Arthritis Flashcards

1
Q

arthrtsis

A

a chronic joint disorder characterised by degreneration of joint cartlidge causing pain and stiffness
can limit physical function

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2
Q

process of osteoarthrsis

A

cells that produce collagen and proteoglycans become abnormal
initally an increase in cartlidge growth and bone dnsity - reducing joint space
soon cartlidge thins and cracks, rough cartlidge causes pain during movement
bone starts to be worn down, bone moves against bone increasing erosion and pain
spurs develop to compensate
inflammation means synovium is thickened - increase synovial fluid
joint swells
ligaments become lax and overstreatched casuing weakness

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3
Q

rheumatoid arthritsis

A

an autoimmune disease affecting the wholw body
affects 1% of the population
3x more common in women

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4
Q

effect of inflammatory cytokines

A

cause weakness, fatigue, loss of appetite, muscle pain and weight loss
may cause myocardial damage and pericarditis

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5
Q

process of rheumatoid arthritsis

A

T cells in synovial fluid become corrupted and unable to distinguish between foreign and normal body cells
excessive production of immunoglobins and inflammatory cytokines
aggressive productinon of interleukin 6 causes persisent inflamation and joint destruction
osteoclasts stimulated
excessive Ig causes abnormal growth and division of synoival and cartlidge cells
macropahges migrate to joints - release enzymes that cause synovitis

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6
Q

what is synovitis

A

increased swelling of joints
stretching of ligaments
enzymes released by macopahages attacks hyaline cartlidge

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7
Q

name some immunglobins

A

IgA
IgG
IgM

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8
Q

name some inflammaroty cytokines

A

Tnf alpha

Interleukins - IL6

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9
Q

5 stages of RA

A

healthy
synovitis
pannus - destroyed hyaline cartlidge, pitted bone, swelling
fibrous ankylosis - joining of connective tissue and bone
bony alkylosis - fixed joint

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10
Q

what can affect arthritsis

A
age 
gender
inactivity 
obesity 
overuse 
infection
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11
Q

how does age affect arthritis

A

increased prevalence in older

natural decline in glucosamine and condition sulphate production

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12
Q

how does gender affect arthritis

A

men have more hip OA
women have more hand/knee OA
women>men RA
oestrogen appears to be protective, with increased OA post menopause

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13
Q

how does inactivity increase arthritis

A

weakness of quads increase risk of OA

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14
Q

how does obesity increase arthritis

A

top 20% for BMI increases risk 7-10 times for hip and knee OA

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15
Q

how does overuse affect arthritis

A

inconclusive data
but histoy of damage predisposed to OA
moderate levels of PA does not increase risk

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16
Q

symptons of arthritis

A
pain and crepitation of movement 
joints become enlarged and deformed 
inflammation 
ligaments become streched - unstable 
decreased ROM
17
Q

problem activities

A
bending 
standing 
walking 
push 
climb 
carry 
sit
reach 
reduces the amount of PA they do which is detrimental
18
Q

effect of arthritis on strength

A

less muscular strength/endurance

decrease 25-50%

19
Q

effect of arthritsis on flexibitly

A

decrease flex and ROM

20
Q

effect of arthritis on peak VO2

A

lower

decrease 20-30%

21
Q

why do exercise measurments decrease

A

inactivity causes detraining
structural changes in bones and tendon
reduce co-ordination and motor control

22
Q

effect of decrease inactivity

A

increase risk of CHD, diabetes, osteoporsis

increase weigth = increase joint loading and reduces mobility further

23
Q

aim of treatment

A
easing of pain 
decrease of pain and inflammation 
improvment in joint function 
lessening in joint damage 
improvement in functional capacity 
reduce risk of co-morbid conditions
24
Q

non exercise treatment

A
balance between exercise and rest 
firm bed/chair 
heat 
massage 
drugs 
weight loss 
surgery
25
Q

drugs

A
asprin 
ibuprofen 
steriods 
diease modifying anti-rheumatic drugs 
cox-2 selective inhibitors
26
Q

benefits of exercise

A
increase joint mobility 
increase muscle strength around joint 
increase stability 
increase shock absorption 
increase bone density 
reduce swelling 
reduce weight 
reduce pain on movement
27
Q

how does exercise help

A

cartlidge has no direct blood vesels or nerves
relies on movement to facilitate diffusion of nutients into cartlidge
movement increases ‘feeding’ of cartlidge
- increase prostagladin production
- increase glucosamine and chrondrontin sulphate secretion

28
Q

benefit of muscle strength increase

A

quads strengthening acts to cushion force transmission through the muscle rather than the joint
improvement in quad/hamstring ratio helps balance loads on joint

29
Q

aim of exercise

A

to preserve or increase ROM and flexibilty
increase muscle strength and endurance
aerobic condtioning
ameliorate health risks of inactivity

30
Q

exercise considerations

A
decreased ROM 
work within pain threshold 
difficulty gripping 
balance problems 
reduce joint load 
joints stiffer when cold 
time of day - stiffer in morning
31
Q

stretching

A
core of program
all joints 
static stretching - hold 10-30 secs 
PNF if supervised - 5 sec hols followed by 10 - 30 sec asssited stretch 
3-4 times