Condensed MS Flashcards
(150 cards)
1
Q
What is a joint?
A
Where two or more bones are attached
2
Q
What is the synovium?
A
Inner lining of joint capsule that produces synovial fluid
3
Q
What is synovial fluid?
A
Slippery film that reduces friction between two opposing bones and provides nutrients to joints/cartilage
4
Q
What is hyaline cartilage?
A
Glistening and white cartilage that covers the articular surface to absorb shock and allow smooth movement
5
Q
What are synovial joints?
A
Freely movable joints where opposing surfaces are covered with smooth layer of hyaline cartilage and are enclosed by a tough joint capsule
6
Q
What is pannus?
A
Abnormal tissue growth in the joints
7
Q
What does malalignment refer to?
A
Incorrect alignment of the joints
8
Q
What are RA nodules?
A
Small lumps of tissue under the skin, typically affecting fingers first, can appear on elbows, forearms, knees/back of knees
9
Q
What is synovectomy?
A
Surgery done by open incision or via laparoscopic procedure to remove synovium from joints with chronic inflammation
10
Q
What are Swan Neck Deformities?
A
Middle knuckle of a finger bends backward while the fingertip bends forward, resembling a swan’s neck laparoscopic
11
Q
What are ulnar deviations?
A
Fingers start bending/deviating towards the pinky finger
12
Q
What is Sjogren’s Syndrome?
A
Develops in the presence of RA causing dry glands, affecting mouth, eyes, vagina
13
Q
What is crepitus?
A
Grating sensation or sound that may occur when moving the affected joints
14
Q
What is hyaluronic acid?
A
A natural substance that acts as a lubricant and shock absorber in joints
15
Q
What is arthrocentesis?
A
The joint is aspirated and tested for presence of uric acid crystals
16
Q
What is hyperuricemia?
A
High levels of uric acid in the blood
- If your body produces too much uric acid or can’t remove it efficiently, the levels can rise, potentially leading to health issues like gout and kidney stones.
A natural waste product created when your body breaks down purines.
17
Q
What is kyphosis?
A
Outward curvature of the thoracic spine causing a humpback
18
Q
What does CSM stand for?
A
Circulation, Sensation, Motion/Movement
19
Q
What is atelectasis?
A
Reversible collapse of the lung
20
Q
How many bones are in the human body?
A
206 bones
21
Q
What type of joint is amphiarthrosis?
A
Slightly movable, for example, in between vertebrae
22
Q
What type of joint is diarthrosis?
A
Freely movable with the greatest degree of movement, examples include knee and elbows
23
Q
What type of movement do hinge joints allow?
A
Only flexion and extension
24
Q
What type of movement do hip and shoulder joints allow?
A
Flexion, extension, abduction, adduction, and circumduction
25
What type of joint is synarthrosis?
Immovable, as seen in the skull
26
What is Rheumatoid Arthritis?
Rapidly developing chronic autoimmune disorder caused by strong genetic factor
## Footnote
It leads to inflammation, pain, and can affect multiple joints.
27
What is Osteoarthritis?
Noninflammatory, localized joint disorder caused by the progressive deterioration and loss of articular cartilage and underlying bone, primarily in weight-bearing joints.
## Footnote
It is the most common form of arthritis.
28
What is Gouty Arthritis?
Systemic metabolic disease where uric crystals deposit into joints causing inflammation and severe pain
## Footnote
It can be categorized as primary or secondary gout.
29
Is Rheumatoid Arthritis curable?
Incurable, but can slow progression & relieve pain
## Footnote
Management focuses on symptom relief and maintaining quality of life.
30
Is Osteoarthritis curable?
Incurable
## Footnote
Treatment focuses on pain management and improving joint function.
31
What characterizes the pathophysiology of Rheumatoid Arthritis?
Synovium thickens in the joint, leading to inflammation, pain, and formation of pannus.
## Footnote
This may result in erosion of cartilage and bone.
32
What are the primary joints affected by Gout?
Smaller joints in the body, especially the Great Toe
## Footnote
It can also affect the knees, ankles, and other joints.
33
What are common clinical manifestations of Rheumatoid Arthritis?
* Morning joint stiffness lasting several hours
* RA Nodules
* Fatigue
* Deformities like Swan Neck Deformities
* Anemia
* Lymph node enlargement
## Footnote
These symptoms may vary in severity and presentation.
34
What is a common complication of Rheumatoid Arthritis?
Sjogren's Syndrome
## Footnote
This condition causes dry glands affecting the mouth, eyes, and vagina.
35
What laboratory test is positive for Rheumatoid Arthritis?
Rheumatoid Factor (RF)
## Footnote
It helps diagnose RA along with other clinical assessments.
36
What is the goal of treatment for Rheumatoid Arthritis?
Pain relief, decrease inflammation, promote quality of life
## Footnote
Treatment is tailored based on severity and lab results.
37
What type of medication is Methotrexate?
Remittive/Rheumatic Agent
## Footnote
It is considered a form of chemotherapy and requires monitoring for side effects.
38
What are common nonpharmacologic methods for managing arthritis pain?
* Hot/Cold therapy
* Rest
* Positioning
* Splints
* Massage
## Footnote
These methods complement pharmacological treatments.
39
What is a potential side effect of long-term steroid use in Rheumatoid Arthritis treatment?
Cushing Syndrome
## Footnote
Other risks include osteoporosis and increased infection risk.
40
What lifestyle factors can increase the risk of developing Osteoarthritis?
* Age
* Obesity
* Joint Injury
* Chronic joint disease
* Family history
## Footnote
These factors contribute to the wear and tear of joints.
41
What dietary recommendations are made for patients with Gout?
Low purine diet: avoid red/organ meats and shellfish
## Footnote
Increasing fluid intake is also important to prevent kidney stones.
42
True or False: Gout can be cured.
True, it is the only curable form of arthritis by limiting uric acid in the body.
## Footnote
Effective management can reverse symptoms.
43
What are the symptoms of Acute Gout?
Sudden onsets, typically in the Great Toe
## Footnote
Symptoms can include severe pain and swelling.
44
What is the purpose of arthrocentesis in arthritis diagnosis?
To analyze synovial fluid for uric acid crystals
## Footnote
This procedure helps confirm a diagnosis of Gout.
45
What are the recommended exercises for arthritis management?
* ROM exercises
* Low impact exercises like walking, swimming, cycling
## Footnote
These help maintain joint mobility and strength.
46
Why should Prednisone be tapered off before total joint surgery?
It can cause delayed wound healing
## Footnote
Delayed healing can lead to complications during recovery from surgery.
47
What should be done with Prednisone after post-op?
It should be continued to avoid exacerbations of disease
## Footnote
Continuing Prednisone helps manage underlying conditions after surgery.
48
How can Prednisone be administered?
Orally or injected directly into joints
## Footnote
Different administration routes can be chosen based on patient needs.
49
Should Prednisone be the primary drug for rheumatoid arthritis?
No
## Footnote
Other medications are preferred for managing rheumatoid arthritis.
50
Define Osteoporosis.
Chronic metabolic disease of cellular regulation in which bone loss causes significant decreased density and possible fractures
## Footnote
Osteoporosis is often referred to as a silent disease.
51
What is a key characteristic of osteoporosis?
Silent disease
## Footnote
It progresses without noticeable symptoms before a fracture occurs.
52
What happens in the pathophysiology of osteoporosis?
Bone minerals are reabsorbed into circulation due to need; breakdown/reabsorption is faster than bone formation
## Footnote
This leads to a weakened bone matrix.
53
List some lifestyle factors that contribute to the etiology of osteoporosis.
* Postmenopause
* Estrogen/Androgen deficiency
* Inactivity/Decreased Mobility
* Lean Body Mass
* Smoking (active/passive)
## Footnote
These factors can significantly increase the risk of developing osteoporosis.
54
What dietary factors are associated with osteoporosis?
* Low Calcium
* Low Vitamin D
* Low Protein
* High alcohol intake
* High caffeine intake
## Footnote
Nutrition plays a crucial role in bone health.
55
What medication use is a risk factor for osteoporosis?
Chronic Steroid Use/Therapy
## Footnote
Long-term steroid use can lead to bone density loss.
56
Which demographics are more commonly affected by osteoporosis?
* Women
* Menopause
* History of total hysterectomy
* Euro-Caucasian or Asian ethnicities
* Age > 50
* Anorexia
* Family History
* History of low trauma fractures
* Rheumatoid Arthritis
## Footnote
These factors increase the likelihood of developing osteoporosis.
57
What are common clinical manifestations of osteoporosis?
* Bone fracture
* Increased susceptibility: wrist, hip, spine
* Loss of height/Postural changes
* Chronic pain
* General weakness/Fatigue
* Joint weakness
## Footnote
These symptoms indicate significant bone loss.
58
What diagnostic tests are used for osteoporosis?
* DEXA scan (hip and spine)
* X-ray
DEXA scans are primarily used to measure bone density and assess the risk of osteoporosis, while X-rays are used to view the structure and condition of bones and tissues, including fractures and dislocations.
## Footnote
These tests help evaluate bone health and density.
59
What is the recommended calcium intake for postmenopausal women?
1500 mg/day
## Footnote
Adequate calcium is essential for bone health, especially in women after menopause.
60
What is the recommended vitamin D intake for osteoporosis management?
1000 units/day
## Footnote
Vitamin D is crucial for calcium absorption and bone health.
61
Name a medication commonly used for osteoporosis prevention and treatment.
Bisphosphonates (e.g., Fosamax)
## Footnote
These medications help slow bone resorption and promote new bone formation.
62
What is the role of SERMs like Raloxifene in osteoporosis treatment?
Mimic Estrogen to increase bone mineral density & reduce bone resorption
## Footnote
SERMs are used to manage osteoporosis in postmenopausal women.
63
What therapy is used to replace estrogen in osteoporosis treatment?
Hormone Replacement Therapy
## Footnote
This therapy can help maintain bone density in women post-menopause.
64
What is the role of Parathyroid hormone (Teriparatide) in osteoporosis treatment?
Build Bone
## Footnote
Teriparatide is used in severe cases of osteoporosis.
65
What are some key interventions for managing osteoporosis?
* Exercise: Active range of motion, weight-bearing exercises, walking
* Proper use of Body mechanics
* Promotion of safety/ADLs
## Footnote
These interventions help improve bone health and reduce the risk of fractures.
66
What nutrients are important for bone health?
* Calcium
* Vitamin D
* Protein
## Footnote
Adequate intake of these nutrients is essential in preventing osteoporosis.
67
True or False: Demineralization of bone is more prone after menopause.
True
## Footnote
This is due to decreased estrogen levels affecting bone density.
68
What is a common type of fracture that occurs in the hip?
Hip Fracture
## Footnote
Hip fractures are significant injuries that often occur in older adults.
69
What is another name for a wrist fracture?
Collie’s (Wrist) Fracture
## Footnote
This type of fracture is common among individuals who fall on an outstretched hand.
70
What are spinal fractures often caused by?
Trauma from fall
## Footnote
Falls are a leading cause of spinal fractures, particularly in older adults.
71
What is an intracapsular fracture?
Within joint capsule
## Footnote
These fractures occur in areas such as the femoral head and neck.
72
What is an example of an extracapsular fracture?
Trochanteric and subtrochanteric
## Footnote
These types of fractures occur outside of the joint capsule.
73
What are some signs and symptoms of fractures?
Changes in:
* Circulation
* Sensation
* Motion
* Crepitus
* Deformity in affected area
* Swelling/Bruising
* Pain
* Numbness/Tingling
## Footnote
These symptoms can vary based on the type and location of the fracture.
74
What is an important diagnostic tool for fractures?
X-Ray
## Footnote
X-Rays are crucial for confirming the presence of a fracture.
75
What does CBC with lytes stand for?
Complete Blood Count with electrolytes
## Footnote
This test is needed by anesthesiology prior to surgery.
76
What is a common surgical treatment for hip fractures?
Hip Arthroplasty
## Footnote
This procedure can involve partial or total replacement of the femoral head and acetabulum.
77
What is balloon kyphoplasty used for?
Stabilize vertebrae compression fracture & pain
## Footnote
This procedure involves inflating a balloon and injecting bone cement to restore vertebra shape.
78
What is the mortality rate of older adults within the first year of a fracture?
50%
## Footnote
High mortality rates are often due to surgery, depression, and decreased mobility.
79
True or False: Patients with both hip and wrist fractures can use crutches effectively.
False
## Footnote
Patients may have difficulty using crutches due to arm restrictions.
80
What is the purpose of closed/manual reduction in fracture treatment?
External manipulation of bone fragments into place
## Footnote
This procedure does not require surgery and is done under local anesthetic.
81
Fill in the blank: _______ is the procedure that involves replacing the femoral head and acetabulum.
Total Hip Arthroplasty
## Footnote
This is a common surgical intervention for severe hip fractures.
82
What is Buck’s traction used for?
To keep the bone aligned
## Footnote
It is considered uncommon in practice.
83
What is the purpose of using blankets and pillows after ankle surgery?
To elevate limbs and relieve pressure on heels
84
What defines a closed (simple) fracture?
A break of disruption of bone that does not extend through the skin
85
What defines an open (compound) fracture?
A fracture that extends through the skin
86
What is the basic wound care procedure for fractures?
Cover with dry sterile dressing to prevent bacteria from entering
87
What is included in a neurovascular assessment?
Assess for poor circulation to extremity
88
What are the 6 P's of neurovascular assessment?
* Paresthesia
* Pain
* Pressure
* Pallor
* Paralysis
* Pulselessness
89
What does CSM stand for in the context of neurovascular assessment?
Circulation, Sensation, Motion
90
What is the treatment for minor fractures?
Closed reduction, where bones are put back into place without surgery
91
What is the purpose of an X-Ray in fracture treatment?
To ensure bones are back in place
92
What does Open Reduction Internal Fixation (ORIF) involve?
Surgical realignment of a fracture with internal hardware
93
What are some complications of fracture surgical repair related to immobility?
* Lung Infection
* VTE and DVT/Pulmonary Embolism
* Renal Calculi
* Pressure Ulcers
* Avascular necrosis
* Joint Contractures/Disability
## Footnote
Immobility can lead to various complications that impact recovery and overall health.
94
What is a recommended intervention to prevent complications from immobility?
Move patient every 2 hours
## Footnote
Regular movement helps prevent complications associated with prolonged immobility.
95
What should be assessed pre-operatively for joint replacement?
* Baseline Intake/Output
* Renal impairment
* ABC (Airway, Breathing, Circulation)
* Fracture Site
* CSM (Circulation, Sensation, Movement) q2h
* Pain level before meds
* Med effectiveness
* Previous level of functioning
* Patient’s realistic goals
## Footnote
A comprehensive assessment is crucial for planning and optimizing patient outcomes.
96
What is the nutritional guideline before surgery?
NPO (Nothing by Mouth)
## Footnote
Patients should not eat or drink before surgery to reduce the risk of aspiration.
97
What should be monitored in the post-operative phase?
* Intake/Output
* Level of consciousness (LOC)
* Compare level of functioning
* Goal progression
## Footnote
Monitoring these aspects helps ensure patient safety and recovery.
98
What are the post-operative nutritional guidelines?
Clear liquids (advance slowly)
## Footnote
Patients should be assessed for alertness before advancing diet.
99
What should be included in patient education for pre/post-operative care?
* Expectations
* Anxiety reduction
* Sexual Activity considerations
* Use of pillows for stability
* Non-weight bearing position
* Use of Incentive Spirometer
## Footnote
Education helps prepare patients for surgery and recovery.
100
What is an important exercise consideration post-surgery?
Leave affected extremity alone until evaluated by PT
## Footnote
Physical therapy is essential for assessing mobility restrictions.
101
What is the role of short-term anticoagulants in post-operative care?
DVT Prevention
## Footnote
Anticoagulants like heparin or lovenox are used to prevent deep vein thrombosis.
102
Who is responsible for the initial dressing change in orthopedic surgeries?
Surgeon
## Footnote
The initial dressing change is typically done by the surgeon to ensure proper healing.
103
What is the role of physical therapy (PT) in post-operative care?
Mobility training and improving muscle outcomes
## Footnote
PT helps patients learn how to move safely after surgery.
104
What does occupational therapy (OT) focus on in post-operative care?
ADL (Activities of Daily Living) training
## Footnote
OT assists patients in regaining independence in daily activities.
105
What are the types of Total Joint Replacements?
Total Hip Arthroplasty/Replacement, Total Knee Arthroplasty/Replacement, Total Shoulder Arthroplasty/Replacement
## Footnote
These are common surgeries performed to replace damaged joints.
106
What type of joint is the hip joint?
Ball-and-Socket
## Footnote
This allows for a wide range of motion.
107
What type of joint is the knee joint?
Hinge Joint
## Footnote
This allows movement in one plane, primarily flexion and extension.
108
What are the postural restrictions for the posterior approach after hip surgery?
* No adduction
* No flexion more than 60-90 degrees
* No internal rotation of foot
## Footnote
These precautions help prevent dislocation and other complications.
109
What are the postural restrictions for the anterior approach after hip surgery?
* No extreme abduction
* No hyperextension
* No extreme external rotation
* No pointing toes outward
## Footnote
These precautions are essential for recovery.
110
What is the purpose of using an abduction pillow post-operatively?
Prevent bringing legs together to prevent injury
## Footnote
This is used to maintain proper positioning after hip surgery.
111
What is a common pain management technique used post-operatively?
* Nerve block
* Ice pad
* OnQ Pump
* Analgesics
## Footnote
These methods help manage pain effectively after surgery.
112
What is the most common type of drain used after hip and knee replacement?
JP drain
## Footnote
This is used to prevent fluid accumulation at the surgical site.
113
What equipment is necessary for knee replacement rehabilitation?
* Knee immobilizers
* Bulky splints
## Footnote
These help reduce swelling and stabilize the knee.
114
What are some complications that can arise after joint replacement surgery?
* Atelectasis
* Constipation
* Anemia
* Foot Drop
* Hip Dislocation
## Footnote
These complications can affect recovery and overall health.
115
What are the signs of hip dislocation?
* Severe Pain
* Shortened Limb
* Inability to move/rotate hip
## Footnote
If dislocation occurs, it must be addressed by a doctor.
116
What patient education is important for preventing constipation post-surgery?
* Increase fluid intake
* Increase fiber intake
* Be active if possible
* Use stool softeners
## Footnote
These measures help manage bowel health after surgery.
117
What exercises should patients focus on during rehabilitation?
* Work on Flexion ROM (0-90 degrees)
* Work on Extension when in bed
* Encourage ROM of wrist/fingers
* Rotational exercises
* ADL training
## Footnote
These exercises promote recovery and mobility.
118
True or False: Total knee replacements are generally more painful than hip replacements.
False
## Footnote
Knee replacements are often reported to be less painful than hip replacements.
119
What is the function of a Front Wheel Walker?
Ambulation
## Footnote
Used after Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA)
120
What is the purpose of an Elevated Toilet Seat/Chair?
Prevent flexion
## Footnote
Used for THA and possibly TKA; risk exists when rising from sitting
121
How should you use a Trigger Reacher?
Grab items that are out of reach
## Footnote
Commonly used after THA; may also be used after TKA
122
What is the function of a Sock Applicator?
Put on sock without bending 90 degrees
## Footnote
Important for THA recovery; improper use can lead to hip dislocation
123
What is the purpose of a Shoe Horn?
Put shoe on without bending
## Footnote
Useful for patients recovering from THA and TKA
124
What is the function of a Shower Chair?
Allows patient to sit while showering/washing
## Footnote
Applicable for THA and TKA recovery; may also be used for TSA
125
What is a 3-in-1 Commode used for?
Elevated device used as a shower chair, commode, or elevated seat for toilet
## Footnote
Suitable for THA and TKA; may also be used for TSA
126
What is the primary function of a Cane?
Ambulation
## Footnote
Used on the unaffected side after TKA and THA
127
What is the purpose of Sequential Compression Devices (SCD)?
Provides intermittent pressure to help with circulation
## Footnote
Used after THA, TKA, and TSA; should be removed BID for 20 minutes
128
What do Thrombo-Embolic Deterrent Stockings (TEDS) provide?
Compression to prevent DVT
## Footnote
Used after THA, TKA, and may be used for TSA
129
What are some risk factors for falls?
* sensory perception issues
* hard of hearing/seeing
* altered mental status
* TIA/Brain Attack
* delirium
* general weakness
130
What can cause falls?
* getting up too fast
* not using assistive devices
131
When do falls commonly occur?
* at night
* poor lighting
* tiredness
* nocturia
* at home
* during change of shift report
132
What are some prevention strategies for falls at home?
* adequate lighting/night light
* assess environment
* non-skid flooring
* remove tripping hazards
* secure rugs
133
What are some fall prevention strategies in hospitals?
* use bedside commode
* non-skid socks
* side rails
* bed/chair alarms
134
What should be included in patient education for fall prevention?
* assess environment
* be aware of physical limitations
135
What is the significance of falls in terms of accidental death causation?
2nd leading cause of accidental death
136
What percentage of falls involve the elderly?
75%
137
Fill in the blank: Falls are the ______ leading cause of accidental death.
2nd
138
True or False: TIA/Brain Attack is a risk factor for falls.
True
139
What are Activities of Daily Living (ADLs)?
Basic self-care tasks essential for independence
## Footnote
Examples include bathing, dressing, toileting, transferring, and self-feeding.
140
Why are Activities of Daily Living important?
They help maintain independence, self-confidence, and mobility
## Footnote
Encouraging independence is a key focus in care.
141
What are the types of Activities of Daily Living?
ADLs and IADLs
## Footnote
ADLs refer to basic self-care tasks, while IADLs involve more complex activities.
142
List examples of Activities of Daily Living (ADLs).
* bathing/hygiene
* dressing
* toileting/continence
* transferring
* self-feeding
## Footnote
These are fundamental tasks that individuals perform daily.
143
What assessment tool is used to evaluate functional independence in ADLs?
PULSES
## Footnote
PULSES stands for Physical condition, Upper extremity function, Lower extremity function, Sensory components, Excretory functions, and Support factors.
144
What does the 'P' in PULSES represent?
Physical condition
## Footnote
It assesses the overall health status of an individual.
145
What does the 'U' in PULSES represent?
Upper extremity function
## Footnote
This evaluates the capability of the upper limbs to perform tasks.
146
What does the 'L' in PULSES represent?
Lower extremity function
## Footnote
This assesses the ability to use the lower limbs effectively.
147
What does the 'S' in PULSES represent?
Sensory components
## Footnote
This evaluates the sensory abilities related to daily living activities.
148
What does the 'E' in PULSES represent?
Excretory functions
## Footnote
This assesses the individual's ability to manage excretory needs.
149
What does the 'S' in PULSES represent?
Support factors
## Footnote
This examines external support systems that assist with daily living.
150
List examples of Instrumental Activities of Daily Living (IADLs).
* telephone
* transporting self
* groceries/meal preparation
* housework/household repair
* laundry
* take own medications
* financial self management
## Footnote
IADLs are more complex tasks that support independent living.
