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DPT 740/1: Clin Med 1 > EXAM 2- Hip Patho > Flashcards

EXAM 2- Hip Patho Flashcards

1
Q

what conditions can cause pathological hip fx

A

osteoporosis
osteomalacia
osteogenesis imperfecta (peds)
pagets disease
tumors

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2
Q

where is the most common site of the fx in a pathological hip fx

A

femoral neck

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3
Q

what are the symptoms of pathological hip fx

A

fx S&S
painful snap then giving way
groin pain (increase with WB)

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4
Q

what can we see in a scan for pathological hip fx

A

ob- shortened, ER LE
painful and asymmetric gait
ROM- several but IR limited
sp test- patellar- pubic percussion
possible sign of buttock

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5
Q

what is the notable observation of pathological hip fx

A

shortened, ER LE due to ER pulling the limb after the fx

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6
Q

what can cause the sign of the buttock

A

fx
tumor
infection
hematoma

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7
Q

what is in the SCAN for the sign of the buttock

A

hx- possible cancer, infection, or fx S&S
ob- gluteal swelling
ROM- limited hip flx in both directions, empty end feels
RST- weak and painful glutes

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8
Q

what is the referral if the sign of buttock is present

A

urgent
if fx, emergent if vascular compromise is thought

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9
Q

what is the referral for pathological hip fx

A

immobilize and emergent

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10
Q

who is most prevalent for pathological hip fx

A

older
women 65, men 70
osteoporosis type patient

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11
Q

what is the biggest concern with pathological hip fx for vascular damage

A

ER pull fx and can cause damage to the artery

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12
Q

What is osteonecrosis

A

Avascular necrosis or AVN femoral head

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13
Q

What is the cause of osteonecrosis through trauma

A

Fx
Dislocation
Slipped femoral epiphysis

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14
Q

What supplies the femoral head

A

Ligamentum teres houses an artery

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15
Q

What is the cause of osteonecrosis through gradual onset

A

Vascular abnormalities
Toxicity (radiation, smoking, alcoholism)
Sickle cell disease
Chronic corticosteroid and oral contraceptive
Bone marrow pathology
Metabolic syndrome

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16
Q

What is the pathology of osteonecrosis

A

Ischemia of bony tissue
Rapid ARJC
Labral tears

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17
Q

What are the symptoms of osteonecrosis

A

Groin, anteromedial thigh pain to the knee
Sign of buttock
Intermittent pain but worsening
Painful and asymmetric gait
ARJC S&S

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18
Q

What is different for osteonecrosis scan findings compared to ARJC

A

Hx of corticosteroid use
Colder to touch

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19
Q

What is the referral for osteonecrosis

A

Urgent referral

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20
Q

What if osteonecrosis is referred to PT

A

Gait training with AD to protect femur
Protection of motion, improve circulation, bone/cartilage integrity

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21
Q

What is Legg-Calve-Perthes

A

Coxa plana or flat hip
AVN femoral head in children

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22
Q

What can cause legg-calve-perthes

A

Trauma
Exposure to 2nd hand smoke
Prenatal factors
Developmental dysfunction of bone or vasculature

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23
Q

What is the pathology of legg-calve-perthes

A

Impaired vascular supply to epiphyses that changes the shape the femoral head and acetabulum

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24
Q

What are the symptoms of legg-calve-perthes

A

Gradual and unknown onset
Unilateral
Painful and asymmetric gait
Painful groin, anteromedial thigh pain to knee
Possible hip atrophy
Limited IR and ABD

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25
Q

What is the referral for legg-calve-perthes

A

Urgent referral

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26
Q

What can we do if legg-calve-perthes

A

Gait training with AD
Protect motion, improve circulation bone/cartilage integrity
periodically bracing, splinting or casted in ABD position

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27
Q

how does casting in ABD position for legg-calve-perthes help bone/cartilage integrity

A

better femoral head contact
maintain and help femoral head shape with acetabulum
prone to contractures

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28
Q

what can happen to a pt with legg-calve-perthes later in life

A

ARJC
corrective sx or early THA
earlier LB and knee pain due to gait dysfunction

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29
Q

what is slipped capital epiphysis

A

anterior displacement of femoral neck on femoral head
adolescent coxa vara
most significant epiphyseal plate disorder

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30
Q

what can cause slipped capital epiphysis

A

idiopathic
endocrine, renal disorder and down syndrome
hypothyroidism

31
Q

what are the RF for slipped capital epiphysis

A

obesity
male
rapid growth
radiation
femoral torsion

32
Q

what is the prevalence of slipped capital epiphysis

A

early adolescence
african american boys
obesity
bilateral

33
Q

what is the patho of slipped capital epiphysis

A

displacement of femoral neck relative to the head though the growth plate due to shear forces and/or weakened epiphyseal plate

34
Q

what are the S&S of slipped capital epiphysis

A

gradual, could be benign trauma
groin pain

35
Q

what can be found in a scan for slipped capital epiphysis

A

ob- painful and asymmetric gait
ER hip
m atrophy if long standing
ROM- limited IR, ABD, FLX
ER when fLX
possible sign of buttock

36
Q

what is the referral for slipped capital epiphysis

A

urgent

37
Q

what would we do if slipped capital epiphysis is <1 cm slip was referred to us

A

splint in ABD with non WB
post splint - gait training with AD, Protect motion, improve circulation bone/cartilage integrity

38
Q

what would we do if slipped capital epiphysis is >1 cm slip was referred to us

A

sx is required

39
Q

what complication are we trying to avoid with slipped capital epiphysis

A

avoid AVN or chondrolysis (rapid loss of articular cartilage)

40
Q

what are vascular insufficiency S&S

A

coldness
blueish or pale discoloration
diminished pulses
impaired capillary refill
shiny skin
hair loss

emergency

41
Q

what is the prevalence of colorectal cancer

A

3rd most common cancer
2nd cause of death
metastasize to thorax

42
Q

what are the RF for colorectal cancer

A

> 50 yrs
family hx
male
IBS
obesity
smoking
SAD

43
Q

what is the pathology of colorectal cancer

A

develops in large intestine

44
Q

what are the S&S for colorectal cancer

A

cancer S&S
dull and L lower quadrant pain
change in bowel
bloody stool or black

45
Q

what are the review components of colorectal cancer

A

ob- wavelike motion in L lower quadrant
palpate lymph nodes and L lower quadrant
vitals - fever

46
Q

what can we do to help a colorectal cancer pt

A

exercise helps bowel function and transmit time

47
Q

what should be done to prevent colorectal cancer

A

routine screen - colonoscopy at age of 45
urgent referral

48
Q

what are the RF for cervical cancer

A

HPV
drug and alcohol abuse
more than 5 sexual partners

49
Q

what is the prevalence of cervical cancer

A

3rd most common female cancer behind breast and colorectal
younger females

50
Q

what is the pathology of cervical cancer

A

HPV limits suppressor gene and malignancy develops

51
Q

what are S&S of cervical cancer

A

cancer S&S
pelvic and lumbar pain
excessive and untimely bleeding
bowel/bladder/sexual dysfunction

52
Q

what are the review components for cervical cancer

A

palpation of lymph nodes
vitals- fever

53
Q

what are complications of treatment for cervical cancer

A

radiation decreases estrogen so decreased bone density

54
Q

what are preventative measures for cervical cancer

A

regular OBGYN visits
HPV vaccine around 11/12 yrs

55
Q

where is chondrosarcoma most effected

A

pelvis and femur

56
Q

who is most effected my chondrosarcoma

A

middle age males

57
Q

what is the pathology of chondrosarcoma

A

thickening cortex
destruction of medullary and cortical bone
malignant cartilage

58
Q

what are S&S of chondrosarcoma

A

progressive and local swelling
cancer S&S
fx S&S

59
Q

what are review components of chondrosarcoma

A

sign of buttock
palpation of lymph nodes
vitals- fever

60
Q

what is the prevalence of appendicitis

A

late adolescence
males

61
Q

what can cause an appendicitis

A

unknown
obstruction due to neoplasm, infection, foreign body

62
Q

what are the S&S of appendicitis

A

periumbilical to R lower quadrant pelvic pain
R hip/groin pain
not eating
infection/cancer S&S
worse with increased abdominal pressure

63
Q

what are review components of appendicitis

A

ob- redness/swelling
ROM- pain and limitation with hip and trunk flexion
palpation- lymph nodes
abdominal quadrant assessment
vitals- fever

64
Q

what is the pathology of inguinal hernia

A

weakness/tearing in the abdominal organ covering that allows portion of organs to move out of their boundary

65
Q

what can cause an inguinal hernia

A

age
obesity
pregnancy
abdominal m weakness
trauma

66
Q

what are the S&S of inguinal hernia

A

progressively bulges and becomes painful
worse with increased abdominal pressure
burning/pinching
may radiate into thigh or pelvic midline

67
Q

what are the review components of inguinal hernia

A

S&S of respective organ
ROM- Pain and limitation with hip and trunk flx
palpation- pain with percussion, bulge

68
Q

what is septic arthritis

A

active local infection on a weakened or compromised jt at primary site of infection

69
Q

what are RF for septic arthritis

A

penetrating trauma
total jt
chronic jt replacement
diabetes
immunosuppression
infectious disease
substance abuse
sickle cell disease
renal failure

70
Q

what is the pathology of septic arthritis

A

microorganism invasion
weakened and compromised jt
bacteria activates clotting factors lead to thrombosis
massive inflammation

71
Q

what are S&S of septic arthritis

A

infection
painful and asymmetrical gait
infection S&S

72
Q

what are the review components of septic arthritis

A

refusal to move- pain, limited ROM, weakness in multiple directions
possible sign of buttock
palpation- TTP, lymph nodes, heat, swelling

73
Q

what is the referral for septic arthritis

A

emergency to avoid permanent jt and bone damage

DPT 740/1: Clin Med 1 (7 decks)

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