NPTE key terms

Forceful exhalation against a closed glottis that sharply raises intrathoracic pressure, briefly reducing venous return and cardiac output before blood pressure rebounds; it can provoke arrhythmia or syncope in at-risk patients.

A life-threatening syndrome in spinal cord injury above roughly T6 in which a noxious stimulus below the lesion triggers unchecked sympathetic outflow, producing severe hypertension, pounding headache, flushing, and sweating; sit the patient upright and remove the stimulus.

One MET equals the resting oxygen consumption of about 3.5 mL/kg/min; activity intensities are expressed as multiples of this value, letting clinicians estimate the cardiac and metabolic demands of tasks and exercise programs.

Heart rate multiplied by systolic blood pressure, an indirect index of myocardial oxygen demand; clinicians monitor it during exercise to keep cardiac workload within safe limits, especially after myocardial infarction.

Infection-control practices applied to every patient regardless of diagnosis, including hand hygiene, gloves, gowns, masks, and eye protection whenever contact with blood or other body fluids is anticipated.

A physician's order specifying how much body weight a limb may accept during mobility, such as non-weight-bearing, partial, weight-bearing as tolerated, or full; exceeding the order can disrupt healing or hardware.

A 14-item performance test scoring sitting, standing, transfers, and reaching tasks from 0 to 4 for a maximum of 56; lower scores indicate greater fall risk and need for supervision.

Accidental puncture by a contaminated needle or blade; immediate response includes washing the site, reporting the exposure, and evaluating need for post-exposure prophylaxis because of bloodborne pathogen transmission risk.

A patient's voluntary agreement to examination or intervention after receiving understandable information about purpose, risks, benefits, and alternatives; the appropriately credentialed provider obtains and documents it before proceeding.

Failure to provide the care a reasonably prudent clinician would deliver in similar circumstances; a claim requires proving duty, breach of that duty, causation, and damages.

Federal law protecting the privacy and security of individually identifiable health information, governing when protected health information may be shared and requiring safeguards in clinical, research, and communication settings.

The legally defined set of activities a licensed clinician may perform, established by state statute and board rules; practicing outside those boundaries exposes the clinician to disciplinary action and liability.

A legal duty of clinicians to notify designated authorities of specified events such as suspected child or elder abuse, certain communicable diseases, or unsafe drivers, regardless of the patient's objection.

A study in which participants are randomly assigned to intervention or comparison groups, distributing known and unknown confounders between groups and supporting causal inference about treatment effects.

Sensitivity is the proportion of people with the condition who test positive; specificity is the proportion without the condition who test negative. Both describe test accuracy independent of how common the condition is.

A ratio comparing how likely a given test result is in people with the condition versus those without it; positive values above 10 and negative values below 0.1 substantially shift diagnostic suspicion.

The number of patients who must receive a treatment for one additional person to achieve the desired outcome; it is the reciprocal of the absolute risk reduction, and smaller values indicate greater benefit.

The smallest change in an outcome score that a patient would perceive as beneficial, used to judge whether a statistically significant result actually matters in practice.

A ranking of study designs by vulnerability to bias, from systematic reviews of randomized trials at the top, through cohort, case-control, and case series designs, to expert opinion at the bottom.

The characteristic proportional loss of passive range in a joint when the entire capsule is involved, such as limited external rotation and abduction at the shoulder; it suggests capsular rather than focal pathology.

The quality of resistance the examiner feels at the limit of passive motion, described as bony, capsular, soft tissue approximation, muscle spasm, or empty; it helps distinguish normal from abnormal joint restriction.

A guide to mobilization direction: when a convex surface moves on a concave one, roll and glide occur in opposite directions; when a concave surface moves on a convex one, they occur in the same direction.

Bone remodels along lines of mechanical stress, adding mass where loading is repeated and losing mass where it is absent; this underpins progressive weight-bearing during bone healing and unloading during immobilization.

Pain out of proportion, tightness, and pain with passive stretch within a closed fascial compartment after trauma or exertion, threatening muscle and nerve viability; it is an emergency requiring urgent decompression.

The number of standard deviations a patient's bone mineral density lies above or below the young adult mean; values of -2.5 or lower define osteoporosis and flag fracture risk during exercise or mobilization.

Findings after damage to the corticospinal tract above the anterior horn cell, including hyperreflexia, spasticity, clonus, Babinski sign, and loss of fine dexterity, often with broadly distributed weakness.

Findings after damage to the anterior horn cell, nerve root, or peripheral nerve, including flaccidity, hyporeflexia, atrophy, and fasciculations, with weakness confined to muscles supplied by the affected nerve.

Rhythmic, involuntary contractions evoked by sudden passive stretch of a spastic muscle, most often tested at the ankle; sustained beats indicate hyperexcitable stretch reflexes from upper motor neuron lesions.

Extension of the great toe with fanning of the other toes when the lateral sole is stroked; normal in infants but after about age two it indicates corticospinal tract damage.

An eight-level description of cognitive and behavioral recovery after traumatic brain injury, running from no response through confused and agitated stages to purposeful, appropriate, and modified independent function.

A six-point ordinal scale grading resistance to passive movement from no increase in tone to rigid flexion or extension, used to quantify spasticity and track response to intervention.

Breakdown of the axon and myelin distal to a nerve injury, followed by regrowth from the proximal stump at roughly one millimeter per day; recovery depends on the type and level of injury.

A drop in blood pressure on assuming upright posture, commonly defined as at least 20 mmHg systolic or 10 mmHg diastolic within three minutes, causing dizziness and falls; managed with slow position changes and compression.

The ratio of ankle systolic pressure to brachial systolic pressure measured with Doppler; values near 1.0 are normal, below 0.9 suggest peripheral arterial disease, and very low values warn against compressive bandaging.

Three conditions that promote thrombosis: venous stasis, endothelial injury, and hypercoagulability; it explains deep vein thrombosis risk after surgery, during immobilization, and in patients with cancer or clotting disorders.

The fraction of forced vital capacity exhaled in the first second of a forced maneuver; a reduced ratio indicates airflow obstruction, while a preserved or high ratio with reduced FVC suggests restriction.

The volume of each breath that does not participate in gas exchange, combining anatomic airway volume with alveoli that are ventilated but poorly perfused; it rises with pulmonary embolism and low cardiac output.

The principle that greater filling of the ventricles stretches cardiac muscle and strengthens the next contraction, within limits; excessive stretch in heart failure reduces effective output.