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109 ch. 68
Mgmt of Pts w/ musculoskeletal Disorders
| Question | Answer |
|---|---|
| What is term of pain radiating down leg | radiculopathy or sciatica |
| What usually relieves acute low back pain? Chronic? | Low back pain: NSAIDS, heat, manipulation chronic: tricyclic antidepressants |
| What is bursitis/tendinitis | inflammatory condition of bursae sacs |
| what is impingement syndrome | lesions that involve the rotator cuff of shoulder |
| what is carpal tunnel syndrome | median nerve at wrist is compressed by thickened tendon sheath, skeletal encroachment, edema or soft tissue mass |
| What sign is used for carpal tunnel syndrome | Tinel's sign |
| what is treatment of carpal tunnel | open nerve release or endoscopic laser surgery |
| what are ganglion | collection of gelatinous material near tendon sheaths adn joints on wrist. TX: aspiration, corticosteroid injection, surgical excision |
| what is Dupuytren's Disease | inherited, slowly progression contracture of palmar fascia, flexes 4th/5th fingers and middle finger. |
| when is ice best | 24-48 hours after surgery |
| what is a corn | area of hyperkeratosis(overgrowth of horny layer of epidermis), usually 5th toe. |
| what is callus | thickened area of skin exposed to friction. |
| what is onychocryptosis | ingrown toe nail, clip straight across |
| Deformities of the foot: Hammer toe Hallux Valgus(bunion, and assoc with OA) Pes Cavus Morton's Neuroma Flatfoot | Hammer toe: flexion of interphalangeal joint Bunion: great toe deviates laterally Pes Cavus: abnormally high arch (clawfoot) Morton's Neuroma: swelling 3rd toe |
| When is peak adult mass achieved? | B/n 18-25 yrs |
| What are some interventions for osteoporosis | incr Ca, weight bearing exercise, decr caffeine, cig, carbonated drinks, alcohol |
| what is osteoporosis | reduced bone mass, deterioration of bone matrix, diminished bone strength. Osteoclast bone resorption out weighs bone formation Leads to kyphosis |
| What hormones related to Ca incr and decr in aged | estrogen and Calcitonin- decr PTH- incr bone turnover and resorption |
| Who is at greatest risk for osteoporosis | small framed, nonobese, Caucasian women |
| Recommended Ca intake? Vit. D? | Ca: 1000-1200 Vit D: 800-1000 |
| where is Ca best absorbed | Duodenum in sm intestine |
| When can osteoporosis be detectable | When 25%- 40% demineralization so BMD testing is recommended for 65 yrs and older |
| what is good mgmt against osteoporosis | rich diet of Ca and Vit. D, 20-30 min weight bearing exercise 3x wk. |
| what is osteomalacia | Usually a lack of Vit. D metabolic bone disease, softening/weakening of skeleton, many fractures |
| how does the liver/kidney aid in Ca absorption | liver/kidney convert Vit. D to active form to absorb Ca |
| What leads to osteomalacia? hyperthyroidism, hypo, hyperpara, hypopara | hyperparathyroidism |
| What is Paget's Disease | localized rapid bone turnover in skull, femur, tibia, pelvic bones, vertebrae. Enlarged skull |
| What retards bone resorption | Calcitonin |
| what is osteomyelitis | infection of the bone that results in inflammation, necrosis, formation of new bone |
| Who is most at risk for osteomyelitis | elderly, malnourished, obese |
| what is process of a bone abscess if not treated | the sequestrum forms- dead bone tissue in abscess cavity then covered by new bone growth, involucrum, surrounds sequestrum. Tx: remove dead bone tissue |
| What kind of benign bone tumors did we learn | "droma" osteochondroma, enchondroma, bone cyst, osteoid osteoma, rhabdomyoma, fibroma |
| what is the most common | osteochondroma, usually at ends of long bones |
| what kind of malignant bone tumors did we learn | "sarcoma" osteosarcoma(most common and most fatal), chondrosarcoma, Ewing's sarcoma, fibrosarcoma |
| which is more common, metastatic bone disease or primary bone tumors | metastatic bone disease(secondary bone tumor) |
| what is autograft? allograft? | autograft: bone tissue from pt allograft: cadaver donor |