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PT S Exam 2 > Ch. 17,18,19,11,12,13 > Flashcards

Ch. 17,18,19,11,12,13 Flashcards

1
Q

approx duration of the Frozen stage of Idiophatic Frozen shoulder

A

9-15 months

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2
Q

How is the right position in supine after a TSA (total shoulder arthoplasty of the glenohumeral)

A

arm in a sling or splint with pillow or blanket under the elbow

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3
Q

decreases external rotation of scapula, decreased flexibility on pec minor and levator, muscle and strength imbalances, are examples of what?

A

faulty posture of increased thoracic kyphosis

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4
Q

a characteristic of the first stage of idiopathic frozen shoulder

A

gradual onset of pain that increases with movement and is present at night

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5
Q

persistent pain, loss of UE strength with functional tasks and loss of shoulder mobility are all and indication of?

A

Glenohumeral arthroplasty

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6
Q

a goal during the maximum protection phase of rehabilitation for painful shoulder syndrome

A

control inflammation

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7
Q

wand exercises are indication during which phase of rehabilitation

A

moderate protection phase

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8
Q

joint instability, particulary with unlinked implants or in patients who previously underwent excision of the radial head is an example of?

A

total elbow arthroplasty complication

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9
Q

it is distinguished from traumatic arthritis the humeroulnar joint in that passive extension is more limited than flexion

A

myositis ossificans

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10
Q

tennis elbow is a commonly used term also known as

A

lateral epicondylitis

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11
Q

appropriate nonoperative interventions to manage overuse syndromes in the protection phase

A

pain reduction, immobilization, patient instruction to avoid motion that aggravate symptoms

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12
Q

tennis elbow affects which structures

A

extensor carpi radialis brevis, extensor digitorum, annular ligament

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13
Q

golfers elbow happens when?

A

there are repetitive movements into wrist flexion

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14
Q

common limitations of elbow disorders

A

pain with pushing and pulling activities, difficulty turning doorknob, difficulty with pushing up from a chair

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15
Q

the nerve that is compressed within the carpal tunnel

A

median nerve

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16
Q

an indication for arthroplasty of the wrist and digits

A

severe pain or destruction of the articular surfaces

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17
Q

common symptoms of tendinopathy in the wrist and hand

A

muscle strength imbalances, warmth and redness with palpation, pain with movement.

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18
Q

common joint pathologies that affect the wrist and hand

A

rheumatoid arthritis, post traumatic arthritis, degenerative joint disease.

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19
Q

usually after 40, develops slowly due to mechanical stress, cartilage degration, joint architecture

affects joint asymmetrically, morning stiffness less than 30 minutes (5 to 10), increases pain with weight bearing

A

Oesteoarthitis

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20
Q

begins btwn age 15-50, suddenly, inflammatory synovitis and irreversible damage to cartilge and bone

bilateral, cardinal signs of inflammation, reduces after walking or WB activity

A

rheumathoid arthritis

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21
Q

interventions that can be used to improve physical conditioning for osteoarthritis

A

AROM, low impact aerobic activities, assistive equipment to minimize stress or to correct faulty biomechanics

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22
Q

similarities and differences btwn fibromyalgia and myofascial pain syndrome

A

They both are chronic pain syndromes, pain in muscles, decrease ROM and postural stresses.

FM: tender point at specific sites, no referred patterns of pain, no taut band in the muscle, fatigue and waking unrefreshed.

MFP: trigger point in muscles, referred patterns of pain, taut band in the muscle, no related fatigue complaints.

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23
Q

signs and symptoms of a possible fracture

A

history of a fall, direct blow, twisting injury, pain that worsens with movement or WB, etc.

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24
Q

What types of interventions are appropriate post-fracture during immobilization and post-immobilization?

A

Teach functional adaptations, and safe ambulation and mobility. Ice, elevation, intermittent muscle setting, AROM to joints above and below immobilized region, ROM activities to all areas not immobilized, resistance exercises to major muscle group not immobilized, etc.

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25
Q

indications for surgery for musculoskeletal disorders

A

-incapacitating pain at rest or with functional activities
- marked limitation of active or passive motion
-gross instability of a joint or bony segments
-joint deformity or abnormal joint alignment
- trauma resulting in significant tissue damage
- significant structural degeneration
- chronic joint swelling
- failed conservative nonsurgical or prior surgical management
- significant loss of function leading to disability as the result of any of the preceding factors.

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26
Q

the 7 components of preoperative pt education

A

Pain, ROM and joint integrity, skin integrity, muscle performance, posture, gait analysis, functional status

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27
Q

steps to inspect a surgical incision site

A

check for signs of redness, palpate along the incision and note for edema and tenderness, mobility of scar as it heals

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28
Q

signs of infection of a surgical incision

A

fever, chills, redness, swelling, bleeding, pus, pain

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29
Q

potential postoperative complications

A

pulmonary dysfunction/pneumonia, infections, delayed wound healing.

30
Q

difference between an open approach versus an arthroscopic approach?

A

Open approaches are necessary for surgeries such as joint replacement, arthrodesis, internal fixation of fractures.
Arthroscopy procedures are performed on ligaments, tendon, and capsule repair or reconstruction, joint debridement, meniscectomy, articular cartilage, and repair.

31
Q

How long after a tendon repair should end-range stretching, and high-intensity resistance exercise be withheld?

A

Stretching and high intensity resistance exercise should not be initiated for at least 8 weeks after repair, when healing of the tendon is mature.

32
Q

What does ORIF stand for? When might it be used?

A

Open Reduction and Internal Fixation of Fractures. A type of surgery used to stabilize and heal a broken bone.

33
Q

Autograft vs Allograft tissue

A

Autograft. A patient’s own tissue, can often be used for a surgical reconstruction procedure.
Allograft tissue, taken from another person, takes longer to incorporate into the recipient’s body

34
Q

mechanisms of a nerve injury?

A

stretch and compression (pressure applied externally, such as tourniquet, or internally, such as from bone, tumor, edema, or soft tissue impingement, resulting in mechanical or ischemic injury).

35
Q

intraneural vs extraneural

A

Intraneural affects the conducting tissues (hypoxia or demyelination) which may restrict the elasticity of the nervous system itself.

Extraneural affects the nerve bed(blood), adhesions of the epineurium to another tissue, and swelling of the tissue adjacent to a nerve (foraminal stenosis) may restrict the gross movement of the nervous system.

36
Q

purpose of the Slump Test

A

a neural tension test used to detect altered neurodynamics or neural tissue sensitivity.

performed in sitting with the addition of spinal flexion for greater overall neural tension.

37
Q

the term for problems in the shoulder girdle region. Disorders that occur when blood vessels or nerves are compressed

A

Thoracic Outlet Syndrome (TOS)

38
Q

signs and symptoms of TOS

A

pain, paresthesia, numbness weakness, discoloration, swelling, loss of pulse, headache, etc.

39
Q

What is Carpal Tunnel Syndrome (CTS)?

A

Confined space btwn the carpal bone dorsally and the transverse carpal ligament.caused by pressure on the median nerve.

40
Q

Common impairments in CTS

A

Increasing pain and paresthesia in the hand with repetitive use, forceful grip and pinch, progressive weakness, or atrophy in the thenar muscles and first two fingers.

41
Q

How can Ulnar Nerve Compression be treated conservatively?

A

Modifying the provoking activity, avoiding pressure to the base of the palm of the hand and providing rest with a hand based ulnar gutter orthosis, ulnar nerve mobilization by moving the wrist into extension and radial deviation then applying overpressure stretch into extension against the ring and little finger.

42
Q

what is functional articulation, and 1 example.

A

soft tissue flexibility.
Scapula movements such as elevation, depression, protraction and retraction.

43
Q

What structure is at most risk of impingement in the subacromial (suprahumeral) space?

A

Weak infraspinatus and teres minor muscles or inadequate external rotation may result in impingement of the soft tissues in the suprahumeral space, causing pain, inflammation, and loss of function.

44
Q

what is a SLAP lesion

A

Superior Labrum Anterior to Posterior) tear, a specific type of labral tear, involves the attachment site of the biceps tendon located at the top of the shoulder joint

45
Q

what is a Bankart tear

A

a torn labrum where the humeral head shifts toward the front of the body, as an anterior labral tear.

46
Q

Total shoulder arthroplasty positioning

A

elbow flexed to 90, forearm and hand resting on abdomen, forward flexion, slight abduction and internal rotation of shoulder, head of bed elevated about 30.

47
Q

Reverse Total Shoulder Arthroplasty positioning

A

lying supine, position humerus slightly anterior to midline of the body, placing arm on a folded towel to avoid excessive stress to the anterior capsule and suture line.

48
Q

Rotator Cuff Repair with abduction orthosis positioning

A

pt supported in an abduction splint may require assistance from member to support the operated arm in the 45 shoulder position when the splint is removed for activities.

49
Q

What is adhesive capsulitis (frozen shoulder)

A

when the tissue in your shoulder joint tightens and restricts movement. This occurs when you are not active because of another injury,

50
Q

how long does the “freezing” stage of shoulder of frozen shoulder last

A

lasts about 2–9 months, there is a gradual onset of diffuse, severe shoulder pain that typically worsens at night.

51
Q

how long does the “frozen” stage of frozen shoulder last

A

This stage can last for 4–12 months, + progressive loss of glenohumeral flexion, abduction, internal rotation and external rotation.

52
Q

how long does the “thawing” stage of frozen shoulder last

A

pt experiences a gradual return of range of motion that takes about 5–26 months to complete.

53
Q

What is rotator cuff tendinitis

A

the inflammation of the rotator cuff muscles that leads to chronic pain

54
Q

What is rotator cuff tear

A

the shoulder becomes destabilized and weak.
Causes: injuries and degeneration.

55
Q

What is Biceps tendinitis

A

is a disorder of the tendon around the long head of the biceps muscle. Inflammation of the biceps tendon within the intertubercular (bicipital) groove.

56
Q

What is the focus of rehab post dislocation of the GH?

A

In the older lower-risk patients, the goals of rehabilitation after anterior shoulder instability are to restore pain-free range of motion and shoulder muscle strength and control.

57
Q

What is the difference between a “pushed elbow” and “pulled elbow

A

Pushed elbow: outstretched hand. The radial hand is pushed proximally in the annular ligament and impinges against the capitulum.

Pulled elbow: forceful pull on the hand. The radius translates distally to the ulna.

58
Q

3 surgical options for displacement of radial head

A

Open reduction and internal fixation: technique if stable fixation can be achieved and if able to repair significant ligament damage, early protective postoperative motion permissible.

Low profile fixation: improved forearm rotation and flexion motion with decreased scarring compared with other techniques. Immediate mobilization of the elbow joints is permissible.

Excision of the radial head: for severely comminuted, nonreducible, and unstable fractures, no potential for mechanical blockage of joint motion from malalignment of fracture fragments or internal fixation, early ROM permissible.

59
Q

what is meant by myositis ossificans

A

To denote only ossification of muscle or bone formation in the muscle tendon unit.
-It develops after a comminuted fracture or dislocation of elbow or tear of the brachialis.

60
Q

are the flexors or extensors on the medial epicondylitis (ulna)

A

flexors

61
Q

are the extensors or flexors on the lateral epicondylitis (radius)

A

extensors

62
Q

signs and symptoms of rheumatoid arthritis in the hands of the patient in early stages.

A

Acute: Pain, swelling, warmth and limited motion from synovial inflammation and tissue proliferation. Progressive muscle weakness and imbalances in length and strength between agonist and antagonist between instinct and extrinsic muscles.
Carpal tunnel syndrome in conjunction with tenosynovitis due to compression of the median nerve from the swollen tissue, muscular fatigue.

63
Q

signs and symptoms of rheumatoid arthritis in the hands of the patient in advanced stages.

A

Advanced: Joint capsule weakening, cartilage destruction, bone erosion and tendon rupture, imbalances in musculotendinous forces that lead to joint instabilities, deformities, etc.

64
Q

What joints of the hand are most susceptible to osteoarthritis?

A

CMC joint of thumb and DIP joints of the digits.

65
Q

signs and symptoms of osteoarthritis in the hands of the patient in early stages.

A

Acute: achiness, stiffness, joint swelling, warmth, and restricted and painful motion.

66
Q

signs and symptoms of osteoarthritis in the hands of the patient in advanced stages.

A

Advanced: capsular laxity resulting in hypermobility or instability, contractures, and limited motion. Joints may become enlarged or sublux, muscle weakness, weak grip strength and poor muscle endurance.

67
Q

non-operative management for carpal tunnel

A

Non-operative management such as splinting, avoid daytime activities that provoke symptoms, over the counter drugs, prescription medicines, exercise, alternative therapies such as yoga, acupuncture, OT, etc.

68
Q

what is the Colles’ fracture

A

break in the radius close to the wrist.

69
Q

how does someone sprain the UCL of the thumb

A

falling on the ski slopes with your hand strapped to a ski pole is a common cause of this injury.

70
Q

what is the DeQuervain’s tenosynovitis

A

a condition affecting the tendons on the thumb side of the wrist.

71
Q

what is tendinopathy

A

a type of overuse injury, where the tendon is repeatedly strained until tiny tears form.

PT S Exam 2 (1 decks)

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