Ober: Passive hip extension and lowering from abd, sidelying, tightness of tensor facia lata and or iliotibial band.}} {\emph{Ely's : tightness of the rectus femoris when hip of tested limb lifts off testing surface with knee flexion, tested in prone. }} {\emph{Trendelenburg sign: observe pelvis of stance leg positive if ipsilateral hip drops when limb support is removed. Indicative of weak glut med or unstable hip }}} \tn 
% Row Count 39 (+ 12)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Special tests for musculoskeletal conditions (cont)}}  \tn
% Row 13
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Knee  	{\bf{1-plain anterior instability }}	{\emph{Lachman: + excessive anterior translation of the tibia compared to the uninvolved limb and lack of firm end feel.}}  {\emph{Anterior drawer : + excessive anterior translation of the tibia compared to the uninvolved limb. }}} \tn 
% Row Count 6 (+ 6)
% Row 14
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{1-plain posterior instability}}	{\emph{Posterior drawer: + excessive posterior translation of the tibia compared to the uninvolved limb. }} {\emph{Posterior sag: tibia sags posteriorly( normally extends 1 cm anteriorly beyond femoral condyle) when positioned supine, hip √ 45° knee √ 90° }}} \tn 
% Row Count 12 (+ 6)
% Row 15
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{1-plain medial-lateral instability }}	{\emph{Varus stress test: + excessive lateral mvmt or pain at the lateral knee}} {\emph{Valgus stress+ excessive medial mvmt or pain at the knee (both tests performed at 0° and 30°√, + at 0° √ indicates major disruption of the knee and one or more rotary tests +. }}} \tn 
% Row Count 18 (+ 6)
% Row 16
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Meniscus tear}} {\emph{McMurray: + reproduction of click and or pain in the knee joint with rotary force applied. }}} \tn 
% Row Count 21 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal  conditions and interventions}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Anklyosing Spondylitis}}: progressive inflammatory disorder that initially affects the axial skeleton, occurs before 40, affects thoracic and lumbar regions, BL SIJ, restricted P/AROM, flexed posture throughout entire spine. \{\{nl\}\} {\emph{Interventions}}: flexibility ex to maintain trunk motions and improve joint motions, especially ext. Implement aerobic such as aquatics for improved activity endurance. Include relaxation techniques such as breathing strategies for improved respiratory function} \tn 
% Row Count 10 (+ 10)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Psoriatic Arthritis}}: chronic erosive inflammatory disorder that typically occurs in the axial skeleton and digits. \{\{nl\}\} {\emph{Intervention}}: joint protection, aerobic activities for reconditioning} \tn 
% Row Count 14 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Rheumatoid arthritis}}: chronic systemic autoimmune disorder characterized by periods of acute exacerbation  and remission. weight loss, fever, extreme fatigue. \{\{nl\}\} {\emph{Interventions}}: joint protection strategies, aerobic conditioning, maintain joint mechanics and connective tissue function} \tn 
% Row Count 20 (+ 6)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Osteomalacia}}: decalcification of bones as a result of vit D deficiency, severe pain, fx, weakness, deformities. \{\{nl\}\} {\emph{Interventions}}: bone protections strat, areobic conditioning, improve joint mechanics} \tn 
% Row Count 25 (+ 5)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Osteochondritis dissecans}}:separation of articular cartilage from underlying bone. Usually involving medial femoral condyle near the intercondylar notch, sometimes occurs on the femoral head or the humeral capitellum. \{\{nl\}\} {\emph{Interventions}} stretches, bone protection strats, aerobic conditioning, strengthening, power and endurance ex.} \tn 
% Row Count 32 (+ 7)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal  conditions and interventions (cont)}}  \tn
% Row 5
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Tendinitis}}: inflammation of tendon caused by microtrauma, direct blow, overuse, excessive tensile force. \{\{nl\}\} {\emph{Interventions: }} manual, stretches, endurance conditioning, pt ed.} \tn 
% Row Count 4 (+ 4)
% Row 6
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Bursitis}}: inflammation of the bursa secondary to overuse, gout, or trauma, or infection. Characterized by pain with rest, and decreased P/AROM due to pain, not in capsular pattern. \{\{nl\}\} {\emph{Interventions}}: stretches, manual therapy, endurance training, modalities, pt ed.} \tn 
% Row Count 10 (+ 6)
% Row 7
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Myositis Ossificans}}: painful condition of abnormal calcification within muscle belly caused by direct trauma. most commonly located in the biceps, brachialis, and quads. \{\{nl\}\} AVOID AGRESSIVE STRETCHING. gentle stretches, manual therapy, endurance conditioning} \tn 
% Row Count 16 (+ 6)
% Row 8
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{GHJ dislocation}}: most common anterior, caused by abduction and forceful ER. Posterior is caused by H Add, and IR. s/p avoid painful positions which may include: GHJ flex 90 deg, H Abd 90+, ER 80.  \{\{nl\}\} {\emph{Interventions}}: restore normal GHJ motions, strength, endurance and stability.} \tn 
% Row Count 22 (+ 6)
% Row 9
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{patellofemoral conditions}}: abnormal malalignment of the patella. causes pain that is made worse with inactivity. \{\{nl\}\} {\emph{interventions}}: McConnel taping, Patellar mobilizations to lessen the abnormality. Correction of muscular imbalances.} \tn 
% Row Count 27 (+ 5)
% Row 10
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Osgood-schlatter}}: jumper's knee, Made worse with activity mechanical dysfunction resulting in traction apophysitis of the tibial tubercle at the patellar tendon insertion. Irregularities of the epiphyseal line.  \{\{nl\}\} {\emph{Interventions}}: modify activities to prevent excessive stress to irritated site.} \tn 
% Row Count 34 (+ 7)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Musculoskeletal  conditions and interventions (cont)}}  \tn
% Row 11
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Anterior compartment syndrome}}: Increased compartmental pressure resulting in local ischemic condition. caused by trauma, fx, overdose, muscle hypertrophy. characterized by deep achey feeling, swelling, parasthesia, severe pain, \{\{nl\}\} {\bf{Acute ACS is considered a medical emergency and requires immediate surgical intervention with fasciotomy to prevent tissue death and permanent disability.}}} \tn 
% Row Count 8 (+ 8)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{ION concentration changes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{hyperkalemia: increased potassium, widened PR interval, QRS wave, and tall T waves, tachycardia (potentially leading to bradycardia, potentially leading to cardiac arrest)} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Hypokalemia: ECG changes (flattened T wave, prolonged PR and QT intervals, hypotension, arrhythmias may progress to V-fib .} \tn 
% Row Count 7 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Hypercalcemia: hypertension, signs of heart block, cardiac arrest} \tn 
% Row Count 9 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{hypocalcemia: arrthmias, hypotension} \tn 
% Row Count 10 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{hypernatremia: increased sodium, hypertension, tachycardia, pitting edema, excessive weight gain} \tn 
% Row Count 12 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{hyponatremia: hypotension, tachycardia} \tn 
% Row Count 13 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{lab values and meaning}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/bmazelle_1632086745_blood cell count.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Lab values and meaning}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/bmazelle_1632086790_basic metabolic count.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{cardiovascular dx tests}}  \tn
% Row 0
\SetRowColor{LightBackground}
chest x-ray: lung condition, impact on lung from other conditions, blood vessels,  fx, other objects & considerations: radiation \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
ECG: records electrical activity, Exercise tolerance test & consider: monitored in room via radio transmission, continuous monitoring during intervention, prvide ex guidlines following cardiac procedure \tn 
% Row Count 13 (+ 8)
% Row 2
\SetRowColor{LightBackground}
myocardial perfusion imaging: ischemic areas of the heart, & considerations: can visualize areas of old infarct \tn 
% Row Count 16 (+ 3)
% Row 3
\SetRowColor{white}
cardiac catheterization, (coronary angiogram): x-ray images capture to evaluate BP in heart and O2 saturations, Stint & considerations: invasive, dye in arteries, requires IV, 2-3 hrs \tn 
% Row Count 22 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Skin changes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{clubbing: associated with chronic O2 deficiency and CHF} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{pale, shiny, dry, loss hair: PVD (arterial insufficency)} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{abnormal pigmentation, ulceration, dermatitis, gangrene: PVD} \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{heart anatomy pg142}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Right atrium: receives blood from systemic circulation from superior and inferior vena cava\{\{nl\}\} SA-node: near superior vena cava; pacemaker of the heart \{\{nl\}\} AV-node: node floor of Right atrium, receives signal from SA-node/ bundle of HIS, to depolarize and contract ventricles} \tn 
% Row Count 6 (+ 6)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Right ventricle: receives blood from RA which pumps blood through pulmonary artery to lungs for oxygenation} \tn 
% Row Count 9 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Left Atrium: receives oxygenated blood from lungs and 4 pulmonary veins} \tn 
% Row Count 11 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Left ventricle: walls are thicker and stronger than the RV and form most of the left side and apex of the heart. \{\{nl\}\} receives blood from the LA and pumps blood via the aorta throughout the entire circulatory system.} \tn 
% Row Count 16 (+ 5)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Heart valves}}}}} \tn 
% Row Count 17 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{Atrioventricular valves: prevent backflow of the blood into the atria during ventricular systole. close when ventricular walls contract. \{\{nl\}\}right heart valve tricuspid, left heart valve,(bicuspid, mitral)} \tn 
% Row Count 22 (+ 5)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{semilunar valves: prevent backflow of blood from the aorta and pulmonary arteries into the ventricles diastole\{\{nl\}\} pulmonary valve prevent right backflow. \{\{nl\}\} aortic valve prevents left backflow} \tn 
% Row Count 26 (+ 4)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Arteries, veins and capillaries}}}}} \tn 
% Row Count 27 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Arteries: transport oxygenated blood from the heart, decrease in size and become arterioles and end as capillaries. have contractile abilities, arterial walls are thicker in order to tolerate high BP. Influenced by elasticity and elasibility of vessle walls and peripheral resistance, amount of blood in body change in diameter when triggered by sympathetic activity of the ANS, vasoconstriction or vasodilation} \tn 
% Row Count 36 (+ 9)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{heart anatomy pg142 (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Veins: transport dark unoxygenated blood from peripheral tissues back to the heart. larger capacity and thinner, weaker walls than arteries, greater in number, one way valve to prevent backflow of blood because they do not have contractile abilities. rely on movement of muscle to squeeze blood back to the heart. Venous reflux occurs when the valves dont function properly caused by enlarged or weakened veins. deep veins accompany arteries while superfical's do not. increased blood return with inspiration, compliancy of right heart.} \tn 
% Row Count 11 (+ 11)
% Row 10
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{capillaries: minute blood vessels that connect the ends of arteries with the beginning of veins, functions for exchange of nutrients and fluids between blood and tissues. capillary walls are thin and permeable} \tn 
% Row Count 16 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{142,144,}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Heart failure}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Left ventricular failure}}}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{S\&S pulmonary congestion}}:dyspnea, dry cough, orthopnea, paroxysmal nocturnal dyspnea, pulmonary rales, wheezin.} \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{S\&S low cardiac output}}: hypotension, tachycardia, lightheaded/ dizziness, cerebral hypoxia(irritability, restlessness, confusion, impaired memory, sleep disturbances), fatigue, weakness, poor exercise tolerance, enlarged heart on x-ray, S3 sound, possibly S4. murmurs of mitral or tricuspid regurgitation.} \tn 
% Row Count 11 (+ 7)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{{\emph{Right ventricular failure}}}}} \tn 
% Row Count 12 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{S\&S pulmonary congestion}}:dependent edema, weight gain, ascites, liver enlargement} \tn 
% Row Count 14 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{S\&S low cardiac output}}: anorexia, nausea, bloating, cyanosis in the nail beds, RUQ pain, jugular vein distension, R-sided S3 heart sounds, murmurs of pulmonary or tricuspid insufficiency.} \tn 
% Row Count 18 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Cardiac medications}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/bmazelle_1632153899_cardiac-medications-1.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Tx considerations for cardiac meds}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Ace Inhibitors}}: watch for potential dizziness or orthostatic hypotension, NSAID's can reduce or negate the effects of the meds. monitor pt closely for elevated BP  \newline % Row Count 4 (+ 4)
{\bf{Ca+ channel blocker}}: use PRE scale for monitoring exertion levels. may reduce blood flow to heart muscle and create ischemic response. monitor for orthostatic hypotension.  \newline % Row Count 8 (+ 4)
{\bf{Alpha blockers}}: monitor for signs of hypotension, and reflex tachycardia; where heart rate increase to compensate for hypotension \newline % Row Count 11 (+ 3)
{\bf{Beta blockers}}: Use PRE scale, watch for bradycardia and OH, can worsen asthma symptoms.  \newline % Row Count 13 (+ 2)
{\bf{Diuretics}}: can cause fluid and electrolyte imbalances; observe pt for muscle weakness or spasms, headache, and poor coordination. Monitor for bradycardia and OH.  \newline % Row Count 17 (+ 4)
{\bf{Nitrates}}: observe for dizziness, tachycardia, and OH. Pt may c/o headache.% Row Count 19 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Lymphedema}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{etiology}}: primary lymphedema: congenital; Secondary lymphedema: occurs as a result of injury to lymphatic vessels or parasitic infection.} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Progressive over time}}: w/o tx, may develop into fibrosis, chronic infection, or loss of limb function} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Symptoms:}} heaviness, tightness, or pain, swelling, and persistent edema, loss of ROM and function in an arm or leg} \tn 
% Row Count 9 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{ Skin changes}}: hardening and/or discoloration of skin} \tn 
% Row Count 11 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Dx}}: history, visual inspection and palpation, girth measurements. \{\{nl\}\} tests may include: MRI \& CT scans; doppler ultrasound, radionuclide imaging of the lymphatic system.} \tn 
% Row Count 15 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Staging:}}0-latent, 1-spontaneously reversible, 2-spontaneously irreversible, 3- lymphostatic elephantiasis} \tn 
% Row Count 18 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Tx}}: complete decongestive therapy, manual lymph drainage, short stretch compression bandages, exercises, functional training, skin care and lymphedema education} \tn 
% Row Count 22 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{6.3899 cm} x{10.8801 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{pulmonary breathing muscles}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Resting Inspiration}} & Diaphragm (Phrenic nerve, C3-5) \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{Deep inspiration}} & Diaphragm; SCM, scalenes- elevate 2 upper ribs; levator costarum, scalenes- elevate remaining ribs; pec major, serratus posterior superior(SCM: CN XI, 2, 3, Scalene: lower cervical root) \tn 
% Row Count 10 (+ 8)
% Row 2
\SetRowColor{LightBackground}
{\bf{forced inspiration }} & muscles of resting and deep inspiration, trapezius, pectorals, serratus, levator scapula (traps: CNX1, pect: medial pectoral C8, T1, serratus: long thoracic C5-7, levator: C3-4,  dorsal scapular) \tn 
% Row Count 18 (+ 8)
% Row 3
\SetRowColor{white}
{\bf{resting expiration}} & same as resting inspiration, internal intercostals( intercostal nerve T2-6 \tn 
% Row Count 21 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{Forced expiration}} & muscles of forced inspiration+ abs, quadratus lumborum, lower iliocostalis, serratus posterior inferior. (abs: 7-12 intercostal nerves, iliohypogastric, ilioguinal nerve, QL: 12th thoracic \&1st lumbar nerves) \tn 
% Row Count 30 (+ 9)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{when having difficulty breathing, SCI pts should lay day to help decrease the effects of gravity upon the diaphragm and improve the inspiratory capacity of the lungs.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{pulmonary percussion positions}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/bmazelle_1632162274_pulmonary percussion.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{5.7358 cm} x{5.5671 cm} x{5.5671 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{17.67cm}}{\bf\textcolor{white}{pneumonia}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{{\emph{bacterial}}}} & {\bf{{\emph{Viral}}}} & {\bf{{\emph{Aspiration}}}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
shaking chills, fever, chest pain if pleuritic involved, productive or purulent, blood streaked, rusty sputum. cackles, tachypnea, increased white blood cell count, hypoxemia, hypocapnea leading to hypercapnea with increasing severity. CXR confirmation of infiltrate. & recent upper respiratory infection, fever, chills, dry cough, headaches, cackles, hypoxemia and hypercapnea, normal wbc count, CXR confirmation of interstitial infiltrate. & aspiration event, dry cough leading productive, dyspnea, tachypnea, cyanosis, tachycardia, wheezes and cackles, hypoxemia hypercapnea, chest pain, fevre, wbc count shows varying degrees of leykocytosis, CXR initially shows pneumonitis. chronic aspiration shows necrotizing pneumonia with cavitation . \tn 
% Row Count 26 (+ 24)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{pulmonary diseases}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{TB}}: airborne, incubation period: 2-10 weeks. to become noninfectious: 2 weeks on antituberculin drugs} \tn 
% Row Count 3 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}