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1
Q

Osteoarthritis

Signs

A

Originates in the cartilage and effects bones, soft tissue and synovial fluid

Bone enlargment

decrease ROM

Crepitus with motion

Tenderness with pressure

Joint effusion

Joint deformity

Inflammation

Malalignment

Pain with activity

Brief stiffness with inactivity

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2
Q

OA

Implications for PT

A

Educate:

Posture

Weight loss (as little as 5lbs)

Exercise (Flexibility, Strengthening)

orthotic devices

Meds

Joint replacement

Pain management

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3
Q

Rheumatoid Arthritis

A

Chronic systemic inflammatory autoimmune disease often effecting several joints, also multiple systems (cardio, pulmonary, GI)

Inflammatory response atacks synovium. Characterized by exacerbations and remission

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4
Q

RA

Implications for PT

A

Know signs

  1. Cervical pain with incontinence/urinary retention
  2. unexplained jt pain x1 month with
    1. skin rash
    2. extensor nodules

Education

Pain management

Increase strength and ROM

Increase fitness

Assist with adaptations

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5
Q

Ankylosing Spondylitis

A

Chronis inflammatory joint disease of the axial skeleton (SI jt, apophyseal jt, costovertebral jt)

A variant of RA

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6
Q

Ankylosing spondylitis

Implications for PT

A

Decrease inflammation and stiffness

Increase flexibility

Energy condervation

Fitness

Stretching

Fall prevention

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7
Q

Fracture types

A

Traumatic

Stress Fatigue

Insufficiency

Pathologic

Displaced vs non-displaced

Open vs closed

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8
Q

Fall

Risk Factors

A

Trauma

Age

Low bone density

Low levels of phyical activity

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9
Q

Fractures

Implications for PT

A

Complications

Delayed union or non-union

Compression fractures for older adults

Fall Prevention

Exercise

Balance

Strenght

Aerobic

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10
Q

Compression fracture

Complications

A

In the elderly can cause:

Urinary retention

GI symptoms

Increased risk for pulmonary complications

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11
Q

Osteonecrosis

A

Death of bone and bone marrow due to loss of blood supply.

Commonly effects the femoral head and other bones with limited blood supply

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12
Q

Osteonecrosis

Implications for PT

A

Recognition of cause

Id of pain (may appear as lumbar, hip, thigh, groin, knee)

Post Op rehab (early mobs, gait, AD)

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13
Q

Legg-Calve’ Perthes

A

(coxa plana)

Necrosis of the femoral head

often leads to arthritis

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14
Q

Legg-Calve’s Perthes

SIgns

A

Male 3-12 y.o.

Slow onset, limp with hip pain

Diagnosed with x-ray, MRI

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15
Q

Legg-Calve’ Perthes

Implcations for PT

A

Gait training

Aquatic therapy

ROM

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16
Q

Osgood-Schlatter Disease

A

Osteochondritis

Patellar tendon pulling small bits of bone from the tibial tuberosity

D/t trauma, malalignment

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17
Q

Signs of Nervous system disorder

A

Alt sensation

Alt movement

Brainstem dysfunction

Higher brain dysfunction

Alt LOC

Memory problems

Emotional stability

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18
Q

Abnormal sensations

A

Abnormal sensation

Hallucination (visual, hearing)

Proprioceptive awareness

Vestibular disturbance

Loss or change in vision

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19
Q

Brainstem dusfunction

A

LOC

BP

HR

Resp

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20
Q

Movement disorders

A

Adnorm tone and movements

hypertonicity

Nystagmus

Dysdiadochokinesia

tremors

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21
Q

Higher brain functions

A

Difficulty understanging language

read

write

understand

pronouncing

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22
Q

Neurologic Tests

A

CT

MRI

FMRI

PET

EEG

BAEP

Near-infrared spectroscopy

Transcranial doppler ultrasonography

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23
Q

CT

A

Computer Tomography

Images of the CNS

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24
Q

MRI

A

Manetic Resonance imaging

Images for spine and brain lesions

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25
FMRI
Functional Magnetic Resonance imaging Brain activiy with functional activity
26
PET
Positron Emission Tomography Cellular activity
27
EEG
Electroencephalography Electrical current of the brain
28
BAEP
Brainstem Auditory Evoked Potentials Evaluate Cranial audityor nerve III
29
Transcutaneous Doppler Ultrasonography
Measures local blood fow
30
Near-Infrared Spectrocsopy
Measures oxygen saturation of the brain
31
Infectious Diseases of the brain
Encephalitis Meningitis Brain abcess
32
Meningitis
Inflammation of the meninges of the brain (dura mater, arachnoid, pia mater) Aseptic (viral) Tuberculous (inhaled) Bacterial (upper resp, mucus)
33
Meningitis signs
Headache Fever Stiff neck Lumbar, post thigh pain Pain with hip flex and knee ext
34
Encephalitis
Inflammation of the parenchymal, brain tissue. Viral invasion/hypersensitivity West nile
35
Encephalitis Sign
Headache Nausea Vomiting follow by alt LOC
36
Brain stem abcess
Circumscribed local infection. Rapid growing effecting the meninges
37
Brain stem abcess Signs
Headache Untreated: Hemiparesis Seizures Lethargy Confusion
38
Infectious Disease Implications for PT
Observe isolation procedures Monitor Vital signs When inflammation is greatest, alt LOC may occur Movement disorders may indicate the depth of insult
39
Neoplasm
Brain Cancer Primry and secondary Impact the brain structures and their function by compression and destruction of tissues
40
Primary Brain Tumors
Develope in the brain or spinal cord or surrounding structures Malignant or benign Cranial nerve VI is susceptible Glioma
41
Glioma
Tumor of cells that insulate, metabolically assist, andsupport neurons Intraspinal Found with MRI
42
Secondary Brain tumors
Originate elsewhere and effect the brain (Metastic) Reached form arterial blood system
43
Primary Brain tumor Implications for PT
recognize signs Unsteady gait poor balance weakness with nausea vomiting headache Education and knowledge Post op Positioning
44
Brain Tumor Med Management
Radiation Chemo Surgery
45
Degenerative Disorders Nervous system
Amyotrophic Lateral Sclerosis Alzheimer's Dystonia Multiple Sclerosis Parkinson's
46
Amyotrophic Lateral Sclerosis
Motor neuron disease Scarring and degeneration of motor neurons in the lateral aspect of the spinal cord, brainstem, and cerebral cortex (upper and lower) 3-10 yrs degeneration frame
47
ALS Symptoms
Muscular weakness Attention Deficiency, Language comprehension, Planning and abstract reasoning (cortical involved)
48
ALS Implications for PT
Education Function Adaption Coping Fall prevention
49
Alzheimer's
Degenerative organic brain syndrome. Destroys neurons of the cerebral cortex. CAn progression to Alzheimer's dementia.
50
Alzheimer's Signs
Early Mild memory loss visual spacial defecits Impaired judgment Math/draw skills lost
51
Alzheimer's Implications for PT
Cognitive stim program Fitness Movement maintainance positioning assistive device Fall education
52
Dystonia
Characterized by involuntary, sustaine muscle contractions resulting in twisting and repetitive mvmnts. Locked posture. Exacerbated by activity
53
Dystonia Implications for PT
Know medications used Assistive device (min help) Intervention is limited
54
Multiple Sclerosis
Autoimmune, chronic degenerative demyelinating neurologic disorder of the CNS. Relapse - remitting is most common
55
Multiple sclerosis Implications for PT
Exercise within individuals ability. Careful monitoring
56
Parkinson's
Chronic disease of the motor component of the CNS
57
Multiple Sclerosis Signs
Painful decrease/loss of vision displopia Weakness Spasticity Balance prroblems Fatigue (motor, mental, sleepiness) presents mid afternoon
58
Parkinson's Signs
Tremors rigidity Bradykinesia Postural instability
59
Parkinson's Implications for PT
Fall education Assoc with dementia, depression Improve movement (claaping, music, side step)
60
Stroke Risk Factors
**Non modifiable:** Age sex race poss genetic **Modifiable:** Smoking HTN Cardiovascular disease Diabetes Increased total cholestorol, with low HDL Abdominal adiposity Alcohol/cocaine use
61
Stroke Signs
Sudden onset of weakness if arm, leg, face Sudden onset of diminished vision in one eye Sudden impaired speech Sudden balance problems Headache with unkown cause Tongue deviation
62
Ischemic Stroke
Results from an occlusion of major blood vessels from and emboli or thrombosis
63
Patterns of Disfunction Middle Cerebral Artery
Total or partial hemiplegia Total or partial loss of sensation on opposite side of body Global aphasia Sensory disturbances, lack of motor control
64
Patterns of Dysfunction Anterior Cerebral Artery
Min dysfunction Contralateral hemparesis and sensory loss
65
Patterns of Dysfunction Posterior Cerebral Artery
Major personality and psychological changes Exaggerated sensation Alt temp Pain/proprioceptive sensation Intractable pain Memory and perception disturbances vision
66
Intracranial Hemorrhage
Most deadly stroke Bleeding occurs in the brain Risk factors include age and HTN
67
Subarachnoid Hemorrhage
Bleed between the arachnoid and pia mater Caused by trauma, developmental defects, vascular malformation, tumors, infection Risk factors: Excessive alcohol, family history, HTN, smoking
68
Stroke Implications for PT
Acute: Positioning, pulmonary hyrgiene, early mobilization (when stable) Recovery: UE function (shld shrugs) Functional training Contraint-induced training Treadmill with PWB Stability mvmnt and control Fall prevention Control of spasticity and contractures Cardiovascualr endurance Family education
69
Traumatic Brain Injury
3 ages of common occurance 1-12 y.o. child abuse 15-24 y.o. risk taking Elderly falls
70
TBI signs
Initial alt LOC Impaired cognition, physical function Behavioral changes, emotional control
71
Levels of Consciousness
Awake Lethargic Obtunded - respondes to repeated stimuli Stuporous - respnds to painful stimuli Coma - unable to wake
72
TBI Implications for PT
Acute: Monitor cranial nerve function Monitor flexive and voluntary motor behaviors Pulmonry hygiene Positioning ROM ex Relaxation techniques Long-term: Vestibular sensitivity Sensory isturbances
73
Cerebral palsy
Non progressive lesion on a developing brain before 2 y.o. resulting in tone and movement disorders Tone * Hypotonia * Hypertonia.spasticity * Ataxia * Fluctuating/athetosis Distribution of involvement * Hemiplegia * Diplegia * Quadriplegia
74
Cerebral Palsy Signs
Speech vision Hearing Perceptual functioning Seizure
75
Cerebral palsy Implications for PT
Life-span emphasis family centered post op care Assistive devices Splinting
76
Autonomic Dysreflexia Signs
Sweating, flushed face Sudden increase in Systolic and diastolic BP Pounding headache Visual field changes, blurred vision Heart rhythm changes increased anxiety
77
Autonomic Dysreflexia Causes
Full bladder Full/ impacted bowel Kidney stone Cantractions of labor DVT Pressure ulcer PE Insect bites Temp change Tight clothing
78
Rancho Los Amigos Levels of cognitive function
I - no response II - General response III - Localized response IV - Confused - agitated V - Confused - inappropriate VI - Confused - appropriate VII - Automatic - appropriate VIII - Purposeful - appropriate
79
Charcot-Marie Tooth Disease
Slow progressive neuropathy involving motor and sensory nerves Initially involving the LE and moving into the FOrearm and hands
80
Charcot -Marie tooh disease Implications for PT
Minimize deformity maximize function Stretching ROM Bracing
81
Carpal Tunnel
Compression of the Median Nerve Pain locally Pain distally to finger tips Pain up to shld Nocturnal pain
82
Sciatica
Nerve root impingement involving sensory and motor nerves Low back Radiating into both legs
83
Bell's Palsy
Unilaterl facial nerve (VII) involvment resulting in rapid paralysis Sensation of fullness in the ear implications: Do not use e-stim Facial exercises
84
Thoracic Outlet Syndrome
Entrapment of the brachial plexus btwn the interscalene and inferior border of scap. May involve vascualr supply Nocturnal Pain Paresthesias tingling Implications: Pain relief, postural changes
85
Saturday Night Palsy
Compression of the radial nerve on the humerus.
86
Neurotmesis
Severed nerve Commonly after GSW, Stab wound, or avulsion injury
87
Gullian-Barre Syndrome
Immune disorder resulting in flaccid paralysis, areflexia and increased protein in the CSF Progressive weakness over days to weeks resulting from inflammtion and demyelinization. Body begins to repair
88
Myasthenia Gravis
Autoimmunie disorder resulting in fluctuating weakness and skeletal muscle fatigability. Chemical receptors in motor end plates are decreased and ineffective
89
Complex regional pain syndrome
Misfiring of the nervous systems causing it to become hyperactive. Pain, edema, movement disorders, atrophy, and abdnormal vasomotor response Implications: education, encourage normal activities while minimizing pain.
90
Traumatic SCI
Compression or dsiplacement of the spinal cord during a forceful injury. Incomplete or complete Determined by the level of sensory impairment or muscles function
91
Concussion
Injury cause by a blow or violent shaking
92
Contusion
Glial tissue and spinal cord surface remain in tact
93
Laceration or maceration
Glia is disrupted, spinal cord may be torn
94
Traumatic SCI Risk Factors
Men \> Women Young people MVA Acts of violence Contact sports High speed sports Fall Diving
95
Brown-Sequard syndrome
Damage to one side of the spinal cord. Commonly from a GSW or a stab. Incomplete lesion Ipsilateral weakness Abdnormal reflexes Ipsilateral spasticity in m. innervated below lesion Loss of proprioception, kinesthia and vibration Loss of pain and temp on contralateral side
96
Anterior Cord Syndrome
Frequently associated with flexion injuries assoc with loss supply from the anterior spinal artery Bilat loss of muscle function Loss of pain and temp
97
Central Cord syndrome
Often caused by hyperextension in the cervical region. Severe neurological involvement on the UE \> LE Function is retained thoracic to sacral Bilat loss of pain and temp sensation
98
Posterior Cord syndrome
Rare Loss of proprioception below lesion Motor function: pain, light touch sensation in tact
99
Conus Medullaris syndrome
Damage at the base of the spinal cord LE paralysis, reflexive bowel
100
SCI Comlications
Tone * Weakness * flaccid paralysis * spasticity Musculoskeletal * Heterotrophic ossification * Scoliosis * body alignment d/t contractures Autonomic dysreflexia Loss of thermoregualtion below lesion Rep complications Increased risk for DVT and PE Pressure ulcers Alteration in the bowel and bladder function Changes in sexual response

PTA Patho (4 decks)

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