EXAM #2 Pathologies Related to UE Flashcards
what is the most common area of metastasis?
lung
esp from colorectal region
why is metastasis common?
due to lungs being the first organ to filter malignant cells in vena cava
who are at risk for lung cancer?
long term smokers
true or false. lung cancer symptoms may not arise until disease is widespread
ture
what is the most common symptom for lung cancer along with other respiratory S&S?
cough
lung cancer may have _____ P! that can be associated with a ______ tumor
shoulder P!
pancoast
lung cancer is what type of referral?
urgent
less common lung cancer in the apical region
pancoast tumor
who has the highest occurrence of pancoast tumors?
men > 50 years of age with a smoking history
S&S of pancoast tumor:
lung cancer S&S
shoulder P! (most common symptom)
compression on subclavian v. –> TOS S&S, ribs, vertebrae, brachial plexus, spinal n –> paresthesia’s along C8 T1
what motions would fatiguing weakness and hand atrophy be present at C8 with a pancoast tumor?
ulnar deviation
5th digit flexion
what motions would fatiguing weakness and hand atrophy be present at T1 with a pancoast tumor?
2nd digit flexion
thumb flexion/abduction
what motions would fatiguing weakness and hand atrophy be present at median nerve with a pancoast tumor?
pronation
wrist flexion
thumb flexion/abduction
what motions would fatiguing weakness and hand atrophy be present at ulnar nerve with a pancoast tumor?
wrist flexion
ulnar deviation
4/5th digit flexion
pancoast tumor dural mobility may possibly be + for what nerves?
median and ulnar
growth of a pancoast tumor may lead to compression on what?
sympathetic ganglion at cervicothoracic junction
what are S&S of pancoast tumor?
ipsilateral fascial flushing and sweating
Horner’s syndrome
respiratory S&S are rare due to smaller apical location
what is psoriatic arthritis?
a type of spondyloarthropathy or spondyloarthritide
what is the cause of psoriatic arthritis?
unclear genetic and environmental factors
onset of psoriatic arthritis typically in ____ and ____
less common than _______
30s and 40s
rheumatoid arthritis
what is a risk factor for psoriatic arthritis?
psoriasis
how does psoriatic arthritis develop?
persistent inflammation targets the entheses and gradually thickens and erodes tissues
fibrous tissue may even fill in the joint space
S&S of psoriatic arthritis
spondyloarthritide S&S
dactylitis - inflammation of entire digit
enthesis - DIPs more affected due to greater number of entheses and very little synovial tissue
what kind of referral for psoriatic arthritis
urgent referral
what do both psoriatic arthritis and rheumatoid arthritis do?
- damage joints causing swelling and stiffness
- damage other tissues and organs
- auto immune disease - produce auto antibodies
what are two differences between psoriatic arthritis and rheumatoid arthritis?
RA attacks synovial joint tissue (MCPs and wrists) PsA attacks entheses (DIPs)
RA - bilateral
PsA - unilateral
what is the prevalence of rheumatoid arthritis?
onset - 30-60s
females > males
what is the cause of rheumatoid arthritis?
unclear genetic and environmental factors
positive rheumatoid factor in blood tests
how does rheumatoid arthritis develop?
- auto-immune disease that breaks down all loose connective tissue throughout the body
- progresses from cartilage degradation to ligament laxity to thickened synovial tissue and finally erosion
what structure is involved in rheumatoid arthritis? it is the most common type of tissue in the body
all loose connective tissue
holds organs in place and attaches skin to underlying tissue
particularly in synovial membrane of synovial joints
what are autoimmune S&S for rheumatoid arthritis?
joint pain and stiffness > 30 minutes in the morning and after prolonged positions
reduced grip strength
rheumatoid arthritis typically starts in ______ peripheral joints, particularly the ______
smaller
hands
what are 3 possibilities that rheumatoid arthritis could progress to?
possible tendon ruptures and deformities: synovitis (enlarged finger joints), swan neck and boutonniere deformities, nodules and spurring, ulnar drift at wrist
carpal tunnel syndrome
may progress to cervical spine
what would a PT prescribe for rheumatoid arthritis?
POLICED
aggressive stretches contraindicated with advanced cases
orthotics/ergonomic education –> unload involved cartilage/support joints, prevent greater deformity/ROM loss
JM: cartilage integrity/joint mobility (contraindicated in advanced cases)
MET: optimal stresses for cartilage integrity/joint mobility
what is the prognosis for rheumatoid arthritis?
progressive
secondary OA changes inevitable
development of joint instability, of concern in upper cervical spine
RA - _______ ________ disease
OA - ________ ________ disorder
connective tissue
articular cartilage
RA affects:
OA affects:
joints, muscles, organs, etc
only affects joints, primarily weight bearing ones
RA symptoms present?
OA symptoms present?
symptoms always present, but with exacerbations/remissions
symptoms aren’t always present
RA pain ____ stiffness
OA stiffness ____ pain
>
RA edema/effusion in _______
OA edema/effusion ________
extremities
localized
`RA and OA bilateral or unilateral?
RA: bilateral
OA: unilateral
