Rheumatology
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| What are the three classifactions of joints? | Synarthrosis-no movement Amphiarthrosis-Little movement Diarthrosis-synovial/movable joints
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| What are the 4 types Diarthrotic joints? | ball and socket-shoulder hinge-elbow saddle-thumb plane-patella
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| 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
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| How do joints deal with stress? | destribute, absorbe force and transfer to muscles
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| What 4 components add stability to a joint? | The shape/location Ligaments-guide/align Muscles and tendons-flexability when needed Synovial fluid-hydrostatic seal
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| What are the 5 areas for intervention for rheumatisms? | Pain
Deformities
Loss of ROM
Disability
Secondary health problems-
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| What is the prevelance of Osteo Arthritis? and it's predicted to be? | 1/10, 1/4
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| What persentage of those with arthritis will have foot problems? | 100%
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| What is the 3 roles of the foot? | Foundation stability
Central located heal
Muscular control
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| How many bones in are in the foot and in how many functional segments? | 26 bones, 3 areas Forefoot, Hindfoot, Midfoot
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| What are the major ligaments of the foot? | Deltoid, Calcaneo, Anterior Talofibular, Posterior talotibial The "spring" navicular ligment
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| What is the plantar fascia? | facia on the bottom supporting the medial arch
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| What is assessed on the Foot? | Gait-with/without foot
Daily habit
Pain
ROM
Sensation
Skin Condition
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| 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
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| 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
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| What are effusion | Swellin of soft tissu
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| What is synovitis? | inflammation of the synovial
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| 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
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| What is the treatment goal of pronation | slow pronation
decrease end range stress
stability push off
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| What is a problem with supination? | High arch,
true ankle pain,
Decreased shock absorption
Increased plantar pressure
Inability to accomodate to the ground
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| What is the goal of treatmen of supination? | Dispers pressure, provide shock absorption
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| What is Pes Planus? | Flat feet
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| What is Pes Cavus? | exaggerated medial arch
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| What do you want to ensure with foot alignment? | The Subtalor joint/achilles is aligned in neutral
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| What is the Transvers metaphalangial arch? | The arch of the toes
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| What is Crossover toe deformity? | crowding and toe crossed over
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| What is Hallux Valgus? | turning out of the big toe (bunion)
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| What is Hallux Rigidus? | Big toe is fused (Osteo arthritis)
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| What is Flat transverse/metatarsal arch? | The balls of the foot, metatarsal bones themselves on ground
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| What are secondary changes resulting from the transverse arch? | Mallet toes
Hammer toes
Claw toes
Cocked up toes
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| 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
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| What do we know about footwear? | It can cause or minimize problems
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| What are signs inappropriate footwear? | Shoe size
Shoe padding
Large shoes
Tight sock
Moisture
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| What are the Treatment for feet? | Footwear, Joint protection, Othoses, Shoe modifications, Prescribed exercise, Thermal modalities, Walking aids
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| 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
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| What are the purposes of orthotics? | Stabalize
Correct and Re-align
*Note need to fit in corrected position/alignment
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| Types of orthotic? | Sansplint-thermoplastic in non weightbearing
Biothotics-special, molded, weightbearing
Foot Maxx-expesive, computer printout
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| What is one of the best type of orthotic? | Semirigid
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| What treament can you do for plantar faciatus? | Inserts
Metatarsal cookies
Toe separators
Toe splints
Toe exercises
Cold to decrease inflamation
Walking aids
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| If you see a client with a flat foot gait what might be the problem? | planter flexion contracture, balance, effusion
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| What you might woant to check with gait? | Phase of gait and contact
Gait deviation
Impairments
Deviation
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| What is joint protection? | learning to do activities to decrease pain, fatigue, deformities, and loss of function
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| What are the goals to joint protection? | Improve function, improve self awareness
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| 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
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| What is energy conservation? | The preservation and planning of activity to maintain energy to balance productivity, leisure and self-care
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| What are the three components of energy conservation? | Physical energy use,
Psychological stressors,
Enviromental obstacles
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| What are the main principles of energy conservation? | Alternate heaviness of work
Plan work time
Plan rest periods
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| What are interventions to maintain the "energy bank"? | Sleep
Relaxation and Stress management, talk
Engagine life pursuits, leisure activities,
Energy conservation
Joint protection principles
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| In the pain cycle the most impacting factor is what? | Psychological
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| What are common relaxation techniques? | Deep breathing
Visualization
Progressive muscle relaxation
Autogenics-using sensation (heat)
Music and Nature sounds.
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| What are psychosocial issues of rheumatoid illnesses? | Identity/self perception
Roles/activities
Response to symptoms-fight or relax
Knowlege & Self efficacy
Change
Self image
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