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Conditions Chap 7
Conditions Chap 7 SM
| Question | Answer |
|---|---|
| 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:
RadGirl13
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