Final Exam Flashcards
Preclinical Disability
-progressive and detectable but unrecognized decline in physical function in older adults
-decreased task efficiency
Phenotypes
-describes how an individual’s characteristics are a result of their genotype interacting with the environment
Musculoskeletal system and aging
-Skeletal muscle of older people is more easily damaged with the loading
-Aging collagen increased cross-links between molecules, increasing the mechanical stability and tissue stiffness
-Tendons exhibit a lower metabolic activity that compromises healing
-joint increased stiffness and decreased flexibility and proprioception
Bone Remodeling influences
-mechanical stress
-Calcium and phosphate
-hormonal levels
4 causes of Fractures
Traumatic, stress, insufficiency, pathologic
Traumatic Fractures
-sudden impact
-Transverse, oblique, spiral
-mostly radius and ulna
-most affected 5-14
Stress Fractures
-partial break
-rhythmic repeated microtrauma
-most in tibial shaft and metatarsal
- Compressive: forceful heel strike during prolonged marching
- Distractive: muscle pull on bone
RF
-increase intensity of training
-females: pelvic and sacral fractures
Insufficiency Fracture
-normal stress applied to abnormal bone
-decreased elastic resistance or decreased mineralization
-minor trauma
Pathologic Fracture
-abnormally fragile bone by disease
Classification of Fractures
Transverse: right angle line, shearing
Oblique/Spiral: twisting force
Comminuted: broken into fragments
Segmented: broken with a segment of free bone is left
Butterfly: separation of a wedge
Greenstick: splintering of bone
Torus: bone bulges out from stress
Hairline/crack: skinny crack
Vertebral Compression Fracture
-most common osteoporosis related fracture
-minor
-pain worse with spinal extension
-height loss and respiration dysfunction
Fracture Healing
- Hematoma (6-12h): Blood clot forms and inflammation
- Proliferation (1-2d): granulation tissue and fibrocartilage
- Callous Formation (1-3w):
Soft callous - Ossification (6w): Soft callous replaced by bony callous
- Remodeling (4m-1y): restoration of medullary canal
Factors to Hinder Fracture Healing
-inadequate blood supply
-poor nutritional status
-poos apposition
-infection
-corticosteroid
Clinical Manifestations of Fractures
-point tenderness
-pain with weight bearing
-swelling and bruising
-loss of mobility
Complications of fractures
-malunion
-delayed union
-nonunion: fibrous union or false joint
Bone Grafting
-enhance bone repair
Autogenous: taken from self, iliac crest of fibula
Allogeneic: donor bank
Tissue Engineering: Porous scaffolds and biodegradable plastics
Bone Healing Prognosis (time)
Children: 4-6w
Adolescents: 6-8w
Adults: 10-18w
Negative Predictors:
-Calcium channel blockers and NSAIDs
PT Implications for LE Fractures
-can begin rehab within 1 week
-immobilized until callus formation
-treat swelling, pain, and ROM deficits
-Weight bearing limitations
Look for
-compartment syndrome
-fat embolisms
-nerve issues
Radiologist
-physicians specializing in radiology
Radiographers
-technicians who produce images
Highest Radiodensity
-Metal/lead
Lowest Radiodensity
-air
Lowest Radiographic density
-Metal
Highest Radiographic density
-air
High Radiodensity Color
-white image
High Radiographic Density Color
-black image
Contrast-Enhanced Radiographs
-contrast medium injected into body and radiograph taken
Arthrography
-joint and soft tissues
Myelography
-spinal cord
-nerve root
-dura
L2-L3, L3-L4, C1-C2
CT Scan
-Conventional Tomography
-different depths of bone
-computer msthmatically reconstructs image
Nuclear Imaging
-radiopharmaceuticals to see changes in anatomy structure by emmiting gamma rays
PET Scan
-Positron Emission Tomography
-inject glucose to see abnormal cells
Radionuclide Bone Scan
-distribution of disease in bone
Ultrasonograph
-refkected sound waves and tissue absorption
-leision to muscles and tendons
Chrondrolysis
-degeneration and narrowing of the joint space
-trauma, surgery, immobilization
Sx: Joint stiffness and loss of motion
Tx: pain reflief, surrgery, weight bearing precautions
Osteoarthritis
-Degeneration fo joint cartilage that affects underlying bone (subchondral)
-inflammation causes more changes and swelling
-most common msk disorder
Sx: pain, bony enlargements, edema, stiffness, loss of ROM
Tx: behavior, education, meds, surgery
Rheumatoid Arthritis
-systemic inflammatory disease
Articular: destruction of joints
Extraarticular: pulmonary, CVD, GI
-associated with graves and hashimotos
-rheumatoid factors found in synovial membranes
-Thickened synovium form destructive granulation tissue Pannus that disolves the joint
Clincial Manifestations of RA: Cervical Instability
-C1-C2 subluxation and brainstem compression
Sx: head falling forward, syncope, vestib issues
-posittive Lhermitte sign, shocklike sensations
Clincial Manifestations of RA: Cutaneous
-rhumatoid nodules: asymptomatic
-can appear in heart, lungs, GI
-joint contractures
-small vessel vasculitis
Clincial Manifestations of RA: Neurologic
-myelopathy
-neck pain
-incontinence
-peripheral neuropathies
Clincial Manifestations of RA: Extra Articular
-cardiopulmonary function
Degenerative Intervertebral Disc Disease
-age related changes
-decline of blood supply to peripheral disc
-issues with nerves
-spondylolisthesis
Juvenile Idiopathic Arthritis
-paurarticular most common
-pain of joints
Spondyloarthropathies
-group of disorders formerly considered RA
-inflammation of joints of the spine
Ankylosing Spondylitis
-inflammation to the axial skeleton
-leads to fusion and calcification
-pain in back, inflammation fo tendons
-bamboo spine
Diffuse Idiopathic Skeletal Hyperotosis (DISH)
-idiopathic variant of OA
-ossification of ligaments
-commonly effects thoracic spine
-no degeneration of vertebreal joints
Sjogren Syndrome
-chronic immune disease causes arthritis effects in organ
-moisture producing glands
-second most common autoimmune rheumatic
Sx: dry eyes and mouth
Psoriatic Arthritis
-seronegative inflammatoy joint disease
-20% of psoriasis havers
Sx:
-joint destruction
-hand deformities
Reactive Arthritis
-arthritis after an infectious process
-nailsR
Reiter Syndrome
-reactive arthritis
-triad: urethritis, conjunctivitis, arthritis
Gout
-joint pain at night
-poroduces uric acid
-deposition of crystals
-diet of purines
Neuroarthropathy
-articular abnormality related the neurologic deficits
Osteochondroses
-aka epiphysitis, osteochondritis, necrosis
-affects epiphyses
Osteochondritis Dissecans
-subchondral softening and necrosis followed by recalcification
-cartilage and subchondral can become loose
-microtrauma
Sx: activity related pain
Osteonecrosis
-death of bone and bone marrow
-avascular necrosis
Sx: prevent weight bearing
Legg-Calve-Perthes
-necrosis of proximal femur
-high chance of labral tears
-common in children
Sx: abnormal posture and pain
Osgood-Schlatter
-fibers of patellar tendon on tibia
-tendonitis
-boys >girls
Heterotopic Ossification
-aka myositis ossificans
-bone formation in non osseous tissue
-after trauma
Sx: loss of ROM, muscle pain
PT: motion, function, no stretching
Polymyalgia Rheumatica
-diffuse pain and stiffness of muscle groups
-mostly shoulder and pelvic girdle
-most decelop arteritis
Myopathy
-nonspecific proximal progressive muscle weakness after illness
-associated with critical illness myopathy
Hereditary: Musclar dystrophy, myotonia, charcot-marie-tooth
Acquired: inflammatory myopathy, endocrine, illness related, drug induced