day nineteen: arthritis

Question 1

osteoarthritis is also known as

Answer 1

degenerative arthritis

Question 2

osteoarthritis def:

Answer 2

defective integrity of the articular cartilage and changes in the underlying bone

Question 3

lupus def:

Answer 3

autoimmune disease causing inflammation and blood vessel abnormalities

Question 4

gout def:

Answer 4

disorder caused by uric acid or urate crystal deposition that usually affect onto a few joint of a time

Question 5

bursitis def:

Answer 5

inflammation of the bursa

Question 6

fibromyalgia def:

Answer 6

diffuse widespread pain with specific tender points (is still an autoimmune disease)

Question 7

inflammation can led to what formation:

Answer 7

osteophyte

Question 8

osteophye is

Answer 8

a small bone spurs that can cause stiffness and problems with the normal mechanics of movements

Question 9

what problems can osteophytes cause?

Answer 9

stiffness

problems with normal mechanics

Question 10

oseteophytes at the MP level can cause

Answer 10

trigger finger

Question 11

hebebden’s nodes:

Answer 11

distal phalanx osetohyte

Question 12

bouchard’s nodes:

Answer 12

proximal phalanx osteophyte

Question 13

crepitus nickname

Answer 13

SNAP CRACKLE POP! rice krispies!!

Question 14

crepitus definition:

Answer 14

grating popping crackling of tissues and joint surfaces
crepitus is a sign of inflammation and in the case of a joint could indicate uneven joint surfaces and deterioration of cartilage

Question 15

what could crepitus indicate?

Answer 15

uneven joint surfaces

deterioration of cartilage

Question 16

crepitus is a sign of

Answer 16

inflammation

Question 17

name like four risk factors:

Answer 17

excess weight
family history
age / previous injury
work history

Question 18

is there a cure for OA?

Answer 18

no.

Question 19

name like two medications for OA:

Answer 19

NSAIDS: naproxen, ibuprofen
compounded cream (topical cream)
Cox 2 inhibitors
chonodroitin

Question 20

indicators of OA:

Answer 20

pain when pinching / gripping
difficulty performing ADLs especially fasteners, opening jars, and containers
difficulty tearing packages

Question 21

eval for OA:

Answer 21

CMC grind test

Question 22

observe these things:

Answer 22

modeling zig zag deformity
tight webspace
ROM
grip and pinch strength

Question 23

key things to look for in hand deformity in OA (ROM of the bones)

Answer 23

thumb flexion / hyperextension of the IP, joint laxity or hyperextension at the MP

Question 24

tight webspace indicates

Answer 24

adductor pollicis tightness

Question 25

ROM of the thumb should be measured especially ____ and _____

Answer 25

palmer and radial ABduction

Question 26

evaluation:

Answer 26

1. assess thumb posture when pinching

2. assess dorsal capsule stability using lateral key pinch

Question 27

what would three things OT would do with OA:

Answer 27

1. educate in web space stretch
2. splinting to support CMC
3. selective strengthening of stabilizing muscles

Question 28

in order to perform isometric strengthening of the flexors you would

Answer 28

air ball squeeze for 10 repetitions

rubber band extension

Question 29

what is the goal of isometric strengthening of the 1 interossei

Answer 29

maintain the natural arch of the thumb which reduces forces at the CMCJ

Question 30

if you create a splint you want the MP

Answer 30

ONLY

MP only and placed at 30 degrees

Question 31

post operative rehab things to do:

Answer 31

cast for 4 to 6 weeks
AROM
scar massage
edema control

Question 32

RA is a

Answer 32

autoimmune disorder

Question 33

what happens in RA:

Answer 33

the immune system attack the body

destroys soft tissue and ligaments

Question 34

RA results in

Answer 34

pain and deformity

Question 35

RA nodeules are

Answer 35

lumps of tissue under the skin

Question 36

name like three s/s of RA that isn’t joint stiffness:

Answer 36

fatigue / muscle pain
flu like symptoms
loss of appetite / weight loss

Question 37

pannus

Answer 37

the synovium thickens from 2 cell layers to 12 layers and turn into a tissue called destructive tissue

Question 38

what stage does pannus occur?

Answer 38

stage 2

Question 39

describe stage 1

Answer 39

most painful
swelling and inflammation that is warm to touch
early dx and tx focusing on decreasing inflammation in stage 1 = less damage in later stage

Question 40

what treatment do you want to focus on in stage 1

Answer 40

decrease of inflammation

Question 41

what is the most painful stage?

Answer 41

1

Question 42

when do s/s start to decrease?

Answer 42

stage 2

Question 43

are there obvious deformities in stage 2?

Answer 43

no

Question 44

pannus eventually leads to

Answer 44

bone erosion

Question 45

stage 3 is defined as

Answer 45

destructive chronic active phase

• pain is less but irreversible joint damage has occurred
• radiographic changes of bones and cartilage destruction joint deformity and possible tendon rupture

Question 46

when are s/s irreversible / dx done

Answer 46

stage 3

Question 47

what happens in stage 4?

Answer 47

skeletal collapse and sever joint deformity

supporting soft tissue are totally deteriorate and the joints become unstable

Question 48

when is soft tissue totally deteriorated

Answer 48

stage 4

Question 49

zig zag deformity is secondary to

Answer 49

lack of ligament support

Question 50

name three splints we would use with RA:

Answer 50

ulnar drift
resting hand splint
wrist support

Question 51

three adaptations for joint protection

Answer 51

built up handles
use larger joints
adaptive equipment