Exam III Study Guide Flashcards
First-degree, grade I AC joint sprain
minimal loss of function
Second-degree, grade II AC sprain
moderate pain, some dysfunction
Third-degree, grade III AC w/ coracoclavicular ligament injury
may have significant dysfunction
AC Joint Sprain Grade I and II rehabilitation
Sling 1-2 weeks
Followed by ROM
Once pain-free, add isometric exercises (clavicular and scapular muscles)
AC Joint Sprain Grade III rehabilitation
Acute first 2-4 weeks:
-PT to decrease pain and swelling
-Reinforce immobilizer use
Return to function based on pain level and tolerance for activity
-ROM
-Strengthening
Clavicle Fracture rehabilitation
Most are treated non-surgically with sling use x 3-4 weeks
Clavicle Fracture ORIF indications
-Open fractures
-Displaced fractures with impending –skin compromise
-Neurovascular compromise
-Widely displaced mid-clavicular fractures
Sling following surgery for 6 weeks
Humerus Fracture rehabilitation
Minimally or non-displaced fracture management
-Sling
-Early PROM within 14 days (avoid adhesive capsulitis)
-AROM at 4-6 weeks
Fractures of the humeral neck
-Most common displaced humeral fracture
-Closed reduction or ORIF
Fractures of greater tuberosity
-Occur with shoulder dislocation
-ORIF if displaced
Benign suffix
-oma
Malignant suffix
-sarcoma
Osteochondroma
Cartilage-capped bony spur/outgrowth on bone surface
Usually occurs at end of long-bone growth plates, interfering with joint function
Most commonly form at knee or shoulder
Osteochondroma symptoms
-A hard, immobile, detectable mass that is painless
-Loss of joint ROM
-Soreness of the adjacent muscles
-Limb length discrepancies
-Pressure or irritation with exercise
-Possibility for changes in blood flow
Osteoid Osteoma
Benign skeletal neoplasm consisting of a nidus of osteoid tissue in the cortex
Osteoid Osteoma symptoms
-Pain at night
-Pain with activity
-Pain relieved with NSAIDs
-Can affect bone growth in individuals with open growth plates
Osteoblastoma
Benign, but larger than osteoid osteoma and likely to grow, usually in the vertebral column (unlike osteoid osteoma) or long bones along diaphysis
Osteoblastoma symptoms
Pain for several months
-Not as severe as osteoid osteoma
-Less likely to be relieved with NSAIDs
-Poorly localized
-Possible scoliosis
-Nerve root impingement
Endochondroma
Cartilage cyst found in bone marrow, often found incidentally
Usually found in metacarpals/metatarsals but also found in humerus and femur
Endochondroma symptoms
-Mostly asymptomatic
-Possible fractures of the affected bone
-Enlargement of affected finger
Chondroblastoma
Slow growing tumor usually at epiphyseal plate, usually femur/tibia/humerus
Benign, but locally aggressive and usually must be excised
Chondroblastoma symptoms
-Localized pain
-Limited joint motion
-Swelling at end of long bones
-Tenderness at end of long bones
Hemangioma
Growth of the endothelial cells that line blood vessels
May involve skin, showing up in neonates
-Self-resolving or permanent
Some involve vertebral bodies
-10% of pop
-Females > males between 40 and 60 years
Giant Cell Tumor of Bone
Wide age distribution
Historically considered benign
Today, low-grade malignant
Center of the epiphysis (i.e. right next to joints) of long bones
Develop slowly
Giant Cell Tumor of Bone symptoms
-Mild pain that progresses with tumor growth
-Limited range of motion (proximity to the joint space)
-Swelling (large growth)
-Pathologic fracture
Malignant Neoplasms
Capacity to expand and travel
Spread by
-Local invasion
-Blood
Sarcomas
Develop in connective and supportive tissue
Osteoblastic pathogenesis of bone tumors
-Neoplastic cells produce osteoid
-Known as tumor bone or neoplastic bone
Osteolytic pathogenesis of bone tumors
Neoplastic cells incite local osteoclastic resorption of bone
Chordoma
Develop from notochord, Slow-growing, locally aggressive, poor long-term prognosis
Osteosarcoma
Most common primary malignant bone tumor
Develops in the metaphysis
-Distal end of the femur
-Proximal end of the tibia, fibula
-Proximal end of humerus
Mainly osteoblastic
Extremely malignant
Radiation resistant
Chondrosarcoma
Relatively slow growing tumor of cartilage, pelvic and shoulder girdles, Men in their 40s to 60s (esp. primary)
Ewing’s Sarcoma
Non-osteogenic primary tumor, 2nd most common in children (10-15 years of age), Favors long tubular bones, Early metastasis to the lung
Multiple myeloma (plasma cell myeloma)
Common clusters of signs/symptoms = CRAB
Calcium (elevated)
Renal failure
Anemia
Bone lesions
Multiple myeloma common complications
Headache
Vision Changes
Radicular pain
Neuropathy
Loss of bowel and bladder control
Paraplegia
hypercalcemia
Spinal Metastasis
From lung, breast, prostate, kidney
To thoracic, lumbosacral and cervical spine
Spinal Metastasis presenting symptoms
Weakness, sensory loss, bowel and bladder sphincter disturbance
1st Trimester changes
first 12 weeks after the first day of the last menstrual period
Breast enlargement
Avg. wt gain 5 lbs
May start to see increase lordosis at 10- 12 weeks
Second Trimester changes
Week 13 to week 27, Uterus will expand to 4x in size from week 12 to 27, rectus abdominis increasing in length and diastasis recti may be forming
Third Trimester changes
week 27-40 +, increased fatigue, heartburn, upper respiratory breathing, swelling , hemorrhoids
Pelvic girdle syndrome
daily pain in all 3 joints with positive pain provocation tests
Synphysiolysis
daily pain in synthesis pubis only- positive pain provocation
One- sided SI syndrome
Daily pain one SI joint with positive provocation tests
Double sided SI syndrome
Daily pain B SI joint with positive provocation tests
Miscellaneous pelvic pain syndrome
daily pain in one or more pelvic joints with inconsistent objective findings
Pelvic joint pain treatment contraindications
-Intravaginal treatment
-Intrarectal only with specific OB clearance
-Assymetrical LE movements
-E-stim or Ultrasound for pain control
-Watch for DR
Perineal injury first degree laceration
vaginal mucosa and perineal skin (no suturing)
perineal injury second - degree laceration
involves muscles of the perineal body without transgressing the anal sphincter
perineal injury Third degree laceration
laceration of anal sphincter
perineal injury Fourth degree laceration
laceration of rectal mucosa
causes of osteoporosis
Estrogen loss
Corticosteroids
Loss of weight bearing, bed rest
Hyperparathyroidism, hyperthyroidism, chronic renal failure
osteoporosis pathogenesis
Combination of increased bone reabsorption and decreased bone formation
Imbalance between osteoclastic and osteoblastic function
Greatest effect on trabecular bone (vertebrae) and metaphysis of long bones
PICO and PICO(T)
Population
Intervention
Comparison
Outcome
(T)ime
PICO is a checklist to help you stay both focused and comprehensive when seeking evidence addressing specific clinical questions
