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OCTH 1031 > Conditions Of The Musculoskeletal System (Week 1) > Flashcards

Conditions Of The Musculoskeletal System (Week 1) Flashcards

(121 cards)

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1
Q

What is the primary cause of fatal and non-fatal injuries in older adults?

A

Falls

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2
Q

Biomechanics

A

Study of structure and function of biological systems

Ex: able to ID a person from across the room by their movement and stance.

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3
Q

What is a negative result of a fall?

A

Fear

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4
Q

Etiology of fractures related to pathology (4)

A
  1. Tumors
  2. Osteoporosis
  3. Osteopenia
  4. Osteoarthritis
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5
Q

Etiology of fractures related to trauma (3)

A
  1. High energy trauma- MVA
  2. Prolonged stress/overuse
  3. Direct blow - knee hits dashboard in MVA
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6
Q

Etiology of Orthopedic conditions (3)

A
  1. Trauma
  2. Pre-existing musculoskeletal limitations
  3. Genetics
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7
Q

Common bones that fracture

9

A
  1. Radius.
  2. Ulna
  3. Carpal bones.
  4. Clavicle
  5. Spine. 8. Femur
  6. Pelvis. 9. Tibia/Fibula
  7. Hip
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8
Q

Common radial fx

A

Colles fx - out reached arm to break fall

Proximal or mid-shaft

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9
Q

Common spinal fx

A

Compression fx - common in osteoporotic population

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10
Q

Common cause of pelvis fx

A

MVA

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11
Q

Common hip fx

A

Femoral neck

Trochanteric

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12
Q

Common femural fx

A

Mid-shaft

Distal

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13
Q

Common Tibial and fibular fx

A

Tibial plateau
Mid-shaft
Distal = ankle fx

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14
Q

Risk Factors for Fx (2)

A

Low bone mineral density

Hx of Fx

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15
Q

Signs of Fx (5)

A
  1. Swelling
  2. Bruising
  3. Deformity
  4. Tenderness with palpation
  5. Loss of function
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16
Q

Signs of loss of function with a fx (2)

A

inability to bear weight

inability to move joint

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17
Q

Symptoms of a Fx (3)

A
  1. Severe pain
  2. Stiffness
  3. Numbness/Tingling
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18
Q

Risk factors of a fx (2)

A
  1. Low bone mineral density

2. Hx of Fx

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19
Q

Two reasons why Hx of Fx is a risk factor (2)

A
  1. Fear of falling increases risk of falling

2. Pathological Fx due to osteoporosis

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20
Q

Progression of Fx (3)

A
  1. Inflammatory
  2. Repair
  3. Remodeling
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21
Q

What happens during the inflammatory response of a Fx?

A

Blood moves into the space around the fracture creating a hematoma. The hematoma transforms into a clot.

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22
Q

Risk Factors of falls (6)

A
  1. decreased strength
  2. decreased balance
  3. comorbidities
  4. medications
  5. Footwear
  6. Chronic pain
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23
Q

What are the two phases of the repair process? (2)

A
  1. Fibrocartilaginous “soft” callus phase

2. Bony “hard” callous phase

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24
Q

What happens during the fibrocartilaginous callus phase? (2)

A
  1. Osteoblasts initiate formation of the bone.

2. Cell density increases

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25
What happens during the bony "hard" callus phase?
Fibrocartilaginous callus converts woven bone which increases in rigidity and thickness until bony union
26
What happens during the remodeling phase of a Fx? (2)
1. Woven bone convert to lamellar bone. | 2. Fracture callus reduces along lines of stress.
27
Medical intervention & management of a Fx (2)
1. Fx reduction | 2. Immobilization
28
Approx. time of immobilization of Fx
~6 weeks
29
What can immobilization cause? (6)
1. Stiffness 2. Decreased ROM 3. Capsular contracture 4. Muscle contracture 5. Muscle atrophy 6. Decreased strength of Connective tissue
30
What are the effects of muscle atrophy? (3)
1. Decreased force generation 2. 20% loss of strength in only 2 weeks 3. Alternated neuromuscular recruitment /coordination
31
What is the ligament /tendon failure point?
The normal stretch of a tendon to snap is lower; increases possibility of snapping.
32
Prognosis of a Fx (2)
1. Post-traumatic arthritis | 2. Women with wrist fx - 50% more likely to have clinically significant functional decline than those without
33
Three types of Fx reduction(3)
1. Closed reduction 2. Open reduction internal fixation 3. External fixation
34
Medical intervention and managment of an Open Reduction Internal Fixation - ORIF (4)
1. Surgical repair 2. Rods, screws, pins, plates 3. Casting/immobilization 4. WB modifications
35
Presentation of ORIF post surgery (4)
1. Pain 2. Edema 3. Limited ROM 4. Strength limits - local, proximal, distal
36
Indications of external fixation (3)
1. Open fracture 2. Closed severe Fx causing soft tissue damage or mutilple fractures 3. Limb alignment
37
Complex regional pain syndrome (CRPS)
Chronic disease characterized by severe pain, swelling and skin changes following trauma . Pain is disproportionate to injury. Usually seen in clients with immobilization and Fx
38
CRPS I
Formerly reflex sympathetic dystrophy | The absence of nerve injury
39
CRPS II
Formerly 'causalgia', nerve injury present
40
Etiology of CRPS
Unknown | Malfunction of the CNS and the PNS
41
Risk factors of CRPS (4)
1. Fx 2. Immobilization 3. Female gender 4. Concurrent motor nerve injury (type II)
42
Sign of CRPS Impact on sensory related function
Temperature changes -cold, clammy, sweaty skin
43
Signs of CRPS Impact on movement related function(4)
1. Edema 2. Decreased joint ROM 3. Muscle spasm/weakness/tremor 4. Alt. movement patterns (dystonia)
44
Signs of CRPS Impact on skin related functions (2)
1. Color - white, red , blue | 2. Texture - shiny, thin
45
Symptoms that Impact sensory function in CRPS (3)
1. May have chronic pain 2. Constant Burning/throbbing 3. Hypersensitivity - touch, cold
46
Symptoms that Impact movement related function in CRPS (2)
1. Joint stiffness | 2. Difficulty moving extremities
47
Symptoms that Impact the mental function in CRPS (3)
1. Depression 2. Anxiety 3. PTSD
48
How do you treat the mental function in CRPS ? (2)
1. Medication | 2. Desensitization with WB exercises
49
Prognosis of CRPS (2)
Children/ teens good recovery | Some- severe pain and disability
50
Osteoporosis
Pathological condition causes decrease in bone density. Leads to pathological fractures occurring during ADLs or trauma. Considered a serious health problem.
51
Most common fx caused by osteoporosis (4)
Vertebrae Wrist Pelvis Hip
52
Etiology of osteoporosis (4)
Estrogen deficiency Hormone imbalance Diet Sedentary lifestyle
53
Risk factors of osteoporosis (5)
1. Female gender 2. Caucasian or Asian descent 3. Increased age increased risk 4. Family hx 5. Ectomorphic body type
54
Ectomorophic body type
Long, thin, tall; lack of muscle or fat tissue.
55
Signs of Osteoporosis (4)
1. Silent - undetected until Fx occurs 2. Stooped posture 3. Loss of Ht. 4. Fx occurs easily
56
Symptom of Osteoporosis
Many people have no symptoms until they have a fx. | Experience pain, back pain
57
Prevention of Osteoporosis
Early bone density screening
58
Osteopenia
Reversible weakening of bone; bone density dwindles but not dangerously
59
Etiology of Osteopenia
Similar to Osteoporosis - Estrogen deficiency; hormone imbalance; diet; sedentary life style
60
Medical intervention and management of Osteopenia (3)
1. diet 2. supplements 3. local WB exercises
61
Osteoarthritis (OA)
Degenerative condition - cartilage degradation leading to bone-on-bone contact; viscous cycle of: Degradation - Pain - Inactivity - Degradation - Pain - Inactivity....
62
Etiology of OA - Primary (1) and Secondary (3)
``` Primary - Idiopathic Secondary - Post - Trauma (falling on joint increases trauma instantly Post - Surgery Mal-alignment ```
63
Risk factors of OA (2)
1. Abnormal carilage | 2. Abnormal stress on cartilage
64
What causes abnormal cartilage in OA? (3)
1. increased age 2. genetics 3. diseases (RA, gout)
65
What causes abnormal stress on cartilage in OA (4)
1. obesity 2. biomechanics 3. trauma to the joint 4. occupational (Repetitive stress)
66
Signs of OA that impact Movement Related Function(5)
1. Decreased ROM 2. Decreased Strength 3. Edema 4. Crepitus 5. Functional limitations located at the site
67
Symptom of OA that impact the sensory related functions
Pain that worsens with activity, is worse in the AM when waking, and in severe cases causes night pain
68
Symptoms of OA that impact the movement related functions (2)
1. Stiffness - AM | 2. Painful joint ROM
69
Symptoms of OA that impact mental functions(2)
1. Social and psychological effects of limited mobility | 2. Depression/Anxiety
70
OA impact on the hand (2)
1. Grip/Pinch | 2. Nodules
71
Heberden's Nodes
hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes).
72
Bouchard's Nodules
Bony bumps on the middle joint of the finger, proximal interphalangeal joints (PIP)
73
OA impact on the shoulder (2)
1. crepitus | 2. pain with sleep, reaching overhead or behind the back
74
OA impact on the hip(2)
1. pain in groin, thigh, buttock or referred to knee (common) 2. pain with walking, squatting, stairs, bending
75
OA impact on knee (2)
1. Crepitus, locking | 2. pain with walking, stairs, squatting
76
OA impact on the ankle
Pain while WB
77
Rheumatoid Arthritis
autoimmune disorder that attacks the synovium, forms a layer of pannus which leads to bone errosion, and cartilage/ligament degredation causing pain, swelling, inflammation and joint deformation. Bilateral presentation, flares, and remission
78
Risk factors of RA (4)
1. Female (2-3x higher than male) 2. Age 3. Genetics 4. Smoking
79
Signs of RA(7)
1. Flare and remission 2. Pain and tenderness (sensory) 3. Joints swollen and warm (movement) 4. Rheumatoid nodules (movement) 5. Fever/Fatigue/weight loss (movement) 6. Joint deformity (movement) 7. Painful ROM (movement)
80
Symptoms of RA (3)
1. Morning Stiffness lasts several hours (movement) | 2. Affected joints
81
Which joints are affected by RA? (9)
1. PIP 2. MCP 3. MTP 4. wrists 5. knees 6. hips 7. ankles 8. shoulders 9. elbows
82
Swan neck deformity - RA
PIP extension and DIP flexion
83
Boutonniere deformity - RA
PIP flexion and DIP extension
84
Ulnar drift - RA
hand deformity in which the swelling of the MCP joints (the big knuckles at the base of the fingers) causes the fingers to become displaced, tending towards the little finger.
85
Medical Intervention and Management of OA and RA
Joint arthroplasty
86
Joint arthroplasty
surgical procuedure to resurface the bones using a prosthetic joint. Cemented or uncemented is used in THA or TKA and pegs/screws are used in a TSA
87
Posterolateral THA precautions(3)
No hip flexion 90* No hip adduction No hip internal rotation (IR)
88
Anterolateral THA precautions (3)
No hip extension beyond neutral no hip external rotation (ER) Don't lay prone
89
Medical intervention and management of THA (4)
1. Pain(sensory) 2. Strength limitations (muscle fn) 3. Limited ROM (movement related) 4. Limited function - bed mobility, ambulation, functional tasks and THP for sitting/driving/reaching/squatting
90
TKA impact on body functions and structures (7)
1. pain!! (sensory) 2. swelling/inflammation (movement) 3. Limited ROM flexion/extension (movement) 4. Strength limitation (muscle function) 5. bed mobility /transfer (function) 6. Ambulation/elevation (function) 7. squat, driving (function)
91
Precautions for TSA (3)
1. Sling 2. Avoid AROM first 4 weeks, 3. No lifting >1lb. for 6 weeks
92
TSA impact on body functions and structures (9)
1. Pain (sensory) 2. Limited ROM (movement) 3. Strength limitations of the shoulder and scapula (muscle function) 4. Overhead reach (movement) 5. Sleeping (movement) 6. Driving (movement) 7. Lifting/carrying (movement) 8. Pushing/pulling (movement) 9. Dressing (movement)
93
Reverse TSA Impact on body functions and structures(2)
1. Loss of ROM | 2. Pain -free
94
Etiology of Tendinopathy
Result of overuse
95
tendinitis
inflammation of the tendon
96
tendinosis
degradation of tendon's collagen due to chronic overuse when tendon wasn't given time to heal
97
Signs of tendinopathy (3)
1. Warmth 2. redness 3. edema * all at the tendon
98
Symptoms of Tendinopathy(2)
1. pain with palpation, muscle contraction, stretch of muscle 2. stiffness after prolonged sitting/sleeping
99
Symptoms of Tendinopathy(2)
1. pain with palpation, muscle contraction, stretch of muscle 2. stiffness after prolonged sitting/sleeping
100
Lateral epicondylagia aka Tennis Elbow (effects? causes?)
Effects the ECRB (extensor carpi radialis brevis) | causes pain with grip and forearm activity.
101
Medial epicondylalgia aka Golfer's elbow (effects? causes?)
Effects the Flexor and pronator tendons (FCR and PT) | Causes pain with squeezing, lifting, shaking hands,turning doorknobs.
102
RTC tear
most often supraspinatus; full or partial
103
RTC tear signs and symptoms(3)
pain raising and lowering arm weakness night pain
104
Which tendon ruptures need immediate surgical intervention (3)
1. Achilles tendon 2. Patellar tendon 3. Triceps tendon
105
popeye deformity
long head biceps rupture
106
ligamentous injuries and instabilities(3)
1. ACL tear (ACL-R - Ant. cruciate ligament replace. ) 2. Ankle instability (ATFL - Ant. talofibular ligament) 3. Glenohumeral dislocation/subluxation (partial disloc.) * most common in athletes
107
Signs of ligament injury(3)
audible pop followed by sudden pain and swelling joint instability immediate functional impairment LE difficulty walking/running UE difficulty lifting carrying throwing etc
108
Etiology of Ligamentous injury/instability(2)
1. trauma | 2. non-contact caused by rolling ankle or directional change during movement (sports)
109
Symptoms of ligament injury (3)
pain(sensory) joint instability (movement) fear of re-injury (mental)
110
post-operative presentation of a ligamentous injury or instability (5)
1. immobilized to protect graft and repair 2. pain swelling and inflammation 3. Restricted ROM 4. Strength limitation 5. Restricted WB
111
orthopedics
injury and disease to bone, joints, and related structures - muscles, tendons, and ligaments
112
heterotopic ossification (HO)
abnormal bone formation in extraskeletal soft tissue
113
Etiology of HO
UNCLEAR 1. Whole body response to trauma - fibroblasts inappropriately start reforming bone 2. Excessive growth near joints - stiffness and loss of movement 3. Most common in ORIF (open reduction internal fixation)
114
ankylosing spondylitis
inflammatory disease that can cause some of the vertebrae in your spine to fuse together
115
Risk factors of HO (3)
traumatic injury - severe burn, spinal cord injuries, head injuries bone forming diseases - ankylosing spondylitis Revisions increase the risk
116
Signs and symptoms of HO
Asymptomatic - diagnosed on film | Usually 1-4 months post injury
117
Compound Fx
open fracture - at risk for infection
118
Comminuted Fx
bone breaks into many fragments
119
displaced Fx
breaks into two or more parts so that the two ends do not align up straight
120
Greenstick Fx
occurs in children with soft growing bones. One side of the bone breaks and the other side bends
121
Transverse Fx
breaks on a right ankle to the longitudinal axis of the bone

OCTH 1031 (22 decks)

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