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final-review 45

ortho 6 pathology

Achilles Tendon Rupture Typically occurs within one to two inches above the tendinous insertion on the calcaneus
Achilles Tendon Rupture Incidence is greatest between 30-50 years of age without history of calf or heel pain
Achilles Tendon Rupture Patients will typically be unable to stand on their toes and tend to exhibit a positive Thompson test
Adhesive Capsulitis Occurs more in the middle-aged population with females having a greater incidence than males
Adhesive Capsulitis Arthrogram can assist with diagnosis by detecting decreased volume of fluid within the joint capsule
Adhesive Capsulitis Range of motion restriction typically in a capsular pattern (lateral rotation, abduction, medial rotation)
Anterior Cruciate Ligament Sprain - Grade III Injury most commonly occurs during hyperflexion, rapid deceleration, hyperextension or landing in an unbalanced position
Anterior Cruciate Ligament Sprain - Grade III Females involved in selected athletic activities have significantly higher ligament injury rates compared to males
Anterior Cruciate Ligament Sprain - Grade III Approximately two-thirds of complete anterior cruciate ligament tears have an associated meniscal tear
Bicipital Tendonitis Increased incidence of injury is associated with selected athletic activities such as baseball pitching, swimming, rowing, gymnastics, and tennis
Bicipital Tendonitis Characterized by subjective reports of a deep ache directly in front and on top of the shoulder made worse with overhead activities or lifting
Bicipital Tendonitis Examination may reveal a positive Speedʼs test or Yergasonʼs test
Carpal Tunnel Syndrome Incidence is higher in females than males with the most common age being from 35-55 years of age
Carpal Tunnel Syndrome Muscle atrophy is often noted in the abductor pollicis brevis muscle and later in the thenar muscles
Carpal Tunnel Syndrome Electromyography studies, Tinelʼs sign, and Phalenʼs test can be used to assist with confirming the diagnosis
Congenital Torticollis Causes the neck to involuntarily contract to one side secondary to contraction of the sternocleidomastoid muscle
Congenital Torticollis The head is laterally flexed toward the contracted muscle, the chin faces the opposite direction, and there may be facial asymmetries
Congenital Torticollis Studies indicate that between 85-90% of patients with congenital torticollis respond to conservative treatment and passive stretching within the first year of life
Degenerative Spondylolisthesis Caused by the weakening of joints that allows for forward slippage of one vertebral segment on the one below due to degenerative changes
Degenerative Spondylolisthesis Most common site of degenerative spondylolisthesis is the L4-L5 level
Degenerative Spondylolisthesis Williamʼs flexion exercises may be indicated to strengthen the abdominals and reduce lumbar lordosis
Fibromyalgia Syndrome Nonarticular rheumatic condition with pain caused by tender points within muscles, tendons, and ligaments
Fibromyalgia Syndrome Greater incidence in females (almost 75% of the cases) potentially affecting any age
Fibromyalgia Syndrome Widespread history of pain that exists in all four quadrants of the body (above and below the waist), axial pain is present, and there is pain in at least 11 of 18 standardized “tender point” sites
Lateral Epicondylitis “Tennis Elbow” Characterized by inflammation or degenerative changes at the common extensor tendon that attaches to the lateral epicondyle of the elbow
Lateral Epicondylitis “Tennis Elbow Repeated overuse of the wrist extensors, particularly the extensor carpi radialis brevis can produce tensile stress and result in microscopic tearing and damage to the extensor tendon
Lateral Epicondylitis “Tennis Elbow Clinical symptoms include difficulty holding or gripping objects and insufficient forearm functional strength
Medial Collateral Ligament Sprain – Grade II Grade II injury is characterized by partial tearing of the ligamentʼs fibers resulting in joint laxity when the ligament is stretched
Medial Collateral Ligament Sprain – Grade II Mechanism of injury is usually a blow to the outside of the knee joint causing excess force to the medial side of the joint
Medial Collateral Ligament Sprain – Grade II Return to previous functional level should occur within four to eight weeks following the injury if no other associated structures are involved
Osteoarthritis Degenerative process primarily involving articular cartilage resulting from excessive loading of a healthy joint or normal loading of an abnormal joint
Osteoarthritis Typically diagnosed based on the results of a clinical examination and x-ray findings
Osteoarthritis Prevalence is higher among women than men with approximately 80-90% of individuals older than 65 years of age demonstrating evidence of osteoarthritis
Patellofemoral Syndrome Causes damage to the articular cartilage of the patella ranging from softening to complete cartilage destruction resulting in exposure of subchondral bone
Patellofemoral Syndrome Etiology is unknown, however, it is extremely common during adolescence, is more prevalent in females than males, and has a direct association with activity level
Patellofemoral Syndrome Management includes controlling edema, stretching, strengthening, improving range of motion, and activity modification
Plantar Fasciitis Chronic overuse condition that develops secondary to repetitive stretching of the plantar fascia through excessive foot pronation during the loading phase of gait
Plantar Fasciitis Characterized by severe pain in the heel when first standing up in the morning (when the fascia is contracted, stiff, and cold)
Plantar Fasciitis Intervention consists of ice massage, deep friction massage, heel insert, orthotic prescription, activity modification, and gentle stretching program of the Achilles tendon and plantar fascia
Rotator Cuff Tendonitis Caused by an inability of a weak supraspinatus muscle to adequately depress the head of the humerus in the glenoid fossa during elevation of the arm
Rotator Cuff Tendonitis Participating in activities that require excessive overhead activity such as swimming, tennis, baseball, painting, and other manual labor activities increase the risk of rotator cuff tendonitis
Rotator Cuff Tendonitis Patient may experience a feeling of weakness and identify the presence of a painful arc of motion most commonly occurring between 60 and 120 degrees of active abduction
Scoliosis Curvature is usually found in the thoracic or lumbar vertebrae and can be associated with kyphosis or lordosis
Scoliosis A patient with scoliosis that ranges between 25 and 40 degrees requires a spinal orthosis and physical therapy intervention for posture, flexibility, strengthening, respiratory function, and proper utilization of the spinal orthosis
Scoliosis Scoliosis does not usually progress significantly once bone growth is complete if the curvature remains below 40 degrees at the time of skeletal maturity
Temporomandibular Joint Dysfunction Females are at greater risk than males with the most common age ranging from 20-40 years of age
Temporomandibular Joint Dysfunction Clinical presentation includes pain (persistent or recurring), muscle spasm, abnormal or limited jaw motion, headache, and tinnitus
Temporomandibular Joint Dysfunction Intervention includes patient education, posture retraining, and modalities such as moist heat, ice, biofeedback, ultrasound, electrostimulation, TENS, and massage
Total Hip Arthroplasty Patients are typically over 55 years of age and have experienced consistent pain that is not relieved through conservative measures which serve to limit the patientʼs functional mobility
Total Hip Arthroplasty Posterolateral approach allows the abductor muscles to remain intact, however, there may be a higher incidence of post-operative joint instability due to the interruption of the posterior capsule
Total Hip Arthroplasty Cemented hip replacement usually allows for partial weight bearing initially, while a noncemented hip replacement requires toe touch weight bearing for up to six weeks
Total Knee Arthroplasty Primary indication for total knee arthroplasty is the destruction of articular cartilage secondary to osteoarthritis
Total Knee Arthroplasty Post-operative care may include a knee immobilizer, elevation of the limb, cryotherapy, intermittent range of motion using a continuous passive motion (CPM) machine, and initiation of knee protocol exercises
Total Knee Arthroplasty Patient education may include items such as avoiding excessive stress to the knee, avoid squatting, avoid quick pivoting, avoid using pillows under the knee while in bed, and avoid low seating
Transfemoral Amputation due to Osteosarcoma Osteosarcoma is a highly malignant cancer that begins in the medullary cavity of a bone and leads to the formation of a mass
Transfemoral Amputation due to Osteosarcoma A patient status post transfemoral amputation may present with fatigue, loss of balance, phantom pain or sensation, hypersensitivity of the residual limb, and psychological issues regarding the loss of the limb
Transfemoral Amputation due to Osteosarcoma Lying in a prone position is beneficial to decrease the incidence of a hip flexion contracture
Transtibial Amputation due to Arteriosclerosis Obliterans Arteriosclerosis obliterans results in ischemia and subsequent ulceration of the affected tissues
Transtibial Amputation due to Arteriosclerosis Obliterans A patient status post transtibial amputation may have a decrease in cardiovascular status depending on the frequency of intermittent claudication experienced prior to the amputation
Transtibial Amputation due to Arteriosclerosis Obliterans Preprosthetic intervention should focus on strength, range of motion, functional mobility, use of assistive devices, desensitization, and patient education for care of the residual limb
Created by: micah10



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