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Occth543

Rheumatology

QuestionAnswer
What are the three classifactions of joints? Synarthrosis-no movement Amphiarthrosis-Little movement Diarthrosis-synovial/movable joints
What are the 4 types Diarthrotic joints? ball and socket-shoulder hinge-elbow saddle-thumb plane-patella
What are the five articular tissues? Articular cartilage-on end of bone Capsule-encases the joint Peri-articular-outside capsule-muscle Synovium-line structures Synovial fluid-inside the joint
How do joints deal with stress? destribute, absorbe force and transfer to muscles
What 4 components add stability to a joint? The shape/location Ligaments-guide/align Muscles and tendons-flexability when needed Synovial fluid-hydrostatic seal
What are the 5 areas for intervention for rheumatisms? Pain Deformities Loss of ROM Disability Secondary health problems-
What is the prevelance of Osteo Arthritis? and it's predicted to be? 1/10, 1/4
What persentage of those with arthritis will have foot problems? 100%
What is the 3 roles of the foot? Foundation stability Central located heal Muscular control
How many bones in are in the foot and in how many functional segments? 26 bones, 3 areas Forefoot, Hindfoot, Midfoot
What are the major ligaments of the foot? Deltoid, Calcaneo, Anterior Talofibular, Posterior talotibial The "spring" navicular ligment
What is the plantar fascia? facia on the bottom supporting the medial arch
What is assessed on the Foot? Gait-with/without foot Daily habit Pain ROM Sensation Skin Condition
What part of skin condition is looked at? Corns-pressure Plantar warts-pain Heal bump on the back Nails-scoriatic artritis Nodules-medication Callouses-Friction
What aspects of pain need to be screened? Morton's Neuroma-tingling and paing between 1st and second toes Metatarsalgia-pain across metatarsals Plantar fascitis-palpate tightness Tendonitis-achilles squeeze pain?ROM Retrocalcaneal bursitis-pain, widening of heal
What are effusion Swellin of soft tissu
What is synovitis? inflammation of the synovial
What is the most common problem seen in rheumatis of the foot? Excessive pronation shifting downward of mid talor area. Excessive joint motion. Increased stress on the joint, reliance of muscle support
What is the treatment goal of pronation slow pronation decrease end range stress stability push off
What is a problem with supination? High arch, true ankle pain, Decreased shock absorption Increased plantar pressure Inability to accomodate to the ground
What is the goal of treatmen of supination? Dispers pressure, provide shock absorption
What is Pes Planus? Flat feet
What is Pes Cavus? exaggerated medial arch
What do you want to ensure with foot alignment? The Subtalor joint/achilles is aligned in neutral
What is the Transvers metaphalangial arch? The arch of the toes
What is Crossover toe deformity? crowding and toe crossed over
What is Hallux Valgus? turning out of the big toe (bunion)
What is Hallux Rigidus? Big toe is fused (Osteo arthritis)
What is Flat transverse/metatarsal arch? The balls of the foot, metatarsal bones themselves on ground
What are secondary changes resulting from the transverse arch? Mallet toes Hammer toes Claw toes Cocked up toes
Besides the feet what areas for arthritis do you want to check? Knees-ROM, Strength, Effusion Hips-ROM, Pain, movement in Gait Leg length discrepency
What do we know about footwear? It can cause or minimize problems
What are signs inappropriate footwear? Shoe size Shoe padding Large shoes Tight sock Moisture
What are the Treatment for feet? Footwear, Joint protection, Othoses, Shoe modifications, Prescribed exercise, Thermal modalities, Walking aids
What are the important features of Footwear education? Heal counter support-suptalor issues higher tops Forfoot support-Metatarsal issues(runners) Midfoot support-pronators Heel height- 1-1 1/2" tops Support-no soft flimsy shoes, othotics, or firm bottom
What are the purposes of orthotics? Stabalize Correct and Re-align *Note need to fit in corrected position/alignment
Types of orthotic? Sansplint-thermoplastic in non weightbearing Biothotics-special, molded, weightbearing Foot Maxx-expesive, computer printout
What is one of the best type of orthotic? Semirigid
What treament can you do for plantar faciatus? Inserts Metatarsal cookies Toe separators Toe splints Toe exercises Cold to decrease inflamation Walking aids
If you see a client with a flat foot gait what might be the problem? planter flexion contracture, balance, effusion
What you might woant to check with gait? Phase of gait and contact Gait deviation Impairments Deviation
What is joint protection? learning to do activities to decrease pain, fatigue, deformities, and loss of function
What are the goals to joint protection? Improve function, improve self awareness
What are the principles of joint protection? Respect pain >2hrs Avoid deformity-flexion, ulnar deviation Avoid long activity Avoid staying in any one position Use large joints Use stable positions Use assistive equipment for flare up Environment mod
What is energy conservation? The preservation and planning of activity to maintain energy to balance productivity, leisure and self-care
What are the three components of energy conservation? Physical energy use, Psychological stressors, Enviromental obstacles
What are the main principles of energy conservation? Alternate heaviness of work Plan work time Plan rest periods
What are interventions to maintain the "energy bank"? Sleep Relaxation and Stress management, talk Engagine life pursuits, leisure activities, Energy conservation Joint protection principles
In the pain cycle the most impacting factor is what? Psychological
What are common relaxation techniques? Deep breathing Visualization Progressive muscle relaxation Autogenics-using sensation (heat) Music and Nature sounds.
What are psychosocial issues of rheumatoid illnesses? Identity/self perception Roles/activities Response to symptoms-fight or relax Knowlege & Self efficacy Change Self image
Created by: swcherry