Chpt. 8 RA, AS, Autoimmune Diseases Flashcards
How is OA initiated? which leads to breakdown or decreased production of what?
- by mechanical forces
- cartilage (cartilage also turns into bone when baby)
Primary OA is ____ but Secondary OA arises after what 4 reasons?
- unknown
- trauma
- inflammatory joint disease
- metabolic (hemochoromatosis) disorder
- endocrine (diabetes) disease
*What are the 8 common affected joints in OA?
- Cervical/Lumbar spine
- 1st CMC joints
- PIP
- DIP
- hip
- knee
- subtalar joint
- MTP (metatarsophalangeal) joint
*The ___ is affected in Heberden’s nodes?
DIP
*The ___ is affected in Bouchard’s nodes?
PIP
*What are 3 differences between OA and RA?
OA: nonsystemic, non-inflammatory, localized pahology
RA: systemic, inflammatory disease; affect multiple joints (affects Organ systems)
What is the basic difference between RA and OA?
RA: inflammed or erroded= need medication to reduce pain
OA: mechanical problem, NOT inflamation =block, osteophytes etc.
What are the 2 extreme scales for the Functional status of an RA client ?
Class 1: Completely able to perform usual activities of daily living
Class 4: Limited in ability to perform usual self- care, vocational/avocational (job+hobby) activities
**What is the Stage 1 scale for the Progression of RA?
- no destructive changes roentgenographic examination (other than evidence of osteoporosis)
**What is the Stage of 4 RA?
-Fibrous/ or bony ankylosis
- cartilage and bone destruction
- Joint deformity, such as subluxation, ulnar deviation, or hyperextension
- Extensive muscle atrophy
**What are 7 Inflammatory Arthropathies (disease of joint)?
- Rheumatoid arthritis
- Spondyloarthropathies
- SLE (Lupas)
- Scleroderma (also affects joints)
- Vasculitis (blood vessels)
- Infectious: septic joint, Lyme, gonococcal, hepatitis (monoarticular)
- Post-infectious: Reactive arthritis, rheumatic fever, parvo B19 (virus)
Why is the neck stiff in RA?
-inflammation of tendons in neck near C1-C2
What is the Tinel’s sign?
- tap on MEDIAN nerve to see if it’s compressed due to inflammation of tendon sheath
- a method to detect irritated nerves
What are 4 basic signs of early inflammatory response in RA in a joint?
- Osteoperosis in bones
- Inflammation of synovium
- Loss of cartilage
- Increased synovial fluid
*What are 2 rare variants/diseases with RA?
- FELTY syndrome: RA + splenomegaly (enlarged spleen)
2. STILL disease: jevenile (kids), fever, hepatosplenomegaly (enlarged liver and spleen)
What is our PT focus for RA (3) ?
- EXERCISE (decrease pain/swelling/ increase R.O.M)
- MODALITIES (TENS, IFC, acupuncture)
- JOINT MOBILITY (traction and glides to provide relief)
*What are 2 ex. for Group 1: Non Steroidal Anti-Inflammatory Drugs” or ‘NSAIDs’ ?
- IBUPROFEN (most common)
-COX-2 inhibitors: prevents inflammation; doesnt let WBC do their job
*What is an example for Group2:
‘Disease Modifying Anti-Rheumatic Drugs’ or ‘DMARDS’?
METHOTREXATE (most common): its a chemotherapy drug, and interferes with DNA and affects cells that reproduce often
*Group 2 primarily used to treat other diseases
What is an example for Group3:
Cortico-Steroids or just Steroids?
PREDNISONE: relieves inflammation
*What is an example for Group4:
‘Biological Response Modifiers” or ‘BRM’s’?
Etanercept : inhibit action of cytokine called the “Tumor Necrosis Factor=TNF “
*they attack tumours/cancer
What are 4 exercise focuses for R.A?
- Maintaining appropriate body weight.
- Sustaining good postural alignment.
- Developing good muscular strength and length.
- Correct movements during functional activities.
What is important to work on in Osteoarthritis, due to joint inflammation?
-Re-establish muscle LENGTH and STRENGTH around the joint
What are 2 important things to teach R.A patients when inflammation fluctuates?
- How to recognize Symptoms
- How to Modify activity according to symptom development and stage of illness (when inflammation occurs, stop or decrease EXERCISE)
What type of exercises are good for RA?
How long do you hold it for?
- isometric contractions= (muscle contraction w/out moving/irritating joint)
- 6 sec. WORK, 20 sec. REST
- What 2 type of exercises are good for OA?
- Isotonic contractions usually,
Isometric contraction in ACUTE phase - Aquatic Therapy!!!