(CN) The Joints - Pathology
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| What are the short-term/acute exacerbation PT goals for the pt w/ rheumatism? (4) | Alleviate pain, Decrease inflammation, Maintain strength and endurance, Provide splinting/assistive devices to increase safety.
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| What are the most commonly affected sites for osteoarthritis? | C5-6, Lspine, Hips, Knees
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| What gender is most affected by osteoarthritis? | Males
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| What is the clinical presentation of osteoarthritis? (10) | Pain in affected joint, Increased pain after exercise, Enlarged joints, Crepitus, Usually localized to a few joints, Increased pain w/ weather changes, Limited ROM, Heberden's or Bouchard's nodes, Gradual onset.
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| What gender is more likely to be affected by rheumatoid arthritis? | Women are 3 times more likely to be affected than men.
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| What is the most common age of onset for rheumatoid arthritis? | 30-50yrs
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| In which joints is it common to find rheumatoid arthritis? | Small joints of the hand, foot, wrist and ankle.
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| Describe the pathogenesis of RA. | Thickening of synovial membrane, Colonization of lyphocytes (synthesize rheumatoid factor), Erosion of cartilage and supporting structures.
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| Describe the clinical presentation of RA. (11) | Gradual, or immediate onset, Pain, tenderness, redness and warmth of affected joints, Symmetrical polyarthritis, Morning stiffness of > 1hr, Malais and increased fatigue, Decreased appetite, Deformities of DIPs/PIPs (boutonniere or swan neck)
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| What is the PT intervention for the RA pt? | Bed rest or regular rest periods as indicated, NSAIDs, Pt education (disease, energy conservation, body mechanics, joint protection), Modalities but not deep heat, splinting, PROM during exacerbations, hydrotherapy, AROM,Isometrics in subacute, Exercise.
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| What PT handling technique is contraindiated in the RA pt? | Aggressive stretching.
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| List the characteristics of the three grades of ligament sprain. | Grade I: Mild pain and swelling, little to no tear of ligament. Grade 2: Moderate pain and swelling, minimal instability, min-mod tearing of ligament, decreased ROM. Grade 3: Severe pain and swelling, substantial instability, total tear of the ligament.
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| What is the difference between a sprain and a strain? | Sprain: Acute injury involving a ligament. Strain: An injury involving the musculotendinous unit; a muscle, tendon or their attachments to bone.
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| List the characteristics of the three grades of strain. | Grade I: Localized pain, minimal swelling & tenderness. Grade 2: Localized pain, moderate swelling, tenderness and impaired motor function. Grade 3: Palpable defect of the muscle, severe pain and poor motor function.
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