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THER 130 > 120 SECOND EXAM > Flashcards

120 SECOND EXAM Flashcards

1
Q

What kind of joint is the hip joint?

A

Ball and socket

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2
Q

What is the most common fracture in the elderly?

A

femoral head

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3
Q

What are hip fractures due to?

A

FALLS, osteoporosis

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4
Q

Osteoarthritis

A

-the wearing down of articular cartilage on the surfaces
-bone to bone

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5
Q

Rheumatoid arthritis

A

-Inflammation and destruction of the synovial lining of the joint

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6
Q

Osteoporosis

A

thinning of the bone

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7
Q

Carcinomas

A

tumours/cancer

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8
Q

Osteosclerosis

A

blood supply to the femoral head is compromised due to fracture leading to death of the bone tissue

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9
Q

HIP FRACTURE

A

FEMORAL FRACTURE

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10
Q

What can result from being immobile

A

pressure sores, Pulmonary Embolism

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11
Q

Femoral neck fracture

A

poor blood supply, takes longer to heal

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12
Q

Intertrochanter

A

in-between the lesser and greater trochanter, heals better, more blood supply

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13
Q

Examples of how to prevent falls

A
  • Balance
  • Clutter
  • Good lighting
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14
Q

Surgically fixated hip replacements

A

-pins, nails, rods, into the femur- “hip-pinning”
-Open reduction

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15
Q

ORIF

A

open reduction internal fixation

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16
Q
  • Hemiarthroplasty-
A

partial hip replacement-
acetabulum still intact, only femoral head replaced with a prosthesis, a faster surgery

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17
Q
  • Resurfacing-
A

Birmingham method- femoral head is resurfaced- metal cap placed over it- younger patients, short recovery time, fewer complications

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18
Q
  • Replacement-
A

total hip replacement

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19
Q

THR

A

End of femur resected- the ball is removed
Acetabulum reamed to fit prosthesis
Metal or ceramic prosthesis

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20
Q

RISKS OF THR

A
  • Blood clots
  • Difference in leg length
  • Infections (UTI’s) or difficulty urinating
  • Stiffness
  • Dislocation of hip
  • Infection of joint
  • Can require re-operation
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21
Q

STEM OF PROSTHESIS
Can be:

A

Cemented or uncemented

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22
Q

Cemented

A

using crutches or walker a person can out some weight on the leg immediately, but continue to use support for the following weeks
-older clients usually have cemented to expedite mobilization

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23
Q

Uncemented

A
  • The surgeon will give specific info about weight bearing
  • Can’t take as much weight as a cemented prosthesis
  • New bone takes 6-12 weeks to grow in
  • Younger clients are better candidates
  • Tend to be stronger in the long run
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24
Q

HIP REPLACEMENT COMPLETE

A
  • New hip is put together, muscles and skin are sewn or stapled
  • The surgeon tests the hip for stability
  • Takes a couple hours
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25
POST SURGERY:
Deep breathing and coughing exercises Must keep pillow b/w legs in bed- 12 weeks Will sit and stand asap Begin ankle pumps and thigh and buttock isometrics asap Must be able to do ADLs safely Must be able to mobilize independently Isometric-holding muscle w/o moving joint
26
NWB
Non weight bearing- (0%) Walker or crutches
27
TTWB
Toe touch weight bearing 10%) Walker or crutches
28
PWB
Partial weight bearing (30-50%) Walker or crutches
29
FWB
Full weight bearing 100% cane or no device
30
WBAT
Weight-bearing as tolerated (guided by pain tolerance) Walker, crutch, cane.
31
HIP PRECAUTIONS
- No flexion past 90 degrees - Don’t internally/externally rotate hip - Don’t adduct hip/leg past midline - Don’t twist excessively at the waist
32
DO NOT COMBINE
hip flexion, internal rotation, and adduction of the operated leg
33
PRECAUTIONS IN LYING
- Keep a pillow in between legs- do not adduct hip/leg past midline - Do not rotate hip: keep toes pointed up - Do not lie on the operated side - Sleeping- on back with legs slightly apart
34
DISLOCATED HIP
- Not following precautions may lead to hip dislocation - The prosthetic femoral head “pops” out of the acetabulum - The joint is less stable because after surgery muscles and tendons are stretched and weakened
35
SIGNS OF DISLOCATION:
- Sudden pain - Shortened leg - Needs to be popped back in under anesthetic, casting, bracing for several weeks - May require revision surgery- more complex
36
PRECAUTIONS IN SITTING:
No low chairs Try to only sit in chairs that have arms Do not cross legs Affected leg out front Get up and move around on a regular basis at least once an hour
37
Assistive devices:
Reacher Shoe horn Sock aide Leg lifter Firm cushion Good shoes-slip on Raised toilet seat Long handled bath sponge Walker, crutches, cane
38
Up stairs
The unaffected leg goes up first Then unaffected Then cane/walker
39
Down stairs
Operated leg down first Use railing
40
DRIVING:
6 weeks Need permission from surgeon Avoid low bucket seats or trying to climb in the back of a two-door vehicle Recline seat A plastic garbage to pivot
41
RETURN TO WORK
Depending on the type of work 3-6 months
42
LONG TERM
For at least 12 weeks post-op, avoid: - Excessive bending - Lifting or pushing several objects - Sitting on low surface - Activities that require quick stops, twisting and high impact loads - Continue post-op exercises - Continue to use assistive devices
43
Recommended:
¡ Walking ¡ Swimming ¡ Golf ¡ Low impact aerobics ¡ Gentle yoga
44
With CAUTION:
¡ Vigorous walking/hiking/jogging ¡ Skiing ¡ Repetitive lifting
45
DISCOURAGED:
¡ Tennis ¡ Skating ¡ Contact sports ¡ High impact sports (basketball, volleyball) ¡ Jumping (skipping rope, trampoline
46
Hip should last
15-20 yrs
47
Why are slings used?
Used in rehabilitation for various conditions Fractures Neurological conditions Stroke=controversial
48
PRO’s of sling use
Protects UE from injury during transfers May prevent tissue stretching Prevents prolonged dangling of extremity May relieve pressure on brachial plexus and artery Supports weight of arm
49
CONS
* May contribute to unilateral neglect * May contribute to learned non-use * May initiate shoulder hand syndrome * May approximate head od humerus to maligned scapula * Prevents reciprocal arm swinging during gait * Prevents arm function * Blocks sensory input * Prevents balance reactions of the UE * Places no motor demands on the UE- contributes to learned non-use of arm
50
Orthosis
A device to support, position or immobilize a body part
51
Prosthesis
An artificial substitute, often mechanical or electrical used to replace a missing body part
52
Causes of amputations
1. Arteriosclerotic Disease 2. Diabetes (Peripheral Neuropathy) 3. Trauma 4. Congenital abnormalities 5. Tumours 6. Infections 7. Frostbite 8. Necrotizing Fasciitis
53
Peripheral neuropathy
disease of the peripheral nerves - Frequently in people who smoke, and have difficulty controlling their blood sugar levels - About half people with diabetes develop PN - Manifestation of many conditions - Sensory nerves damaged= sensation may be diminished, lacking or abnormal - Damaged motor nerves impair movement or function
54
Foot amputation
most commonly toe amputation due to frostbite
55
BKA
an amputation above the ankle but below the knee. Can be difficult for amputees to put weight on the wound
56
AKA
above knee amputation: An amputation in the thigh
57
Hip disarticualtion
leg and part of pelvis removed
58
TRansmetacarpal
through the metacarpals- loss of gripping ability
59
wrist disarticulation
removal of the hand
60
BE
Below elbow
61
elbow disarticulation
removal of the arm above the elbow
62
shoulder disarticulation
removal of the entire arm
63
Neuroma
tangle of nerve endings
64
Complication of amputation
- Neuromas - Phantom sensation - More traumatic amputation is—more sensation - Pain gets mapped in the brain - Weakness - Skin breakdown
65
Mechanical prosthesis
utilizes body power with a harness to operate the hook or terminal device.
66
Myoelectric prosthesis
- Is controlled myoelectric signals from the muscles

THER 130 (6 decks)

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