Exam III Study Guide

Question 1

First-degree, grade I AC joint sprain

Answer 1

minimal loss of function

Question 2

Second-degree, grade II AC sprain

Answer 2

moderate pain, some dysfunction

Question 3

Third-degree, grade III AC w/ coracoclavicular ligament injury

Answer 3

may have significant dysfunction

Question 4

AC Joint Sprain Grade I and II rehabilitation

Answer 4

Sling 1-2 weeks

Followed by ROM

Once pain-free, add isometric exercises (clavicular and scapular muscles)

Question 5

AC Joint Sprain Grade III rehabilitation

Answer 5

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

Question 6

Clavicle Fracture rehabilitation

Answer 6

Most are treated non-surgically with sling use x 3-4 weeks

Question 7

Clavicle Fracture ORIF indications

Answer 7

-Open fractures
-Displaced fractures with impending –skin compromise
-Neurovascular compromise
-Widely displaced mid-clavicular fractures

Sling following surgery for 6 weeks

Question 8

Humerus Fracture rehabilitation

Answer 8

Minimally or non-displaced fracture management
-Sling

-Early PROM within 14 days (avoid adhesive capsulitis)

-AROM at 4-6 weeks

Question 9

Fractures of the humeral neck

Answer 9

-Most common displaced humeral fracture
-Closed reduction or ORIF

Question 10

Fractures of greater tuberosity

Answer 10

-Occur with shoulder dislocation
-ORIF if displaced

Question 11

Benign suffix

Answer 11

-oma

Question 12

Malignant suffix

Answer 12

-sarcoma

Question 13

Osteochondroma

Answer 13

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

Question 14

Osteochondroma symptoms

Answer 14

-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

Question 15

Osteoid Osteoma

Answer 15

Benign skeletal neoplasm consisting of a nidus of osteoid tissue in the cortex

Question 16

Osteoid Osteoma symptoms

Answer 16

-Pain at night
-Pain with activity
-Pain relieved with NSAIDs
-Can affect bone growth in individuals with open growth plates

Question 17

Osteoblastoma

Answer 17

Benign, but larger than osteoid osteoma and likely to grow, usually in the vertebral column (unlike osteoid osteoma) or long bones along diaphysis

Question 18

Osteoblastoma symptoms

Answer 18

Pain for several months
-Not as severe as osteoid osteoma
-Less likely to be relieved with NSAIDs
-Poorly localized

-Possible scoliosis
-Nerve root impingement

Question 19

Endochondroma

Answer 19

Cartilage cyst found in bone marrow, often found incidentally

Usually found in metacarpals/metatarsals but also found in humerus and femur

Question 20

Endochondroma symptoms

Answer 20

-Mostly asymptomatic
-Possible fractures of the affected bone
-Enlargement of affected finger

Question 21

Chondroblastoma

Answer 21

Slow growing tumor usually at epiphyseal plate, usually femur/tibia/humerus

Benign, but locally aggressive and usually must be excised

Question 22

Chondroblastoma symptoms

Answer 22

-Localized pain
-Limited joint motion
-Swelling at end of long bones
-Tenderness at end of long bones

Question 23

Hemangioma

Answer 23

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

Question 24

Giant Cell Tumor of Bone

Answer 24

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

Question 25

Giant Cell Tumor of Bone symptoms

Answer 25

-Mild pain that progresses with tumor growth -Limited range of motion (proximity to the joint space) -Swelling (large growth) -Pathologic fracture

Question 26

Malignant Neoplasms

Answer 26

Capacity to expand and travel Spread by -Local invasion -Blood

Question 27

Sarcomas

Answer 27

Develop in connective and supportive tissue

Question 28

Osteoblastic pathogenesis of bone tumors

Answer 28

-Neoplastic cells produce osteoid -Known as tumor bone or neoplastic bone

Question 29

Osteolytic pathogenesis of bone tumors

Answer 29

Neoplastic cells incite local osteoclastic resorption of bone

Question 30

Chordoma

Answer 30

Develop from notochord, Slow-growing, locally aggressive, poor long-term prognosis

Question 31

Osteosarcoma

Answer 31

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

Question 32

Chondrosarcoma

Answer 32

Relatively slow growing tumor of cartilage, pelvic and shoulder girdles, Men in their 40s to 60s (esp. primary)

Question 33

Ewing’s Sarcoma

Answer 33

Non-osteogenic primary tumor, 2nd most common in children (10-15 years of age), Favors long tubular bones, Early metastasis to the lung

Question 34

Multiple myeloma (plasma cell myeloma)

Answer 34

Common clusters of signs/symptoms = CRAB Calcium (elevated) Renal failure Anemia Bone lesions

Question 35

Multiple myeloma common complications

Answer 35

Headache Vision Changes Radicular pain Neuropathy Loss of bowel and bladder control Paraplegia hypercalcemia

Question 36

Spinal Metastasis

Answer 36

From lung, breast, prostate, kidney To thoracic, lumbosacral and cervical spine

Question 37

Spinal Metastasis presenting symptoms

Answer 37

Weakness, sensory loss, bowel and bladder sphincter disturbance

Question 38

1st Trimester changes

Answer 38

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

Question 39

Second Trimester changes

Answer 39

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

Question 40

Third Trimester changes

Answer 40

week 27-40 +, increased fatigue, heartburn, upper respiratory breathing, swelling , hemorrhoids

Question 41

Pelvic girdle syndrome

Answer 41

daily pain in all 3 joints with positive pain provocation tests

Question 42

Synphysiolysis

Answer 42

daily pain in synthesis pubis only- positive pain provocation

Question 43

One- sided SI syndrome

Answer 43

Daily pain one SI joint with positive provocation tests

Question 44

Double sided SI syndrome

Answer 44

Daily pain B SI joint with positive provocation tests

Question 45

Miscellaneous pelvic pain syndrome

Answer 45

daily pain in one or more pelvic joints with inconsistent objective findings

Question 46

Pelvic joint pain treatment contraindications

Answer 46

-Intravaginal treatment -Intrarectal only with specific OB clearance -Assymetrical LE movements -E-stim or Ultrasound for pain control -Watch for DR

Question 47

Perineal injury first degree laceration

Answer 47

vaginal mucosa and perineal skin (no suturing)

Question 48

perineal injury second - degree laceration

Answer 48

involves muscles of the perineal body without transgressing the anal sphincter

Question 49

perineal injury Third degree laceration

Answer 49

laceration of anal sphincter

Question 50

perineal injury Fourth degree laceration

Answer 50

laceration of rectal mucosa

Question 51

causes of osteoporosis

Answer 51

Estrogen loss Corticosteroids Loss of weight bearing, bed rest Hyperparathyroidism, hyperthyroidism, chronic renal failure

Question 52

osteoporosis pathogenesis

Answer 52

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

Question 53

PICO and PICO(T)

Answer 53

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