Arthritis, arthroplasty, amputations Flashcards
arthritis
inflammation of joints
RA
systemic, symmetrical, affects many joints
most commonly small joints of hands
unknown etiology (theories are infection and autoimmune)
s/s: pain, stiffness, limited ROM, fatigue, swelling, deformities
common RA deformities
- ulnar deviation (drift) and subluxation of wrists and MCPs
- boutonniere: flexion of PIP and hyperextension of DIP
- swan neck: hyperextension of PIP and flexion of DIP
osteoarthritis
degenerative joint/bone disease
wear and tear, not systemic
affects large joints
attacks hyaline cartilage
etiology: genetic, trauma, inflammation
s/s: pain, stiffness, limited ROM, bone spurs
types of OA bone spurs
- herbden’s nodes at DIP joints
- bouchard’s nodes at PIP joints
Osteogenesis imperfecta (OI)
progressive!
dysfunction of genes that produce collagen to strengthen bones
s/s: malformed bones short small body, triangular face, barrel shaped rib cave, brittle bones, fractures, loose joints, sclera of whites of eyes, hearing loss
8 types of OI
type 1: mild symptoms
types 4, 5, 6: moderate symptoms
types 2, 3, 7, 8: severe symptoms
OT intervention OI
weight bearing to facilitate bone growth
adapting activities
assistive devices
modifications
preventative positioning and splinting
inc muscle strength
health education
*prevention of fractures/deformities and doing AROM are emphasized
hip fractures and arthroplasty eval and tx
review WB status and precautions
ADLS: dressing, bathing, t/f
ROM and strength of UEs
intervention: bed mobility, ADLs, functional ambulation, t/f, assistive devices practice with WB status
hip precautions (posterolateral)
do not flex beyond 90
no adduction (crossing legs)
no internal rotation (pigeon toes)
t/f with hip extended in front
sit on raised chair and tiolet
need long handled equipment
hip precautions (anterolateral)
no ER
no hip extension
need long handled equipment
prosthetic terminal devices (TDs)
function to grasp and maintain hold on an object
- body operated prostheses: use shoulder/scapula (hook and prosthetic hand, voluntary opening or voluntary closing)
-myoelectric: use muscle contractions
amputation interventions
- wrap and shape residual limb (distal to proximal)
- edema magement
- desensitization
- phantom limb pain
- strengthening of other joints and muscles
- ADL training
- t/f training
- wound skin care
- standing tolerance and functional mobility
rotator cuff tendinitis
conservative approach sleep with shoulder extended and adducted (think of sling position)
surgeon determines when exercise should be initiated after surgery
Body powered myoelectric prosthetic with terminal device positioning
flexed at 90 degrees with neutral degrees pronation/supination
