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Human Analysis Summer 2014 > Work-Related Musculoskeletal Disorders > Flashcards

Work-Related Musculoskeletal Disorders Flashcards

(68 cards)

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1
Q

where are Musculoskeletal disorders the predominant occupational health problem ?

A

industrialized countries

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2
Q

what are WRMD’s?

A

Painful disorder of muscles, tendons, nerves due to overuse, repetitive injury NOT traumatic

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3
Q

what do WRMD result in?

A

loss of productivity

on both the working and non-working lives

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4
Q

what are the body regions usually involved?

A

hands, wrists, elbows, shoulders & neck

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5
Q

what are the 2nd most injured body regions?

A

back, lower extremities

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6
Q

what are other names for WRMD?

A

Cumulative Trauma Disorders (CTD) (north america)
Repetitive Strain/Stress Injuries (RSI)
Occupational Cerviobrachial Disorder (OCD)
Overuse Syndrome
Repetitive Motion Disorders
Regional MS Disorders
Soft tissue disorders

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7
Q

are WRMD a diagnosis?

A

no just a general category

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8
Q

what % of WMSD represent registered occupational disease?

A

1/3 or more

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9
Q

what % of WMSD are UE symptoms?

A

20-30%

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10
Q

what do WMSD cause more of than any other group of diseases?

A

work absenteeism or disability

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11
Q

what are general high risk sectors?

A 
Nursing facilities
Air transportation
Mining
Food processing
Leather tanning
Heavy/light manufacturing
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12
Q

what are high risk UE sectors?

A 
Clerical work
Postal service
Cleaning
Industrial inspection
Packaging
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13
Q

what are high risk LE sectors?

A 
Truck drivers
Warehouse workers
Baggage handlers
Construction
Health care workers
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14
Q

what is the most common category of injury?

A

overexertion (25%)

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15
Q

how much do indirect costs affect cost?

A

Indirect costs are estimated to be from 2-5 times the direct costs

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16
Q

what are WMSD risk factors?

A 
Repetition
High force
Awkward postures
Direct pressure
Vibration
Prolonged static positioning
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17
Q

what does repetition cause?

A

tissue micro trauma & fatigue

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18
Q

what is fatigue proportional to?

A

the amount of force & duration of force application

i.e. hazardous movements hand & wrist

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19
Q

what does intr-muscular pressure cause?

A

decreased blood flow -> muscle energy crises & pain

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20
Q

what are the results of sufficient vs insufficient recovery?

A

sufficient recovery is permitted after trauma, results may be stronger tissue. If recovery in insufficient, muscle injury may occur

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21
Q

what are txs for repetition and force?

A

Rest
Splinting
Anti-inflammatory meds

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22
Q

what can awkward postures lead to?

A

muscle imbalance

pressure around, stretch of nerves

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23
Q

what are issues of muscle imbalance?

A

weakness, pain
overuse, underused
muscle lengthening, shortening

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24
Q

how do you tx awkward postures?

A

Ergonomic modification
breaks,
alternative postures,
fitness

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25
what are psychological risk factors?
Job repetition, dissatisfaction Anxiety Depression Pain
26
how do you tx psychological causes for WMSD?
Goal directed & educational gives people control and relief
27
What are characteristics of WMSD?
``` Mechanical & physiological Related to work intensity & duration Develops/recovers over weeks, months, years unreported multifactorial ```
28
what are symptoms of WMSD like?
poorly localized, non-specific, episodic
29
what are the 4 categories of WMSD?
nerve compression (entrapment) syndrome tendinitis/tenosynovitis pain syndromes other
30
what is nerve compression (entrapment) syndrome?
incompatibility between volume of PN structure & anatomical space available to nerve
31
what is tendinitis/tenosynovitis?
inflammation of tendon & synovial membrane of tendon sheath
32
what are nerve compression syndromes?
``` Cervical radiculopathy Thoracic Outlet Syndrome (TOS) Cubital Tunnel Syndrome Anterior Interosseous Syndrome Pronator Teres Syndrome Carpal Tunnel Syndrome Guyon’s Canal Syndrome ```
33
where does tendonitis of the shoulder occur?
``` Rotator cuff muscles Biceps Brachii (long head) ```
34
how does tendonitis of the elbow occur?
Lateral (extensor) Epicondylitis | Medial (flexor) Epicondylitis
35
how does tendonitis of the wrist occur?
deQuervain’s (APL, EPB) | FCU, FCR, EIP
36
what are examples of pain syndromes?
Complex Regional Pain Syndrome Myofascial Pain syndrome Fibrositis Fibromyalgia
37
what are examples of other syndromes?
Vibration white fingers Osteoarthritis vascular syndromes
38
what does nerve compression cause?
Inflammation/thickening of tendon = compression of nerve & vascular supply
39
what is more involved in nerve compression?
sensory>motor
40
what is an indication of nerve compression?
hormone changes
41
what are symptoms of nerve compression?
vague but include pain, tingling, numbness, weakness
42
what is compressed in carpal tunnel syndrome?
median nerve
43
what are early symptoms of WMSD?
aching & tiredness of limb during work but disappears at night/days off. No reduction of work
44
what are intermediate symptoms of WMSD?
aching and tiredness occurs early in work day, persists at night, reduced capacity for repetitive work
45
what are late symptoms of WMSD?
all symptoms persist at rest, inability to sleep perform even light duties
46
what occurs during the tendonitis cycle?
overuse = micro trauma = swelling, pain, less motion followed by rest, disuse, and weakness
47
what is the presentation of tendonitis?
localized pain, swelling, pain on resisted motion, movement limitation, weakness, and crepitation of tendon
48
what are the symptoms of tendonitis?
pain and limited ROM reproduced with work
49
what does myofascial pain cause?
Muscle overuse causes hyperirritability with a focal point = “trigger point”
50
how does muscle overuse present itself?
local inflammatory response, muscular hardness, local ischemia & connective tissue irritation
51
how do overused muscles palpate?
muscles feel “ropey”
52
what are symptoms of muscle overuse?
generalized, diffuse pain & weakness, traditional treatment for tendinitis has failed
53
what are indicators of grade 1 cumulative trauma disorders (CTD)?
pain after activity, resolves with rest no decrease in amount or speed of work no objective findings
54
what are indicators of grade 2 CTDs?
pain while working, resolves with rest productivity mildly affected may have objective findings
55
what are indicators of grade 3 CTDs?
pain in 1 or more sites while working pain after activity stops productivity affected, many breaks needed affect activity outside of work weakness, loss of dexterity, tingling, numbness active or latent trigger points
56
what are indicators of grade 4 CTDs?
all common uses of hand & UE cause pain 50% - 75% of time can work/works in limited capacity objective findings: weakness, loss of control & dexterity, tingling, numbness, trigger points
57
what are indicators of grade 5 CTDs?
loss of ability to use hand/UE due to chronic unrelenting pain usually unable to work symptoms may persist indefinitely
58
how do you tx CTDs?
OT must take active role in investigating relationship between injury (pathology) and activity
59
what do OT's do in tx for CTDs?
``` Restriction of movement Application of heat/cold/modalities Exercise Medication Surgery ```
60
what occurs during phase 1 of tx?
Symptom Control: reduce symptoms while teaching self-management Strengthening: only when symptoms begin to subside
61
what are some modalities used in tx?
Hot packs, Neuromuscular Electrical Stimulation (NMES), Ultra Sound, Splinting
62
what occurs during phase 2 of tx?
Conditioning: when acceptable strength has returned but endurance is needed, all symptoms resolved Ergonomic Assessment: in acute phase Return to work (job analysis)
63
what is the vocational model of tx?
person as client OT works with rehab professionals to find employment for injured worker as job options are developed, OT reviews for physical appropriateness, suggests supports and adjustments
64
what occurs in case management model of tx?
OT works as consultant to insurance co
65
what does OT do as a case manager?
follows injured worker through medical & rehab process coordinates services, stays in communication with worker facilitates worker through WC system so time isnt wasted and person returns to work
66
what occurs in the industrial model of tx?
ergonomic training of employees and supervisors, on site evaluations, prevention of injury screening of new employees to comply with ADA
67
how can job design prevent WMSD?
Mechanization Rotation Enlargement/enrichment Teamwork
68
how can WMSD be prevented?
job design Workplace Design Tools & Equipment Design Work practices

Human Analysis Summer 2014 (6 decks)

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