Pathologies Related to the Pelvis and Hip

Question 1

function of colon and rectum

Answer 1

colon = dehydrate food and form into stool; bacteria feed on waste and break down further

rectum = stool stored prior to bowel movement

Question 2

incidence/prevalence of colorectal cancer

Answer 2

3rd most common cancer

2nd leading cause of cancer death

most commonly metastasizes to thorax

Question 3

risk factors for colorectal cancer

Answer 3

> 50
family hx
male
IBS
obesity
smoking/alcohol
diets low in veggies and high in sugar and animal fat

Question 4

pathogenesis of colorectal cancer

Answer 4

malignant neoplasm that develops in large intestines

Question 5

possible Hx for colorectal cancer

Answer 5

cancer S&S

possible referred pain that is dull/diffuses to L lower quadrant (T10-S2)

change in bowel/bladder function; possible obstruction

bloody (hallmark) or black stool

Question 6

observation for colorectal cancer

Answer 6

wavelike motion in lower L quadrant if obstructed

Question 7

lymph node findings for cancer

Answer 7

abnormal

> 2cm

firm/immobile

Non tender

Question 8

signs that you may find with colorectal cancer

Answer 8

pain with palpation and percussion in lower left quadrant with inflammation

vital signs = fever

Question 9

PT implications for colorectal pain

Answer 9

ensure routine screening i.e. colonoscopy beginning at 45

exercise helps bowel function and transit time

urgent referral to MD

Question 10

function of cervix

Answer 10

sex cell motility

protect from bacteria/foreign objects

path for birthing

Question 11

risk factors and etiology for cervical cancer

Answer 11

human papillomavirus (HPV) is primary risk factor

drug and alcohol use that inhibits judgement

> 5 sexual partners

has become very preventable

Question 12

incidence/prevalence for cervical cancer

Answer 12

3rd most common female cancer behind breast and colorectal

increasing in younger females

Question 13

how does HPV create a pathogenesis for cervical cancer

Answer 13

HPV limits neoplasm surpressors in cervix and allows malignant neoplasm to develop

Question 14

Hx possible for cervical cancer

Answer 14

cancer S&S

pelvic/LBP

excessive and untimely bleeding

bowel/bladder and or sexual function due to pressure from enlarged cervix

Question 15

PT implications if cervical cancer is suspected

Answer 15

ensure regular OB/GYN visits

HPV vaccine at 11-12; less effective after sexual activity

radiation decreases estrogen so decreased bone density may be a side effect; think about bony ramifications and diseases

URGENT REFERRAL

Question 16

what is a chondrosarcoma (etiology, common locations and populations)

Answer 16

slow growing malignant neoplasm

sporadic and unkown etiology

common in pelvis/femur

middle aged males most affected

Question 17

what happens with a chondrosarcoma

Answer 17

thickening of the cortex

destruction of the medullary and cortical bone

soft tissue mass

pathogenesis: chromosomal abnormalities lead to malignant cartilage neoplasm and possible bony changes

Question 18

possible Hx for chondrosarcoma

Answer 18

progressive/localized pain and swelling

cancer S&S

possible fx S&S if advanced

Question 19

exam findings for chondrosarcoma

Answer 19

potential mechanical symptoms because of space occupying potential but it wont match orthopedic conditions

possible sign of the buttock

palpation of lymph nodes like cancer

fever

Question 20

referral for chondrosarcoma

Answer 20

urgent

Question 21

incidence/prevalence of appendicitis

Answer 21

most common in late adolescence

males > females

rare in older adults but half of all deaths due to rupture are those > 70

Question 22

etiology of appendicitis

Answer 22

unknown in 50% of cases

obstruction due to neoplasm, infection, foreign body preventing normal drainage

Question 23

pathogenesis of appendicitis

Answer 23

inflammation that can result in infection, necrosis, and rupture

Question 24

Hx for appendicitis

Answer 24

classic sequence:
-periumbilical to R lower quadrant pelvic pain
-may also have R hip or groin P!
-not eating
-possible infection or cancer S&S

worse with increased abdominal pressure:
-fwd bending or knees to chest
-valsalva maneuver (i.e. coughing, laughing)

Question 25

observation with appendicitis

Answer 25

redness and swelling/hot with infection in R lower quad

Question 26

ROM findings for appendicitis

Answer 26

pain and limitations with hip and trunk flexion at end ranges

Question 27

palpation findings for appendicitis

Answer 27

>2cm firm tender if infection is acute non tender/immobile if cancer

Question 28

appendicitis referral

Answer 28

urgent unless severe pain then emergent

Question 29

overview/pathogenesis of inguinal hernia

Answer 29

congenital or aquired weakness/tearing int eh abdominal organ covering that allows portions of organs to move out of their boundary or herniate

Question 30

etiology of inguinal hernia

Answer 30

age obesity/pregnancy abdominal muscular weakness trauma like sx/heavy lifting

Question 31

incidence/prevalence of inguinal hernia

Answer 31

most common type of hernia 75% of all hernias can occur at any age

Question 32

Hx for inguinal hernia

Answer 32

painless and small at first progressively bulges and becomes painful in groin area worse with increased abdominal pressure burning/pinching may radiate into thigh/pelvic midline

Question 33

S&S for inguinal hernia

Answer 33

herniating organ may become resitricted and dysfunctional and may develop into systemic S&S of the respective organ that is herniated ROM = pain with hip/trunk flexion at end range pain with palpation and percussion in lower quads; palpable bulge especially with activity

Question 34

referral for inguinal hernia

Answer 34

urgent

Question 35

what is septic or infective arthritis

Answer 35

active local infection on a weakened or compromised joint at site of primary infection

Question 36

risk factors/etiology of septic or infective arthritis

Answer 36

penetrating trauma total joint replacement chronic joint damage diabetes immunosuppression infectious disease substance abuse sickle cell disease renal failure affects immunity

Question 37

incidence of septic or infective arthritis

Answer 37

most common in LE joints, particularly hip and knee infants, children, and older adults at increased risk

Question 38

pathogenesis of septic arthritis

Answer 38

microorganizsm invasion that could be bacterial. viral, or fungal multiplies rapidly due to weakened/compromised joint health and moist nature of synovial fluid of joint bacteria activates clotting factors that may lead to thrombosis massive inflammation or pannus erods articular cartilage and subchondral bone in a few weeks

Question 39

Hx and observation for septic arthritis

Answer 39

acute/sudden onset of infection and antalgic and asymmetrical gait other infection S&S

Question 40

scan findings for septic arthritis

Answer 40

refusal to move or allow affected joint to be moved so pain and limited ROM and weakness in multiple/all directions possible sign of buttock

Question 41

palpation for septic arthritis

Answer 41

severe TTP abnormal lymph nodes (firm and tender) heat swelling

Question 42

referral for septic arthritis

Answer 42

emergency early dx is critical to avoid permanent joint and bone damage treatment within 4 days of infection can prevent damage