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Ortho > Degenerative Joint Disorders > Flashcards

Degenerative Joint Disorders Flashcards

1
Q

Etiology of DJD

A

Combination of factors
-biomedical
-Biomechanical
-genetic factors

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2
Q

Pathogenesis of DJD

A

narrowing of joint capsule
wear and tear on bones
hyaline cartilage decreases
Shock absorber decreases and muscles begin absorbing shock
localized to joints

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3
Q

Primary vs secondary DJD

A

primary- spontaneous
Secondary- due to fx, injury or disease, process can be halted if this is the cause

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4
Q

medical treatment for DJD

A

pain meds, weight reduction, arthroplasties, arthrodesis, osteotomy, osteoplasty

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5
Q

Clinical presentation of DJD

A

joint tenderness/ pain
impaired ROM
pain increased with activity and decreased with rest
Crepitus
morning and night stiffness
Pain progresses

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6
Q

Bone changes

A

Proliferation of bones- bone spurs
Osteophyte formation- at site of capsular and ligament attachment
capped by layers of cartilage

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7
Q

Heberden’s Nodes

A

distal phalanx slide along middle phalanx on the forces applied to pinch and grasp
Results in great shearing stress

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8
Q

Bouchard nodes

A

PIP joints

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9
Q

Conservative tx for arthritis

A

reduce pain
modalities
maintain and increase strength as long as pain does not increase
increase independence
educate the client on ways to protect the joints that have the smallest muscles around them

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10
Q

Pre-operative tx

A

Patient education
objective assessment (look at how their life is now vs how it will be after surgery)
functional assessment
pre-op splinting if needed

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11
Q

Post-op therapy of OA

A

static splint
Dynamic splint if indicated
Edema and Scar control
AROM/PROM
Monitor pain
Functional use/retraining

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12
Q

Arthroplasty def and goals

A

replacement of joints
Goals: relive pain, improve function, increase ROM

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13
Q

Total arthroplasty vs hemiarthroplasty

A

Total- 2 surfaces are replaced (ex. acetabulum and femoral head)
Hemi- only 1 joint surface replaced (ex. only femoral head)

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14
Q

Restrictions following an Arthroplasty

A

Related to severity of fx if indicated
Ability of device to withstand stress
Weight of patient
cognitive status

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15
Q

Most common place for musculoskeletal disorder of spine

A

Degeneration first noted in lumbar and cervical spine regions

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16
Q

Causes of MSK disorder of spine

A

mechanical factors
chemical factors
injuries
Spondylolisthesis (forward slip of vertebral body)
infection

17
Q

Disc degeneration causing MSK disorder of spine

A

nucleus degenerates due to lack of hydration
Decreased resilience, thickness and height
loses elasticity
Causes segmental instability, hyper extension, narrowing, stenosis

18
Q

Segmental instability causing MSK disorder of spine

A

smooth motion lost due to disk degeneration
uneven and excessive motion
joints form traction spurs
more susceptible to injury
chronic backache
pain may be referred to buttocks

19
Q

Segmental hyperextension of spine

A

Degenerative changes in annulus fibrosus
caused by obesity or decreased abdominal tone
Presents with chronic low back pain

20
Q

Segmental narrowing

A

Progressive narrowing of disc space with age
decreased joint motion, stiff, decreased pain
late stage of Degenerative disc disease
loss of mobility in lumbar spine

21
Q

Herniation of intervertebral disc

A

effects young males most
Stretching of the annulus fibrosis causes pain
herniation compresses/stretches nerve root- sciatica
loss of lumbar lordosis, trunk shifts to one side
mobility of spine lost

22
Q

Spinal stenosis

A

most common in lumbar spine
ache in buttocks, thigh, calf when walking or standing
common over age of 50
narrowing of spinal canal compresses nerve roots
pain relieved by sitting or reclining

23
Q

Aim of tx for MSK disorders of spine

A

Decrease pain
increase function
back education programs

24
Q

treatment methods for MSK disorders of spine

A

psychological considerations- reassurance
pharmacology- decrease inflammation
Bed rest with early mobility- rest of short period on firm mattress
Spinal braces
OT adresses IADL, ADL and donning and doffing braces

25
Q

Spinal fusion

A

most common
will not be able to increase ROM
Fuse higher and lower than injury

26
Q

Laminectomy

A

decompression
Removed part of bone, spurs and ligaments and then fuse

27
Q

Foraminotomy

A

Widens spaces for nerve roots

28
Q

Discectomy

A

Surgical removal of herniated disc lateral removes the central portion of the intervertebral disc and the nucleus

29
Q

Disc replacement

A

new vertebrae
for pts whose back pain has not be reduced by non-operative methods

30
Q

Intervention after spinal surgery

A

Bracing
Gradual return to activity
Teach adaptive care techniques to avoid trunk rotation
Log rolling in bed
no pushing/pulling
use AE

Ortho (7 decks)

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