Clinical Application Template Flashcards
Achilles Tendon Rupture
Typically occurs within one to two inches above the tendinous insertion on the calcaneus
Incidence is greatest between 30-50 years of age without history of calf or heel pain
Patients with an Achilles’ tendon rupture will typically be unable to stand on their toes and tend to exhibit a positive Thompson test
Adhesive Capsulitis
Occurs more in the middle-aged population with females having a greater incidence than males.
Arthrogram can assist with diagnosis by detecting decreased volume of fluid within the joint capsule.
Range of motion restriction typically in a capsular pattern (lateral rotation, abduction, medial rotation).
Amyotrophic Lateral Sclerosis
Risk is higher in males than females and usually occurs between 40-70 years of age.
Clinical presentation may include both upper and lower motor neuron involvement with weakness occurring in a distal to proximal progression.
Average course of the diagnosis in two to five years with 20-30% of patients surviving longer than five years.
Ankylosing Spondylitis
Systemic condition characterized by inflammation of the spine and the larger peripheral joints.
Males are at two to three times greater risk than females with peak onset observed 20-40 years of age.
Clinical presentation initially includes recurrent and insidious onset of back pain, morning stiffness, and impaired spinal extension.
Anterior Cruciate Ligament Sprain - Grade lll
Injury most commonly occurs during hyperflexion, rapid deceleration, hyperextension or landing in an unbalanced position.
Females involved in selected athletic activities have significantly higher ligament injury rates compared to males.
Approximately two-thirds of complete anterior cruciate ligament tears have an associated mental tear.
Bicipital Tendonitis
Increased incidence of injury is associated with selected athletic activities such as baseball pitching, swimming, rowing, gymnastics, and tennis.
Characterized by subjective reports of a deep ache directly in front and on top of the shoulder made worse with overhead activities or lifting.
Examination may reveal a positive Speed’s test or Yergason’s test.
Carpal Tunnel Syndrome
Incidence is higher in females than males with the most common age being from 35-55 years of age.
Muscle atrophy is often noted in the abductor pollicis brevis muscle and later in the thenar muscle.
Electromyography studies, Tinel’s sign, and Phalen’s test can be used to assist with confirming the diagnosis.
Cerebral Palsy
Spastic cerebral palsy involves upper motor neuron damage, athetold cerebral palsy involves damage to the cerebellum, cerebellar pathways or both.
Clinical presentation includes motor delays, abnormal muscle tone and motor control, reflex abnormalities, poor postural control, and balance impairment.
Mental retardation and epilepsy are present in 50-60% of children diagnosed with cerebral palsy.
Cerebrovascular Accident (CVA)
Types of CVA include ischemic stroke (thrombus, embolus, lacunar) and hemorrhagic stroke (intracerebral, subdural, subarachnoid).
Left CVA may present with weakness or paralysis to the right side, impaired processing, heightened frustration, aphasia, dysphasia, and motor apraxia.
Right CVA may present with weakness or paralysis to the left side, poor attention span, impaired awareness and judgment, spatial deficits, memory deficits, emotional lability, and impulsive behavior.
Congestive Heart Failure (CHF)
Common etiologies contributing to CHF include arrhythmia, pulmonary embolism, hypertension, valvular heart disease, myocarditis, unstable angina, renal failure, and severe anemia.
Left-sided heart failure is generally associated with signs of pulmonary venous congestion, right-sided heart failure is associated with signs of systemic venous congestion.
Diminished cardiac output causes compensatory changes including an increase in blood volume, cardiac filing pressure, heart rate, and cardiac muscle mass.
Degenerative Spondylolisthesis
Caused by the weakening of joints that allows for forward slippage of one vetebral segment on the one below due to degenerative changes.
Most common site of degenerative spondylolisthesis is the L4-L5 level.
William’s flex ion exercises may be indicated to strengthen the abdominal and reduce lumbar lordosis.
Down Syndrome
Clinical manifestations include hypotonia, flattened nasal bridge. Simian line (palmar crease), epicanthal folds, enlargement of the tongue, and developmental delay.
Detection occurs in approximately 60-70% of women tested that are carrying a baby with Down Syndrome.
Exercise is essential for a child with Down syndrome on order to avoid inactivity and obesity.
Cystic Fibrosis
Causes the exocrine glands to overproduce thick mucus which causes subsequent obstruction.
Autosomal recessive genetic disorder (both parents are carriers of the defective gene) located on the long arm of chromosome seven.
A terminal disease, however the median age of death has increased to 35 years of age due to early detection and comprehensive management.
Diabetes Mellitus (Type 1)
Insulin is functionally absent due to the destruction of the beta cells of the pancreas where the insulin would normally be produced.
Start in children ages four years or older, with the peak incidence of onset coinciding with early adolescence and puberty.
Common symptoms include polyuria, polydipsia, nausea, weight loss, fatigue, blurred vision, and dehydration.
Duchenne Muscular Dystrophy
X-linked recessive trait manifesting in only male offspring while female offspring become carriers.
Clinical presentation includes wadding gait, proximal muscle weakness, toe walking, pseudohypertrophy of the calf, and difficulty climbing stairs.
There is usually rapid progression of the disease with the inability to ambulate by ten to twelve years of age with death occurring as a teenager or less frequently in the 20s.
