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OCTH 1031 > Conditions Of The Musculoskeletal System (Week 1) > Flashcards

Conditions Of The Musculoskeletal System (Week 1) Flashcards

1
Q

What is the primary cause of fatal and non-fatal injuries in older adults?

A

Falls

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2
Q

Biomechanics

A

Study of structure and function of biological systems

Ex: able to ID a person from across the room by their movement and stance.

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3
Q

What is a negative result of a fall?

A

Fear

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4
Q

Etiology of fractures related to pathology (4)

A
  1. Tumors
  2. Osteoporosis
  3. Osteopenia
  4. Osteoarthritis
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5
Q

Etiology of fractures related to trauma (3)

A
  1. High energy trauma- MVA
  2. Prolonged stress/overuse
  3. Direct blow - knee hits dashboard in MVA
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6
Q

Etiology of Orthopedic conditions (3)

A
  1. Trauma
  2. Pre-existing musculoskeletal limitations
  3. Genetics
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7
Q

Common bones that fracture

9

A
  1. Radius.
  2. Ulna
  3. Carpal bones.
  4. Clavicle
  5. Spine. 8. Femur
  6. Pelvis. 9. Tibia/Fibula
  7. Hip
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8
Q

Common radial fx

A

Colles fx - out reached arm to break fall

Proximal or mid-shaft

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9
Q

Common spinal fx

A

Compression fx - common in osteoporotic population

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10
Q

Common cause of pelvis fx

A

MVA

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11
Q

Common hip fx

A

Femoral neck

Trochanteric

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12
Q

Common femural fx

A

Mid-shaft

Distal

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13
Q

Common Tibial and fibular fx

A

Tibial plateau
Mid-shaft
Distal = ankle fx

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14
Q

Risk Factors for Fx (2)

A

Low bone mineral density

Hx of Fx

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15
Q

Signs of Fx (5)

A
  1. Swelling
  2. Bruising
  3. Deformity
  4. Tenderness with palpation
  5. Loss of function
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16
Q

Signs of loss of function with a fx (2)

A

inability to bear weight

inability to move joint

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17
Q

Symptoms of a Fx (3)

A
  1. Severe pain
  2. Stiffness
  3. Numbness/Tingling
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18
Q

Risk factors of a fx (2)

A
  1. Low bone mineral density

2. Hx of Fx

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19
Q

Two reasons why Hx of Fx is a risk factor (2)

A
  1. Fear of falling increases risk of falling

2. Pathological Fx due to osteoporosis

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20
Q

Progression of Fx (3)

A
  1. Inflammatory
  2. Repair
  3. Remodeling
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21
Q

What happens during the inflammatory response of a Fx?

A

Blood moves into the space around the fracture creating a hematoma. The hematoma transforms into a clot.

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22
Q

Risk Factors of falls (6)

A
  1. decreased strength
  2. decreased balance
  3. comorbidities
  4. medications
  5. Footwear
  6. Chronic pain
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23
Q

What are the two phases of the repair process? (2)

A
  1. Fibrocartilaginous “soft” callus phase

2. Bony “hard” callous phase

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24
Q

What happens during the fibrocartilaginous callus phase? (2)

A
  1. Osteoblasts initiate formation of the bone.

2. Cell density increases

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25
Q

What happens during the bony “hard” callus phase?

A

Fibrocartilaginous callus converts woven bone which increases in rigidity and thickness until bony union

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26
Q

What happens during the remodeling phase of a Fx? (2)

A
  1. Woven bone convert to lamellar bone.

2. Fracture callus reduces along lines of stress.

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27
Q

Medical intervention & management of a Fx (2)

A
  1. Fx reduction

2. Immobilization

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28
Q

Approx. time of immobilization of Fx

A

~6 weeks

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29
Q

What can immobilization cause? (6)

A
  1. Stiffness
  2. Decreased ROM
  3. Capsular contracture
  4. Muscle contracture
  5. Muscle atrophy
  6. Decreased strength of Connective tissue
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30
Q

What are the effects of muscle atrophy? (3)

A
  1. Decreased force generation
  2. 20% loss of strength in only 2 weeks
  3. Alternated neuromuscular recruitment /coordination
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31
Q

What is the ligament /tendon failure point?

A

The normal stretch of a tendon to snap is lower; increases possibility of snapping.

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32
Q

Prognosis of a Fx (2)

A
  1. Post-traumatic arthritis

2. Women with wrist fx - 50% more likely to have clinically significant functional decline than those without

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33
Q

Three types of Fx reduction(3)

A
  1. Closed reduction
  2. Open reduction internal fixation
  3. External fixation
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34
Q

Medical intervention and managment of an Open Reduction Internal Fixation - ORIF (4)

A
  1. Surgical repair
  2. Rods, screws, pins, plates
  3. Casting/immobilization
  4. WB modifications
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35
Q

Presentation of ORIF post surgery (4)

A
  1. Pain
  2. Edema
  3. Limited ROM
  4. Strength limits - local, proximal, distal
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36
Q

Indications of external fixation (3)

A
  1. Open fracture
  2. Closed severe Fx causing soft tissue damage or mutilple fractures
  3. Limb alignment
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37
Q

Complex regional pain syndrome (CRPS)

A

Chronic disease characterized by severe pain, swelling and skin changes following trauma . Pain is disproportionate to injury.
Usually seen in clients with immobilization and Fx

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38
Q

CRPS I

A

Formerly reflex sympathetic dystrophy

The absence of nerve injury

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39
Q

CRPS II

A

Formerly ‘causalgia’, nerve injury present

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40
Q

Etiology of CRPS

A

Unknown

Malfunction of the CNS and the PNS

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41
Q

Risk factors of CRPS (4)

A
  1. Fx
  2. Immobilization
  3. Female gender
  4. Concurrent motor nerve injury (type II)
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42
Q

Sign of CRPS Impact on sensory related function

A

Temperature changes -cold, clammy, sweaty skin

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43
Q

Signs of CRPS Impact on movement related function(4)

A
  1. Edema
  2. Decreased joint ROM
  3. Muscle spasm/weakness/tremor
  4. Alt. movement patterns (dystonia)
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44
Q

Signs of CRPS Impact on skin related functions (2)

A
  1. Color - white, red , blue

2. Texture - shiny, thin

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45
Q

Symptoms that Impact sensory function in CRPS (3)

A
  1. May have chronic pain
  2. Constant Burning/throbbing
  3. Hypersensitivity - touch, cold
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46
Q

Symptoms that Impact movement related function in CRPS (2)

A
  1. Joint stiffness

2. Difficulty moving extremities

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47
Q

Symptoms that Impact the mental function in CRPS (3)

A
  1. Depression
  2. Anxiety
  3. PTSD
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48
Q

How do you treat the mental function in CRPS ? (2)

A
  1. Medication

2. Desensitization with WB exercises

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49
Q

Prognosis of CRPS (2)

A

Children/ teens good recovery

Some- severe pain and disability

50
Q

Osteoporosis

A

Pathological condition causes decrease in bone density. Leads to pathological fractures occurring during ADLs or trauma. Considered a serious health problem.

51
Q

Most common fx caused by osteoporosis (4)

A

Vertebrae
Wrist
Pelvis
Hip

52
Q

Etiology of osteoporosis (4)

A

Estrogen deficiency
Hormone imbalance
Diet
Sedentary lifestyle

53
Q

Risk factors of osteoporosis (5)

A
  1. Female gender
  2. Caucasian or Asian descent
  3. Increased age increased risk
  4. Family hx
  5. Ectomorphic body type
54
Q

Ectomorophic body type

A

Long, thin, tall; lack of muscle or fat tissue.

55
Q

Signs of Osteoporosis (4)

A
  1. Silent - undetected until Fx occurs
  2. Stooped posture
  3. Loss of Ht.
  4. Fx occurs easily
56
Q

Symptom of Osteoporosis

A

Many people have no symptoms until they have a fx.

Experience pain, back pain

57
Q

Prevention of Osteoporosis

A

Early bone density screening

58
Q

Osteopenia

A

Reversible weakening of bone; bone density dwindles but not dangerously

59
Q

Etiology of Osteopenia

A

Similar to Osteoporosis - Estrogen deficiency; hormone imbalance; diet; sedentary life style

60
Q

Medical intervention and management of Osteopenia (3)

A
  1. diet
  2. supplements
  3. local WB exercises
61
Q

Osteoarthritis (OA)

A

Degenerative condition - cartilage degradation leading to bone-on-bone contact; viscous cycle of:
Degradation - Pain - Inactivity - Degradation - Pain - Inactivity….

62
Q

Etiology of OA - Primary (1) and Secondary (3)

A 
Primary   - Idiopathic
Secondary - 
   Post - Trauma (falling on joint increases trauma instantly 
   Post - Surgery 
   Mal-alignment
63
Q

Risk factors of OA (2)

A
  1. Abnormal carilage

2. Abnormal stress on cartilage

64
Q

What causes abnormal cartilage in OA? (3)

A
  1. increased age
  2. genetics
  3. diseases (RA, gout)
65
Q

What causes abnormal stress on cartilage in OA (4)

A
  1. obesity
  2. biomechanics
  3. trauma to the joint
  4. occupational (Repetitive stress)
66
Q

Signs of OA that impact Movement Related Function(5)

A
  1. Decreased ROM
  2. Decreased Strength
  3. Edema
  4. Crepitus
  5. Functional limitations located at the site
67
Q

Symptom of OA that impact the sensory related functions

A

Pain that worsens with activity, is worse in the AM when waking, and in severe cases causes night pain

68
Q

Symptoms of OA that impact the movement related functions (2)

A
  1. Stiffness - AM

2. Painful joint ROM

69
Q

Symptoms of OA that impact mental functions(2)

A
  1. Social and psychological effects of limited mobility

2. Depression/Anxiety

70
Q

OA impact on the hand (2)

A
  1. Grip/Pinch

2. Nodules

71
Q

Heberden’s Nodes

A

hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes).

72
Q

Bouchard’s Nodules

A

Bony bumps on the middle joint of the finger, proximal interphalangeal joints (PIP)

73
Q

OA impact on the shoulder (2)

A
  1. crepitus

2. pain with sleep, reaching overhead or behind the back

74
Q

OA impact on the hip(2)

A
  1. pain in groin, thigh, buttock or referred to knee (common)
  2. pain with walking, squatting, stairs, bending
75
Q

OA impact on knee (2)

A
  1. Crepitus, locking

2. pain with walking, stairs, squatting

76
Q

OA impact on the ankle

A

Pain while WB

77
Q

Rheumatoid Arthritis

A

autoimmune disorder that attacks the synovium, forms a layer of pannus which leads to bone errosion, and cartilage/ligament degredation causing pain, swelling, inflammation and joint deformation. Bilateral presentation, flares, and remission

78
Q

Risk factors of RA (4)

A
  1. Female (2-3x higher than male)
  2. Age
  3. Genetics
  4. Smoking
79
Q

Signs of RA(7)

A
  1. Flare and remission
  2. Pain and tenderness (sensory)
  3. Joints swollen and warm (movement)
  4. Rheumatoid nodules (movement)
  5. Fever/Fatigue/weight loss (movement)
  6. Joint deformity (movement)
  7. Painful ROM (movement)
80
Q

Symptoms of RA (3)

A
  1. Morning Stiffness lasts several hours (movement)

2. Affected joints

81
Q

Which joints are affected by RA? (9)

A
  1. PIP
  2. MCP
  3. MTP
  4. wrists
  5. knees
  6. hips
  7. ankles
  8. shoulders
  9. elbows
82
Q

Swan neck deformity - RA

A

PIP extension and DIP flexion

83
Q

Boutonniere deformity - RA

A

PIP flexion and DIP extension

84
Q

Ulnar drift - RA

A

hand deformity in which the swelling of the MCP joints (the big knuckles at the base of the fingers) causes the fingers to become displaced, tending towards the little finger.

85
Q

Medical Intervention and Management of OA and RA

A

Joint arthroplasty

86
Q

Joint arthroplasty

A

surgical procuedure to resurface the bones using a prosthetic joint. Cemented or uncemented is used in THA or TKA and pegs/screws are used in a TSA

87
Q

Posterolateral THA precautions(3)

A

No hip flexion 90*
No hip adduction
No hip internal rotation (IR)

88
Q

Anterolateral THA precautions (3)

A

No hip extension beyond neutral
no hip external rotation (ER)
Don’t lay prone

89
Q

Medical intervention and management of THA (4)

A
  1. Pain(sensory)
  2. Strength limitations (muscle fn)
  3. Limited ROM (movement related)
  4. Limited function - bed mobility, ambulation, functional tasks and THP for sitting/driving/reaching/squatting
90
Q

TKA impact on body functions and structures (7)

A
  1. pain!! (sensory)
  2. swelling/inflammation (movement)
  3. Limited ROM flexion/extension (movement)
  4. Strength limitation (muscle function)
  5. bed mobility /transfer (function)
  6. Ambulation/elevation (function)
  7. squat, driving (function)
91
Q

Precautions for TSA (3)

A
  1. Sling
  2. Avoid AROM first 4 weeks,
  3. No lifting >1lb. for 6 weeks
92
Q

TSA impact on body functions and structures (9)

A
  1. Pain (sensory)
  2. Limited ROM (movement)
  3. Strength limitations of the shoulder and scapula (muscle function)
  4. Overhead reach (movement)
  5. Sleeping (movement)
  6. Driving (movement)
  7. Lifting/carrying (movement)
  8. Pushing/pulling (movement)
  9. Dressing (movement)
93
Q

Reverse TSA Impact on body functions and structures(2)

A
  1. Loss of ROM

2. Pain -free

94
Q

Etiology of Tendinopathy

A

Result of overuse

95
Q

tendinitis

A

inflammation of the tendon

96
Q

tendinosis

A

degradation of tendon’s collagen due to chronic overuse when tendon wasn’t given time to heal

97
Q

Signs of tendinopathy (3)

A
  1. Warmth
  2. redness
  3. edema
    * all at the tendon
98
Q

Symptoms of Tendinopathy(2)

A
  1. pain with palpation, muscle contraction, stretch of muscle
  2. stiffness after prolonged sitting/sleeping
99
Q

Symptoms of Tendinopathy(2)

A
  1. pain with palpation, muscle contraction, stretch of muscle
  2. stiffness after prolonged sitting/sleeping
100
Q

Lateral epicondylagia aka Tennis Elbow (effects? causes?)

A

Effects the ECRB (extensor carpi radialis brevis)

causes pain with grip and forearm activity.

101
Q

Medial epicondylalgia aka Golfer’s elbow (effects? causes?)

A

Effects the Flexor and pronator tendons (FCR and PT)

Causes pain with squeezing, lifting, shaking hands,turning doorknobs.

102
Q

RTC tear

A

most often supraspinatus; full or partial

103
Q

RTC tear signs and symptoms(3)

A

pain raising and lowering arm
weakness
night pain

104
Q

Which tendon ruptures need immediate surgical intervention (3)

A
  1. Achilles tendon
  2. Patellar tendon
  3. Triceps tendon
105
Q

popeye deformity

A

long head biceps rupture

106
Q

ligamentous injuries and instabilities(3)

A
  1. ACL tear (ACL-R - Ant. cruciate ligament replace. )
  2. Ankle instability (ATFL - Ant. talofibular ligament)
  3. Glenohumeral dislocation/subluxation (partial disloc.)
    * most common in athletes
107
Q

Signs of ligament injury(3)

A

audible pop followed by sudden pain and swelling
joint instability
immediate functional impairment
LE difficulty walking/running
UE difficulty lifting carrying throwing etc

108
Q

Etiology of Ligamentous injury/instability(2)

A
  1. trauma

2. non-contact caused by rolling ankle or directional change during movement (sports)

109
Q

Symptoms of ligament injury (3)

A

pain(sensory)
joint instability (movement)
fear of re-injury (mental)

110
Q

post-operative presentation of a ligamentous injury or instability (5)

A
  1. immobilized to protect graft and repair
  2. pain swelling and inflammation
  3. Restricted ROM
  4. Strength limitation
  5. Restricted WB
111
Q

orthopedics

A

injury and disease to bone, joints, and related structures - muscles, tendons, and ligaments

112
Q

heterotopic ossification (HO)

A

abnormal bone formation in extraskeletal soft tissue

113
Q

Etiology of HO

A

UNCLEAR

  1. Whole body response to trauma - fibroblasts inappropriately start reforming bone
  2. Excessive growth near joints - stiffness and loss of movement
  3. Most common in ORIF (open reduction internal fixation)
114
Q

ankylosing spondylitis

A

inflammatory disease that can cause some of the vertebrae in your spine to fuse together

115
Q

Risk factors of HO (3)

A

traumatic injury - severe burn, spinal cord injuries, head injuries
bone forming diseases - ankylosing spondylitis
Revisions increase the risk

116
Q

Signs and symptoms of HO

A

Asymptomatic - diagnosed on film

Usually 1-4 months post injury

117
Q

Compound Fx

A

open fracture - at risk for infection

118
Q

Comminuted Fx

A

bone breaks into many fragments

119
Q

displaced Fx

A

breaks into two or more parts so that the two ends do not align up straight

120
Q

Greenstick Fx

A

occurs in children with soft growing bones. One side of the bone breaks and the other side bends

121
Q

Transverse Fx

A

breaks on a right ankle to the longitudinal axis of the bone

OCTH 1031 (22 decks)

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