OT EXAM ARTHRITIC HAND Flashcards

1
Q

What is osteoarthritis?

A

-“Wearing away” of the cartilage results in irritation of the bone.
-Seen in joints that bear weight (Knees, hips, spine)

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2
Q

Where in the hand is OA seen?

A

CMCJ of the thumb, DIPS PIPS

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3
Q

What part of the bone is affected in OA?

A

Subchondral bone

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4
Q

Symptoms of OA

A

Crepitus, less ROM, joint pain, joint stiffness and swelling

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5
Q

osteophytes are?

A

bone growth

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6
Q

Where are Herberdens nodes found?

A

DIP

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7
Q

Where are Bouchards nodes found?

A

PIP

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8
Q

Squaring at the wrist?

A

due to prominence of 1st CMC joint

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9
Q

How does OA appear initially?

A

asymmetrically

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10
Q

TX for OA:

A

Medication
Avoiding activities which cause pain
Maintain ADL’s- joint protection and energy conservation principles
Splinting
Moist heat or paraffin
AROM
Mild strengthening exercises

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11
Q

Avoid what movements with OA?

A

-sustained pinch (knitting, hand tools, garden tools)
-sustained pinch with torque (key turning, can opening)
-Pinch with pushing and pulling (vegetable peeling, hand sawing, ski poles),
-repetitive movements (cutting with scissors, spray bottles)

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12
Q

RA:

A
  • A systemic disease
  • 75% affected are women
  • Morning stiffness
  • Proliferation of the synovium in joints
  • Synovitis invades the joint capsule destroying the supporting structures of the joint
  • Chronic synovitis is persistent with repeated inflammation of the synovium
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13
Q

Where is RA seen in the hands?

A

MCPJ and PIPJ

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14
Q
  • Pannus
A

Inflamed synovium, turns into diseased tissue which eats the ends of the bones away

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15
Q

How does RA appear?

A

Usually symmetrical- attacks the wrists, hands, knees, elbows, shoulders, ankles

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16
Q

Stages of RA

A

ACUTE-INFLAMMATORY
PROLIFERATIVE STAGE
DESTRUCTIVE PHASE: ADVANCED
FINAL STAGE: CHRONIC

17
Q

Medications for arthritis

A
  • NSAIDS
  • Steroids
  • DMARDS
  • Analgesics
18
Q

Surgical TX’s

A
  • Synovectomy- removal of diseased synovium
  • Tenosynovectomy- removal of diseased tendon
  • Tendon surgeries: repair, release, transfer
  • Arthroplasty: joint replacement
  • Arthrodesis: joint fusion
19
Q

Mallet finger

A

-Droop of DIP
-Damage of insertion of the extensor tendon

20
Q

Boutonniere

A

-PIP bends, DIP extends
-destruction of central slip of the extensors and volar slipping of the lateral bands.

21
Q

Swan neck deformity

A
  • PIPJ in hyperextension and DIPJ in flexion.
  • Caused by overstretching of the volar plate of the PIPJ.
22
Q

TX principles

A

O ROM- gentle AROM should be done at least once daily
O Gentle stretching of intrinsics (MCPs extended, flex IPs)
O Resistive exercises: often “soft” resistance only
O Heat and cold modalities.
O Joint protection and energy conservation
O Pain management; relaxation, yoga.
O Splinting

23
Q
A