Conditions Chap 7 SM
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| Avulsion | When the ligament is completely or partially torn from their attachment to a bone
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| Bursae | Closed sacs or cavities filled with synovial fluid & lined with a synovial membrane
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| Crepitation (Crepitus) | Clicking or crackling sounds heard with joint movement
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| Fascia | Specialized flat band of tissue just below the skin that covers & separates underlying tissues (muscle commonly)
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| Meniscus | 2 Semi-Lunar cartilages found in the knee joint medially & laterally
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| Metatarsophalangeal (MTPJ) | Pertaining to the metatarsus & phalanges of the toes (joint between the proximal phalanges & "base" of foot)Hallux-big toe
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| Metacarpophalangeal (MCPJ) | The joint between the proximal phalanges & the metacarpals of hand (Knuckles) Bennett's & Boxer's FX's Pollux-thumb
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| Synovial | Pertaining to a lubrication fluid around a joint, bursa, & tendon sheath
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| Lordosis | Exaggerated inward curvature of the spine in the Lordotic region (Lower T/L spine)Protruding Abs & butt
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| Etiology of Lordosis | Excessive Abdominal weight gain/tumors; pregnancy; high heels; pre-pub~rapid bone growth; Osteoporsis in elders
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| 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
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| What TXs are used for Lordosis | Weight loss; Core training; Pelvic tilt/posture; birth; severe--spinal fusion & osteotomy
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| Importance of OT for Lordosis | Preventive measures-posture, exercise, support devices; patient teaching & adjustments to sitting enviro's
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| Kyphosis | Exaggerated outward curvature of the spine in the Upper Kyphotic region (upper T spine)Rounded shoulders & head protrudes forward
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| T/F-Patients suffering from Kyphosis will know at or soon after onset? | False: Kyphosis is insidious & asymptomatic until Hump becomes obvious
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| What symptoms accompany Kyphosis | Mild pain, fatigue, tenderness along spine, decreased spinal mobility, rounded shoulders, protruding head
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| Who should be screened for Kyphosis | Pts w/complaints of persistant upper back pain, w/no HX of injury or symptoms of infection
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| Etiology of Kyphosis | young children~~developmental; Adolescent~~Scheuermann's Dis(degen deform of T-spine); others=tumors, TB of vertebra, ankylosing spondylitis: older women
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| What modalities are used to DX Kyphosis | Xray, bone scans/density tests, visual inspection
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| 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
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| what is vertebroplasty | SX where balloon is inflated w/in vertebra & methyl methacrylate is inserted as a cement to reestablish vertebral height
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| Importance of OT to Kyphosis | Preventitive measures-posture, exercises, support devices, support when seated. Med's for osteoporosis, pain & inflammation, Nutrition Calc & Vit D
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| What may a Pt w/kyphosis be lacking nutritionally | Calcium & Vit D
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| Scoliosis | lateral curvature of the spine
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| Who might be a typical scoliosis pt. | adolescent female
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| 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
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| Etiology of Scoliosis | Idiopathic most common; some genetic.
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| What are other suggested causes of scoliosis | uneven leg lengths, muscle degeneration, paralysis from diseases--pliomyelitis, CP, MD
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| How is Scoliosis DX | Visual. Eval'd for muscle weakness/disease, congenital cond's, neuro disords, DDD/spine degen. Xray confirms, measures & monitors
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| 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)
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| Importance of OT to Scoliosis | Posture training, bracing, instr to avoid stressing affect spine. KIDS W/SIGNIFICANT SHOULD AVOID AGGRESSIVE CONTACT SPORTS
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| Osteoarthritis DJD | Arthritis that results from the breakdown & eventual loss of cartilage of 1 or more joints. most common Arthritis
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| Where does osteoarthritis normally occur | Large weight bearing joints esp knees/hips, & PIPs
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| Is the onset of osteoarthritis noticeable | No it is insidious
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| Where does osteoarthritis normally occur | Large weight bearing joints esp knees/hips, & PIPs
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| Is the onset of osteoarthritis noticeable | No it is insidious
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| Common symptoms of osteoarthritis | joint soreness, aching, stiffness esp a.m./weather, edema, dull pain, deformity, crepitus
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| Etiology of osteoarthritis | idiopathic-gen assoc w/aging
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| How is osteoarthritis DX | Eval to exclude 100+ other arthritis then-Xray, CT, MRI
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| How is osteoarthritis TX | PT & Drug Ther, nutrition, SX (severe)
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| Is osteoarthritis curable | No
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| Is osteoarthritis curable | No
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| How is osteoarthritis TX | PT & Drug Ther, nutrition, SX (severe)
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| Is osteoarthritis curable | No
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| How is osteoarthritis TX | PT & Drug Ther, nutrition, SX (severe)
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| 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
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| What are you going to teach osteoarthritic pts | Diet, supplements, meds, exercise
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| Bursitis | Inflammation of a bursa
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| Symptoms of Bursitis | tenderness when moving part, flexion/extension limitation, edema at site.
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| most common bursitis sites | shoulder, knee, hip, tibia (tendon/muscle)
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| if bursae are continually or chronically inflammed, what can occur | calcifications and/or adhesions
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| 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
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| How is bursitis tX | Acute-moist heat, immobilize, aspirin, antiinflam's (nonsteroid), corticoids. Drainage, antibiotics if needed. Ice for chronic
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| Is bursitis curable | yes
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| Importance of OT to bursitis | positioning (prolonged leaning/kneeling on area)avoiding repititous movement (throwing),education on aggravating factors
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| Osteomyelitis | serious infection of the bone requiring aggressive antibiotic TX
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| Symptoms of Osteomyelitis | Inflammation, swelling, localized heat, redness, pain, local tenderness @ site, chills, fever, sweating, malaise. (eventually can have subperiosteal abscess-causes pressure/fx)
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| Osteomyelitis | serious infection of the bone requiring aggressive antibiotic TX
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| Symptoms of Osteomyelitis | Inflammation, swelling, localized heat, redness, pain, local tenderness @ site, chills, fever, sweating, malaise. (eventually can have subperiosteal abscess-causes pressure/fx)
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| Most common bones involved in osteomyelitis | Proximal ends of humerus & tibia, distal end of femur , occasionally vertebrae
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| how does osteomyelitis usually begin | as an acute infection (bacteria 90% staph/ strep next largest)
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| How is osteomyelitis DX | aspiration & culture , WBC, ESR,MRI, CT, bone scans
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| how does osteomyelitis usually begin | as an acute infection (bacteria 90% staph/ strep next largest)
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| 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
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| How is osteomyelitis DX | aspiration & culture , WBC, ESR,MRI, CT, bone scans
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| 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
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| 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)
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| Is osteomyelitis curable | yes
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| Importance of osteomyelitis to OT | Educate pts on importance of antibiotic TX-may have PICC line
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| 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)
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| is osteomyelitis preventable | not usually--randomly occurs. people w/predisposed cond's should watch for signs of infection & report
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| 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)
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| Importance of osteomyelitis to OT | Educate pts on importance of antibiotic TX-may have PICC line
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| Is osteomyelitis curable | yes
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| is osteomyelitis preventable | not usually--randomly occurs. people w/predisposed cond's should watch for signs of infection & report
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| Importance of osteomyelitis to OT | Educate pts on importance of antibiotic TX-may have PICC line
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| Gout | chronic metabolic disorder of uric acid; overproduction or decreased extretion of uric acid & urate salts
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| 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
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| who does gout usually affect | mostly men after puberty, some women after menopause
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| Patient complaints with gout | severe acute joint pain, mild systemic symptoms
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| 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
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| 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
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| tophi | deposit of monosodium urate crystals in people with longstanding high levels of uric acid in the blood
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| How is gout TX | Bed rest, ice packs, immobilization, Nsaids, corticoids, low-purine diet, fluids, dairy prod's, meds, wt. loss
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| Is gout curable | No but maneagable. limit alcohol, avoid dehydrating, eat proper-low purine(cert protein, yeast), high dairy
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| Osteoporosis | loss of bone density-bone becomes porous, spongy & compressible
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| symptoms of osteoporosis | SILENT DISEASE! deterioration of bone mass/density;
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| who is most likely to get osteoporosis | post menopausal women; small boned, n.european/asian, smokers w/fam hx
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| 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
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| 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)
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| 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
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| 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.
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| Osteomalacia/Ricketts | Defective mineralization of bones causing them to become soft, flexible, & deformed.Called ricketts in ped's
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| 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
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| Etiology of osteomalacia | lack of Vit D--can't absorb Ca & P, lack of sunshine, chronic renal diseases
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| How is osteomalacia DX | blood tests, ESR, Xrays, bone scans/biopsies, screening for metabolic disorders
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| How is osteomalacia TX | Vit D supp's with Ca, Calcitonin, sunlight exposure, TX underlying disorders
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| Importance of osteomalacia to OT | Encourage good health, Adaptations/equipment, parental educ for ped's
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| FX-Break | chip in bone
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| FX-closed | simple-skin intact
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| FX-compound | open--skin broken. more severe--infection risk (osteomyelitis)
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| FX-longitudinal | length of bone--usually long bone (along diaphysis)--like hairline crack
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| FX-Transverse | horizontally straight across bone
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| FX-oblique | at any angle on bone
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| 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)
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| FX-comminuted | several breaks/pieces
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| FX-impacted | compresses bones into each other--shortens (spine, hip, shoulder)
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| 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
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| FX- non-displaced | pieces of bone are still in alignment
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| FX- displaced | pieces of bone are not aligned
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| FX- Spiral | bone FX caused by a twisting force. common in sports, abuse, water skiing
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| 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
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| FX-Depression | skull driven inward usually from blunt force trauma
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| FX-Colle's | Distal Radial head fX --common to breaking a fall (cast)
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| FX- Humeral | obvious displacement with shortening of the extremity & abnormal mobility. closed reduction. use sling (w/cast)
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| 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
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| 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
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| FX-Femoral | CAR WRECK/severe trauma; CASTED; immobilize YOUNG ADULTS, EFD-external fixation device-on long bones, comminuted
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| FX-Tibial | Sports, trauma, impact--strong force on lower leg; Open or Closed Reduction; CAST
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| FX-Vertebral | C-spine=Accelerate/decelerate (whiplash); immobilize: T/L spine-immobilize: SX repair & hardware-rods/plates
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| Orthotics | for Hand/wrist--
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| Adhesive Capsulitis | frozen shoulder
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| shin splints | inflammation of periostium, extensor muscles in lower leg & surrounding tissues. overuse/overpronation. ice/nsaids
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| Calcaneal spur | plantar fasciitis. inflammatory response @ bottom of calcaneus. occurs when inflexible fascia is repeatedly under tension (running/heels/age/family/toe running/shoes)
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| Torn meniscus | usually sports related from sudden twisting or external rotation of leg while knee is flexed
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