Week 5 Flashcards by Alyssa Powell

Orthoses for arthritis are used to do what?

Reduce inflammation
Support and stabilize joints during function to reduce pain
Protect joints from increased stress/demand
Prevent joint contractures
Immobilize unstable joints
Increase ROM
Increase Function
Position joints for occupational performance

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What is the presentation for Rheumatoid arthritis?

Boutonniere deformity of thumb
Ulnar deviation of metacarpophalangeal joints
Swan neck deformity of fingers

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What is the presentation for Osteoarthritis?

Fusiform swelling of joints
Heberden’s nodes
White in joint spaces in X-ray demonstrating bone overgrowth

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What is Wolff’s law?

If you don’t use it, you lose it.

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What joints does OA often affect?

DIP, PIP and CMC joints

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What are the common symptoms of OA?

Joint tenderness

Crepitus pain-creaking joints

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What often occurs to the wrist joint for RA patients?

95% develop bilateral wrist joint involvement

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What are the four types of orthoses used for RA?

Resting orthosis
Static orthosis
Static progressive orthosis
Dynamic splints

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What are the aspects of the resting orthosis?

Provides passive immobilization during acute stage of inflammation
Alleviate pain
Facilitate the use of uninvolved joints

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What are the aspects of the static orthosis?

Provides support, stabilization, protection, and immobilization
No moving components

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What do finger orthoses do?

Prevent swan neck deformity

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What does a thumb post do?

Prevent swan neck deformity of thumb

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What does a HO do?

Stabilizes CMC joint and MP joint

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What should be used with more wrist involvement?

A WHO

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What are the aspects of the static progressive orthosis?

Used to regain joint motion
Joint motion is achieved by the hook and loop closures, hinges, screw, and turnbuckles
Reduces ulnar deviation

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What are the aspects of the Dynamic orthosis?

Used to apply force to lengthen tissue in order to restore motion
Counteract the deforming forces of RA with constant gentle traction
Essential for post-op rehabilitation to maintain the surgically achieved mobility

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How many people in the US suffer from traumatic brain injury each year/

1.5 million

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How many people die from TBI each year?

50,000

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How many people suffer long term disabilities?

85,000

How many people in the US live with disabilities cause by TBI?

5.3 million

What are the top three causes of TBI injury?

MVA
Firearms
Falls

Who are involved in the highest incident rates?

Males, 15-24

Geriatrics, 75+

What are the two classifications of TBI?

Open head injury

Closed head injury

What is open head injury?

Involved acceleration/deceleration with penetration

What is closed head injury?

Rapid acceleration/deceleration without apparent visible damage.

How do open head injuries occur?

Bullet wounds Penetration of the skull Largely focal damage

How do closed head injuries occur?

Slip and fall, MVA Focal damage and diffuse damage to axons Effects tend to be broad NO penetration of skull

What are the immediate damages of closed head injuries?

``` scalp laceration skull fracture cerebral contusions cerebral lacerations intracranial hemorrhage diffuse axonial injury ```

What are the secondary damages of closed head injuries?

Ischemia hypoxia cerebral swelling infection

What is another name for deceleration injuries?

Diffuse axonal injuries

What is diffuse axonal shearing?

When the brain is slammed back and forth inside the skull it is alternately compressed and stretched because of the gelatinous consistency till they are torn

What are deceleration injuries?

The long, fragile axons of the neurons are also compressed and stretched

What occurs when axonal shearing happens?

The neuron dies

What is Coup Contra-coup injury?

Instance where the brain bounces back and forth inside of the head, causing damage to the brain where it hit the skull

What determines how a patient will present?

The extent of brain injury

What are the different types of TBI presentations?

Hemiplegia Diplegia Quadraplegia

What should be checked on TBI patients?

Each affected limb for flexor or extensor synergy patterns

What is synergy?

Synergy occurs when muscles are firmly linked together and the patient is unable to master individual joint movements

What can the static tests show?

The affected limb may manifest as dystonic with dominant synergy pattern slowly taking precidence

What are the different limb synergies?

Reflexive Voluntary A combination of reflexive and voluntary

What is a reflexive synergy pattern?

Involuntary evoked response to a physical agent (touch, stretching, vibration)

What is a voluntary synergy pattern?

Produced through volitional movement, such as active knee or elbow extension

Why are orthotic subscribed to TBI patients?

``` Prevent contractures Maintain mobility (for hygiene) ```

What orthosis can be used for TBI patients?

A WHO to maintain wrist alignment and prevent finger flexor deformities Finger separators are preferred to prevent friction between fingers

What device should be used if spasticity occurs in the finger flexors and full extension can't be reached?

A sphere-shaped palmer device

What can be used if the patient has hypersensitivity to palmar contact?

A dorsal splint because palmar contact can elicit a grasp response

What additional resources might benefit OA, RA and TBI populations?

Assistive devices | Knowledge-pamphlets, support groups, 360 care