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DPT 740/1: Clin Med 1 > EXAM 2- Hip Patho > Flashcards

EXAM 2- Hip Patho Flashcards

(73 cards)

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1
Q

what conditions can cause pathological hip fx

A

osteoporosis
osteomalacia
osteogenesis imperfecta (peds)
pagets disease
tumors

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2
Q

where is the most common site of the fx in a pathological hip fx

A

femoral neck

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3
Q

what are the symptoms of pathological hip fx

A

fx S&S
painful snap then giving way
groin pain (increase with WB)

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4
Q

what can we see in a scan for pathological hip fx

A

ob- shortened, ER LE
painful and asymmetric gait
ROM- several but IR limited
sp test- patellar- pubic percussion
possible sign of buttock

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5
Q

what is the notable observation of pathological hip fx

A

shortened, ER LE due to ER pulling the limb after the fx

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6
Q

what can cause the sign of the buttock

A

fx
tumor
infection
hematoma

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7
Q

what is in the SCAN for the sign of the buttock

A

hx- possible cancer, infection, or fx S&S
ob- gluteal swelling
ROM- limited hip flx in both directions, empty end feels
RST- weak and painful glutes

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8
Q

what is the referral if the sign of buttock is present

A

urgent
if fx, emergent if vascular compromise is thought

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9
Q

what is the referral for pathological hip fx

A

immobilize and emergent

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10
Q

who is most prevalent for pathological hip fx

A

older
women 65, men 70
osteoporosis type patient

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11
Q

what is the biggest concern with pathological hip fx for vascular damage

A

ER pull fx and can cause damage to the artery

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12
Q

What is osteonecrosis

A

Avascular necrosis or AVN femoral head

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13
Q

What is the cause of osteonecrosis through trauma

A

Fx
Dislocation
Slipped femoral epiphysis

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14
Q

What supplies the femoral head

A

Ligamentum teres houses an artery

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15
Q

What is the cause of osteonecrosis through gradual onset

A

Vascular abnormalities
Toxicity (radiation, smoking, alcoholism)
Sickle cell disease
Chronic corticosteroid and oral contraceptive
Bone marrow pathology
Metabolic syndrome

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16
Q

What is the pathology of osteonecrosis

A

Ischemia of bony tissue
Rapid ARJC
Labral tears

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17
Q

What are the symptoms of osteonecrosis

A

Groin, anteromedial thigh pain to the knee
Sign of buttock
Intermittent pain but worsening
Painful and asymmetric gait
ARJC S&S

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18
Q

What is different for osteonecrosis scan findings compared to ARJC

A

Hx of corticosteroid use
Colder to touch

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19
Q

What is the referral for osteonecrosis

A

Urgent referral

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20
Q

What if osteonecrosis is referred to PT

A

Gait training with AD to protect femur
Protection of motion, improve circulation, bone/cartilage integrity

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21
Q

What is Legg-Calve-Perthes

A

Coxa plana or flat hip
AVN femoral head in children

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22
Q

What can cause legg-calve-perthes

A

Trauma
Exposure to 2nd hand smoke
Prenatal factors
Developmental dysfunction of bone or vasculature

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23
Q

What is the pathology of legg-calve-perthes

A

Impaired vascular supply to epiphyses that changes the shape the femoral head and acetabulum

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24
Q

What are the symptoms of legg-calve-perthes

A

Gradual and unknown onset
Unilateral
Painful and asymmetric gait
Painful groin, anteromedial thigh pain to knee
Possible hip atrophy
Limited IR and ABD

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25
What is the referral for legg-calve-perthes
Urgent referral
26
What can we do if legg-calve-perthes
Gait training with AD Protect motion, improve circulation bone/cartilage integrity periodically bracing, splinting or casted in ABD position
27
how does casting in ABD position for legg-calve-perthes help bone/cartilage integrity
better femoral head contact maintain and help femoral head shape with acetabulum prone to contractures
28
what can happen to a pt with legg-calve-perthes later in life
ARJC corrective sx or early THA earlier LB and knee pain due to gait dysfunction
29
what is slipped capital epiphysis
anterior displacement of femoral neck on femoral head adolescent coxa vara most significant epiphyseal plate disorder
30
what can cause slipped capital epiphysis
idiopathic endocrine, renal disorder and down syndrome hypothyroidism
31
what are the RF for slipped capital epiphysis
obesity male rapid growth radiation femoral torsion
32
what is the prevalence of slipped capital epiphysis
early adolescence african american boys obesity bilateral
33
what is the patho of slipped capital epiphysis
displacement of femoral neck relative to the head though the growth plate due to shear forces and/or weakened epiphyseal plate
34
what are the S&S of slipped capital epiphysis
gradual, could be benign trauma groin pain
35
what can be found in a scan for slipped capital epiphysis
ob- painful and asymmetric gait ER hip m atrophy if long standing ROM- limited IR, ABD, FLX ER when fLX possible sign of buttock
36
what is the referral for slipped capital epiphysis
urgent
37
what would we do if slipped capital epiphysis is <1 cm slip was referred to us
splint in ABD with non WB post splint - gait training with AD, Protect motion, improve circulation bone/cartilage integrity
38
what would we do if slipped capital epiphysis is >1 cm slip was referred to us
sx is required
39
what complication are we trying to avoid with slipped capital epiphysis
avoid AVN or chondrolysis (rapid loss of articular cartilage)
40
what are vascular insufficiency S&S
coldness blueish or pale discoloration diminished pulses impaired capillary refill shiny skin hair loss emergency
41
what is the prevalence of colorectal cancer
3rd most common cancer 2nd cause of death metastasize to thorax
42
what are the RF for colorectal cancer
> 50 yrs family hx male IBS obesity smoking SAD
43
what is the pathology of colorectal cancer
develops in large intestine
44
what are the S&S for colorectal cancer
cancer S&S dull and L lower quadrant pain change in bowel bloody stool or black
45
what are the review components of colorectal cancer
ob- wavelike motion in L lower quadrant palpate lymph nodes and L lower quadrant vitals - fever
46
what can we do to help a colorectal cancer pt
exercise helps bowel function and transmit time
47
what should be done to prevent colorectal cancer
routine screen - colonoscopy at age of 45 urgent referral
48
what are the RF for cervical cancer
HPV drug and alcohol abuse more than 5 sexual partners
49
what is the prevalence of cervical cancer
3rd most common female cancer behind breast and colorectal younger females
50
what is the pathology of cervical cancer
HPV limits suppressor gene and malignancy develops
51
what are S&S of cervical cancer
cancer S&S pelvic and lumbar pain excessive and untimely bleeding bowel/bladder/sexual dysfunction
52
what are the review components for cervical cancer
palpation of lymph nodes vitals- fever
53
what are complications of treatment for cervical cancer
radiation decreases estrogen so decreased bone density
54
what are preventative measures for cervical cancer
regular OBGYN visits HPV vaccine around 11/12 yrs
55
where is chondrosarcoma most effected
pelvis and femur
56
who is most effected my chondrosarcoma
middle age males
57
what is the pathology of chondrosarcoma
thickening cortex destruction of medullary and cortical bone malignant cartilage
58
what are S&S of chondrosarcoma
progressive and local swelling cancer S&S fx S&S
59
what are review components of chondrosarcoma
sign of buttock palpation of lymph nodes vitals- fever
60
what is the prevalence of appendicitis
late adolescence males
61
what can cause an appendicitis
unknown obstruction due to neoplasm, infection, foreign body
62
what are the S&S of appendicitis
periumbilical to R lower quadrant pelvic pain R hip/groin pain not eating infection/cancer S&S worse with increased abdominal pressure
63
what are review components of appendicitis
ob- redness/swelling ROM- pain and limitation with hip and trunk flexion palpation- lymph nodes abdominal quadrant assessment vitals- fever
64
what is the pathology of inguinal hernia
weakness/tearing in the abdominal organ covering that allows portion of organs to move out of their boundary
65
what can cause an inguinal hernia
age obesity pregnancy abdominal m weakness trauma
66
what are the S&S of inguinal hernia
progressively bulges and becomes painful worse with increased abdominal pressure burning/pinching may radiate into thigh or pelvic midline
67
what are the review components of inguinal hernia
S&S of respective organ ROM- Pain and limitation with hip and trunk flx palpation- pain with percussion, bulge
68
what is septic arthritis
active local infection on a weakened or compromised jt at primary site of infection
69
what are RF for septic arthritis
penetrating trauma total jt chronic jt replacement diabetes immunosuppression infectious disease substance abuse sickle cell disease renal failure
70
what is the pathology of septic arthritis
microorganism invasion weakened and compromised jt bacteria activates clotting factors lead to thrombosis massive inflammation
71
what are S&S of septic arthritis
infection painful and asymmetrical gait infection S&S
72
what are the review components of septic arthritis
refusal to move- pain, limited ROM, weakness in multiple directions possible sign of buttock palpation- TTP, lymph nodes, heat, swelling
73
what is the referral for septic arthritis
emergency to avoid permanent jt and bone damage

DPT 740/1: Clin Med 1 (7 decks)

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