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Conditions Chap 7

Conditions Chap 7 SM

QuestionAnswer
Avulsion When the ligament is completely or partially torn from their attachment to a bone
Bursae Closed sacs or cavities filled with synovial fluid & lined with a synovial membrane
Crepitation (Crepitus) Clicking or crackling sounds heard with joint movement
Fascia Specialized flat band of tissue just below the skin that covers & separates underlying tissues (muscle commonly)
Meniscus 2 Semi-Lunar cartilages found in the knee joint medially & laterally
Metatarsophalangeal (MTPJ) Pertaining to the metatarsus & phalanges of the toes (joint between the proximal phalanges & "base" of foot)Hallux-big toe
Metacarpophalangeal (MCPJ) The joint between the proximal phalanges & the metacarpals of hand (Knuckles) Bennett's & Boxer's FX's Pollux-thumb
Synovial Pertaining to a lubrication fluid around a joint, bursa, & tendon sheath
Lordosis Exaggerated inward curvature of the spine in the Lordotic region (Lower T/L spine)Protruding Abs & butt
Etiology of Lordosis Excessive Abdominal weight gain/tumors; pregnancy; high heels; pre-pub~rapid bone growth; Osteoporsis in elders
If you have persistent low back pain, what diseases should be ruled out prior to DX Lordosis? Degenerative & Congenital spinal diseases, Spondylitis (inflammation), conditions involving kidneys,prostate gland, aorta,& pancreas
What TXs are used for Lordosis Weight loss; Core training; Pelvic tilt/posture; birth; severe--spinal fusion & osteotomy
Importance of OT for Lordosis Preventive measures-posture, exercise, support devices; patient teaching & adjustments to sitting enviro's
Kyphosis Exaggerated outward curvature of the spine in the Upper Kyphotic region (upper T spine)Rounded shoulders & head protrudes forward
T/F-Patients suffering from Kyphosis will know at or soon after onset? False: Kyphosis is insidious & asymptomatic until Hump becomes obvious
What symptoms accompany Kyphosis Mild pain, fatigue, tenderness along spine, decreased spinal mobility, rounded shoulders, protruding head
Who should be screened for Kyphosis Pts w/complaints of persistant upper back pain, w/no HX of injury or symptoms of infection
Etiology of Kyphosis young children~~developmental; Adolescent~~Scheuermann's Dis(degen deform of T-spine); others=tumors, TB of vertebra, ankylosing spondylitis: older women
What modalities are used to DX Kyphosis Xray, bone scans/density tests, visual inspection
What TX is used for Kyphosis general~Core exercises (back muscles/lig's), back braces;If resp/cardia inv~spinal fusion/temp immobiliz; severe=vertebroplasty
what is vertebroplasty SX where balloon is inflated w/in vertebra & methyl methacrylate is inserted as a cement to reestablish vertebral height
Importance of OT to Kyphosis Preventitive measures-posture, exercises, support devices, support when seated. Med's for osteoporosis, pain & inflammation, Nutrition Calc & Vit D
What may a Pt w/kyphosis be lacking nutritionally Calcium & Vit D
Scoliosis lateral curvature of the spine
Who might be a typical scoliosis pt. adolescent female
Symptoms of scoliosis back pain, fatique, SOB w/exertion. observe~one shoulder or hip higher, enlarged muscle mass on one side of backside when bending
Etiology of Scoliosis Idiopathic most common; some genetic.
What are other suggested causes of scoliosis uneven leg lengths, muscle degeneration, paralysis from diseases--pliomyelitis, CP, MD
How is Scoliosis DX Visual. Eval'd for muscle weakness/disease, congenital cond's, neuro disords, DDD/spine degen. Xray confirms, measures & monitors
What TX is used for Scoliosis mild <40=exercise along w/bracing for adolescent. severe >40=surgical intervention to decrease curve, realign/stabilize; fusion; internal fixation (rods,wires,plates, screws)
Importance of OT to Scoliosis Posture training, bracing, instr to avoid stressing affect spine. KIDS W/SIGNIFICANT SHOULD AVOID AGGRESSIVE CONTACT SPORTS
Osteoarthritis DJD Arthritis that results from the breakdown & eventual loss of cartilage of 1 or more joints. most common Arthritis
Where does osteoarthritis normally occur Large weight bearing joints esp knees/hips, & PIPs
Is the onset of osteoarthritis noticeable No it is insidious
Where does osteoarthritis normally occur Large weight bearing joints esp knees/hips, & PIPs
Is the onset of osteoarthritis noticeable No it is insidious
Common symptoms of osteoarthritis joint soreness, aching, stiffness esp a.m./weather, edema, dull pain, deformity, crepitus
Etiology of osteoarthritis idiopathic-gen assoc w/aging
How is osteoarthritis DX Eval to exclude 100+ other arthritis then-Xray, CT, MRI
How is osteoarthritis TX PT & Drug Ther, nutrition, SX (severe)
Is osteoarthritis curable No
Is osteoarthritis curable No
How is osteoarthritis TX PT & Drug Ther, nutrition, SX (severe)
Is osteoarthritis curable No
How is osteoarthritis TX PT & Drug Ther, nutrition, SX (severe)
Importance of OT to osteoarthritis ROM, Alt moist heat/ice, massage, compression, splints, analgesics, muscle relaxers, Nsaids, steroid inject's, hyaluronic acid, fish oil, glucosamine, chondroitin, SX-hip rplmt, 1st MCj,Knee (ankle,wrist,elbow,shoulder) fusion-c/l spine
What are you going to teach osteoarthritic pts Diet, supplements, meds, exercise
Bursitis Inflammation of a bursa
Symptoms of Bursitis tenderness when moving part, flexion/extension limitation, edema at site.
most common bursitis sites shoulder, knee, hip, tibia (tendon/muscle)
if bursae are continually or chronically inflammed, what can occur calcifications and/or adhesions
how is bursitis DX evaluation if no injury from Hx & exam-poss gout/arthritis. Puncture wounds-look for infection. MRI & Xray indicate-aspiration for inflamed or septic bursae
How is bursitis tX Acute-moist heat, immobilize, aspirin, antiinflam's (nonsteroid), corticoids. Drainage, antibiotics if needed. Ice for chronic
Is bursitis curable yes
Importance of OT to bursitis positioning (prolonged leaning/kneeling on area)avoiding repititous movement (throwing),education on aggravating factors
Osteomyelitis serious infection of the bone requiring aggressive antibiotic TX
Symptoms of Osteomyelitis Inflammation, swelling, localized heat, redness, pain, local tenderness @ site, chills, fever, sweating, malaise. (eventually can have subperiosteal abscess-causes pressure/fx)
Osteomyelitis serious infection of the bone requiring aggressive antibiotic TX
Symptoms of Osteomyelitis Inflammation, swelling, localized heat, redness, pain, local tenderness @ site, chills, fever, sweating, malaise. (eventually can have subperiosteal abscess-causes pressure/fx)
Most common bones involved in osteomyelitis Proximal ends of humerus & tibia, distal end of femur , occasionally vertebrae
how does osteomyelitis usually begin as an acute infection (bacteria 90% staph/ strep next largest)
How is osteomyelitis DX aspiration & culture , WBC, ESR,MRI, CT, bone scans
how does osteomyelitis usually begin as an acute infection (bacteria 90% staph/ strep next largest)
What are some pre-disposing factors for people diabetes mellitus, PVD peripheral vascular disease, prosthetic hardware. also sickle cell, immuno's, ped's as secondary from strep
How is osteomyelitis DX aspiration & culture , WBC, ESR,MRI, CT, bone scans
What are some pre-disposing factors for people diabetes mellitus, PVD peripheral vascular disease, prosthetic hardware. also sickle cell, immuno's, ped's as secondary from strep
How is osteomyelitis TX long term parenterel antibiotics, vit ABC for cell regen, bed rest, control of chronic cond's, immobilization, drainage of purulent material (bone abcess)
Is osteomyelitis curable yes
Importance of osteomyelitis to OT Educate pts on importance of antibiotic TX-may have PICC line
How is osteomyelitis TX long term parenterel antibiotics, vit ABC for cell regen, bed rest, control of chronic cond's, immobilization, drainage of purulent material (bone abcess)
is osteomyelitis preventable not usually--randomly occurs. people w/predisposed cond's should watch for signs of infection & report
How is osteomyelitis TX long term parenterel antibiotics, vit ABC for cell regen, bed rest, control of chronic cond's, immobilization, drainage of purulent material (bone abcess)
Importance of osteomyelitis to OT Educate pts on importance of antibiotic TX-may have PICC line
Is osteomyelitis curable yes
is osteomyelitis preventable not usually--randomly occurs. people w/predisposed cond's should watch for signs of infection & report
Importance of osteomyelitis to OT Educate pts on importance of antibiotic TX-may have PICC line
Gout chronic metabolic disorder of uric acid; overproduction or decreased extretion of uric acid & urate salts
symptoms of gout manifests as acute episodes of arthritis, hard nodules of uric acid deposits in tissues, kidney stones, affects Hallux-severe pain, joints of feet, ankles, knees, hands; slight fever, chills, headache, nausea. symptom free between attacks
who does gout usually affect mostly men after puberty, some women after menopause
Patient complaints with gout severe acute joint pain, mild systemic symptoms
Etiology of gout Inherited abnormal metabolic condition; lack of enzyme(uricase) . renal gout=kidney disf. predisp fx= excessive wt.gain, leukemias, lymphomas, diuretics & TB meds
How is gout DX Eval'd to exclude many other arthr's--R/A, spondylitis, reactive arth, joint infect; xray to assess damage to joints, aspirate synovial fluid to see uric acid deposits
tophi deposit of monosodium urate crystals in people with longstanding high levels of uric acid in the blood
How is gout TX Bed rest, ice packs, immobilization, Nsaids, corticoids, low-purine diet, fluids, dairy prod's, meds, wt. loss
Is gout curable No but maneagable. limit alcohol, avoid dehydrating, eat proper-low purine(cert protein, yeast), high dairy
Osteoporosis loss of bone density-bone becomes porous, spongy & compressible
symptoms of osteoporosis SILENT DISEASE! deterioration of bone mass/density;
who is most likely to get osteoporosis post menopausal women; small boned, n.european/asian, smokers w/fam hx
Etiology of osteoporosis Most common metabolic bone disease. imbalance between catabolic & anabolic bone manufacturing. originate from hormonal or dietary factors or trauma, also radiation, smoking, alcohol, immobility, R/A, malabsorption, calcium-wasting nephropathy
how is osteoporosis DX Screened when fX or cancer screens,hormonal imbalances, kidney disease, by blood serum, xray, CT & bone scans, DEXA is best (dual energy xray absorptiometry)
How is Osteoporosis TX Increased Calcium, CACO3, CACO3 w NaF,Phosphate supp's, Vit's esp. D, estrogen replacement, Bisphosphonate (BP)--Fosamax, Calcitonin, boniva reclast. Exercise, PT
Importance of OT to Osteoporosis strength trng, weight bear exercise, adaptations-equip/techniques, home safety:teach healthy diets, vit D/calcium intake, exercise prog's, fall risk ed to prevent fx's.
Osteomalacia/Ricketts Defective mineralization of bones causing them to become soft, flexible, & deformed.Called ricketts in ped's
symptoms of osteomalacia general fatigue, progressive stiffness, tender painful bones, backaches, muscle twitches/cramps, difficulty standing up. progressively fx's, bowing legs, chest deformity, spine shortening
Etiology of osteomalacia lack of Vit D--can't absorb Ca & P, lack of sunshine, chronic renal diseases
How is osteomalacia DX blood tests, ESR, Xrays, bone scans/biopsies, screening for metabolic disorders
How is osteomalacia TX Vit D supp's with Ca, Calcitonin, sunlight exposure, TX underlying disorders
Importance of osteomalacia to OT Encourage good health, Adaptations/equipment, parental educ for ped's
FX-Break chip in bone
FX-closed simple-skin intact
FX-compound open--skin broken. more severe--infection risk (osteomyelitis)
FX-longitudinal length of bone--usually long bone (along diaphysis)--like hairline crack
FX-Transverse horizontally straight across bone
FX-oblique at any angle on bone
FX-greenstick on oneside-not broken thru completely-other side bent. common to see in children(swing falls) or adult phalanges (like a green twig that doesn't break all the way thru)
FX-comminuted several breaks/pieces
FX-impacted compresses bones into each other--shortens (spine, hip, shoulder)
FX-pathologic bone breaks in an area that is weakened by another disease process. Causes of weakened bone include tumors, infection, and certain inherited bone disorders. FX usually occurs w/normal activity
FX- non-displaced pieces of bone are still in alignment
FX- displaced pieces of bone are not aligned
FX- Spiral bone FX caused by a twisting force. common in sports, abuse, water skiing
FX-Avulsion an injury to the bone in the area where a tendon or ligament attaches to the skeleton. common to the 3rd phalanx on the palmar side of the hand
FX-Depression skull driven inward usually from blunt force trauma
FX-Colle's Distal Radial head fX --common to breaking a fall (cast)
FX- Humeral obvious displacement with shortening of the extremity & abnormal mobility. closed reduction. use sling (w/cast)
FX-Pelvic ORIF-open reduction internal fixation=glue, wires, sutures, pins, plates, screws, SX Bedrest, immobilize/traction. usually due to severe trauma/accident, sometimes pathology
FX-HIP usually FALL--elderly (femoral surgical neck),Trauma, osteoporosis, pathology; Outward rotation (foot) w/shortening of extremity; SX w/prosthesis or pins/both if comminuted/impacted
FX-Femoral CAR WRECK/severe trauma; CASTED; immobilize YOUNG ADULTS, EFD-external fixation device-on long bones, comminuted
FX-Tibial Sports, trauma, impact--strong force on lower leg; Open or Closed Reduction; CAST
FX-Vertebral C-spine=Accelerate/decelerate (whiplash); immobilize: T/L spine-immobilize: SX repair & hardware-rods/plates
Orthotics for Hand/wrist--
Adhesive Capsulitis frozen shoulder
shin splints inflammation of periostium, extensor muscles in lower leg & surrounding tissues. overuse/overpronation. ice/nsaids
Calcaneal spur plantar fasciitis. inflammatory response @ bottom of calcaneus. occurs when inflexible fascia is repeatedly under tension (running/heels/age/family/toe running/shoes)
Torn meniscus usually sports related from sudden twisting or external rotation of leg while knee is flexed
Created by: Shannon Manigault Shannon Manigault on 2012-10-04



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