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Older adult > Degenerative diseases > Flashcards

Degenerative diseases Flashcards

(43 cards)

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1
Q

Rheumatic diseases

A

Characterized by chronic pain, and progressive impairment of the joints and soft tissue

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2
Q

Examples of rheumatic diseases

A

Osteoarthritis, rheumatoid arthritis, systemic lupus erthematosus, ankylosing spondylitis, scleroderma, gout, fibromyalgia

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3
Q

General guidelines assessment

A

pain, skin integrity, sensory disturbances, edema, presence of or propensity for deformities, knowledge of disease, activity tolerance, depression, cognitive- impairments, visual- perceptual impairments

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4
Q

Pain assessments

A

Face or numbers

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5
Q

General guidelines for treatment

A

Joint protection/ energy conservation, edema care, skin integrity, pain management, functional mobility, splinting, assistive devices, ROM, lifestyle modifications, community services, complementary and alternative services

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6
Q

Osteoarthritis

A

Degenerative joint disease; most common type of arthritis, may be limited to 1 joint or may be in several joints, not systemic (wear and tear)

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7
Q

Joint degernation

A

Characterized by progressive loss of articular cartilage

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8
Q

Types of osteoarthritis

A

Primary or secondary

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9
Q

Primary osteoarthritis

A

Genetic

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10
Q

Secondary osteoarthritis

A

due to trauma, occupational stress, disease

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11
Q

Common sites for osteoarthritis

A

Hands, cervical spine, lumbar spine, hips, knees, ankles and feet

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12
Q

Stages of tissue breakdown

A

(1) smooth cartilage softens & loses elasticity (2) large sections of cartilage wear away and result in bone-on-bone contact (3) ends of bone thicken and osteophytes are formed, & joint loses normal shape (4) fluid filled cysts or bone cartilage particles float loose in the joint space

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13
Q

Osteoarthritis clinical features

A

joint stiffness, tenderness, limited ROM, crepitus, morning stiffness, stiffness following inactivity, bony appearance of their joints

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14
Q

Mallet finger

A

extensor tendon disruption; tendon tears and causes DIP to come apart

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15
Q

Rheumatoid arthritis

A

Symmetrical, polyarticular pain & swelling, joint deformities, early morning stiffness, malaise and fatigue and no cure

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16
Q

Can affect other systems including

A

eyes, skin, lungs, heart, gastrointestinal system, kidneys, nervous system and blood

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17
Q

Treatment for RA wrist

A

Synovectomy (early stages), wrist reconstruction, wrist fusion (10 degrees of flexion)

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18
Q

RA MCP deformities

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A

Ulnar drift and volar dislocation

19
Q

RA thumb deformities

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A

Boutonniere, hyperextension MP and IP joint, swan neck, gamekeepers thumb

20
Q

Thumb deformities surgical procedures

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A

fusion/ arthodesis, arthroplasty, ligament reconstruction and tendon interposition

21
Q

Fusion/ arthodesis

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A

Isolated IP (0-20 degrees of flexion), multiple joint is avoided- “last ditch”

22
Q

Arthroplasty

23
Q

Ligament reconstruction and tendon interposition (LRTI)

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A

CMC joint was replaced and going in and using the tendon

24
Q

Swan neck deformity

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A

hyperextension of PIP joints with flexion of DIP joint

25
Boutonniere deformity
Hyperextension of DIP & MCP joints with flexion of PIP joints
26
Swan neck deformity treatment
focus on correcting PIP joint hyperextension and DIP extension, conservative: silver ring splints, surgical: Fusion DIP, PIP flexor tenodesis or reconstruction retinacular ligament
27
Trigger finger
Synovial proliferation on the flexor tendon
28
Medical management for RA
Suppress inflammation, pain reduction and education
29
Ways to suppress inflammation
disease- modifying anrirheumatic drug, corticosteroids
30
Ways for pain reduction
Acetaminophen, NSAIDs
31
OT evaluation
Comorbidities, medication, OT profile/ social hx, occupational performance (BADL & IADL), ROM/ strength, Edema, grip & pinch (modified), endurance, determine pain levels, self- reported outcomes
32
Re-evaluation
Location of pain, hot & inflamed joints, swelling, tendon rupture, nodules, crepitus, subluxations or dislocations, deformities, synovitis, nodules
33
Therapy goals
Maintain/ increase function, maintain joint mobility, prevent joint deformity, problem solving skills for modifications of activities, maintain/ increase strength, balance activity & rest, facilitate coping skills for adjustment to disability, education
34
More therapy goals
Daily, GENTLE ROM, no stretching during flare- up, pain after ROM shouldn't last more than 1 hour, appropriate splinting
35
Exercise
Don't exercise during exacerbations, isometric exercise during exacerbation, acquatic exercises
36
Joint protection
Respect pain, distribute load over several joints, reduce the force & effort required in ax, use correct patterns of movement, use good body positioning/ posture/ and moving and handling techniques, use the strongest/ largest joint avaliable, avoid staying in one position for too long, use ergonomic equipment, pace activities, use work simplification, modify the environment, maintain muscle strength & ROM
37
Systemic lupus erythematosus
Systemic autoimmune disorder- multiple organ involvement, remissions & exacerbations, fever & fatigue, butterfly rash, Raynaud's phenomenon, kidney disease, cardiopulmonary, joint symptoms occur in >90%, conjunctivitis, photophobia, monocular blindness, blurred vision, dry eyes, psychosis, cognitive impairment, seizures and strokes
38
SLE medication
NSAIDs, antimalarial drugs, corticosteroids, immunosuppressants, biologics
39
Fatigue management
maintain engagement in everyday ax, avoid vigorous ax, work simplification , identifying triggers & managing set backs
40
Work simplification & energy conservation
prioritize ax, breaking down tasks/ ax, increase efficiency, teach alternative strategies, adaptations
41
Identifying triggers and managing set backs
triggers can be physical, psychological or environmental, develop a balance between ax, avoid exacerbations of symptoms
42
Fibromyalgia
Fatigue, waking unfreshed, cognitive problems, symptoms lasting at least 3 months at a similar level, no other health problem that would explain the pain & other symptoms
43
Fibromyalgia treatment
Relaxation, regular sleep pattern, exercise often, educate yourself

Older adult (7 decks)

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