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PT-409 Pathology > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Osteoarthritis Primary Changes

A
  • Loss of Cartilage
  • Remodeling of Bone
  • Osteophytes
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2
Q

Osteoarthritis affects who the most?

A
  • > 65

- Women

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3
Q

Osteoarthritis: Knee exam findings

A
  • Decreased ROM
  • Crepitus
  • Deformity
  • Effusion
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4
Q

Osteoarthritis: Hip exam findings

A
  • Loss of IR
  • Loss of ABD
  • Leg Length changes
  • Trandelenberg gait
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5
Q

Osteoarthritis: Radiograph findings

A
  • weight bearing
  • narrowing
  • osteophytes
  • cysts
  • deformity
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6
Q

Inflammatory: Possible problems

A
  • RA
  • Lupus
  • Psoriatic arthritis
  • Ankylosing Spondylitis
  • Poor bone
  • On steroids
  • Multiple joint involvement
  • Less responsive to PT
  • Significant deformity
  • High complications and infection
  • Cervical spine involvement in RA
  • Stiffness in AS
  • UE involvement in RA-platform walker
  • Severe valgus deformity
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7
Q

Osteonecrosis: Need to Know

A
  • Primary in HIP
  • 10% of THA due to necrosis
  • 80% Bilateral
  • MRI is 99% sensitive and specific
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8
Q

Osteonecrosis: Causes

A
  • Alcohol abuse
  • Steroids
  • Irradiation
  • Idiopathic
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9
Q

Femoroacetabular Impingement: Need to Know

A
  • 2nd to arthritis
  • Repetitive problem due to structure abnormalities
  • CAM = Young Males
  • Pincer = Young Females
  • LABRAL Tears
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10
Q

Femoroacetabular Impingement: Treatment

A
  • Arthroscopy
  • Pelvic Osteotomy
  • THA
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11
Q

Osteoarthritis: Medical Management

A
  • NSAIDS
  • Acetaminophen
  • PT/HEP
  • Glucosamine/Chondrotin
  • Activity modification
  • Exercise Program
  • Knee sleeve
  • Injections
  • TJR when ALL ELSE FAILS
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12
Q

TKA: Goal

A
  • Restore normal alignment
  • Improve Function
  • Decrease pain
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13
Q

TKA: Gold Standard

A

Cemented

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14
Q

TKA: need to know

A
  • Pre-op ROM = >post-op ROM
  • Goal = 0-115
  • 95% last >10 years
  • Immediate WB
  • Knee noise
  • 1 year for full recovery
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15
Q

TKA: Post-op

A
  • NO running / jumping
  • CAN cross legs
  • CAN kneel
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16
Q

Partial Knee Replacement: Contraindications

A
  • Inflammatory Arthritis / RA
  • Absent ACL
  • Obesity
  • Lateral Patellofemoral wear
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17
Q

THA: Approaches

A
  • Direct Anterior
  • Direct Lateral
  • Posterior
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18
Q

THA: Anterior approach

A
  • Quick recovery (2-4 weeks)
  • LOW risk for dislocation
  • Femoral N. injury/pain
  • Higher blood loss
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19
Q

THA: Lateral approach

A
  • Low dislocation rate
  • Heterotropic ossification
  • better for potential future surgery
  • LIMP
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20
Q

THA: Posterior approach

A

Higher risk of dislocation

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21
Q

THA: need to know

A
  • non cemented more common
  • Similar recovery (6 weeks)
  • Anterior approach very difficult (1 surgeon)
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22
Q

THA: Complications

A
  • Heterotropic ossification
  • Vascular injury <1%
  • Dislocation 1-3%
  • Infection 1-2%
  • DVT
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23
Q

THA: Take Home Points

A
  • WBAT
  • ROM and Strength will return
  • Cane in opp.
  • Leg Length Discrepancy <7mm
  • Precautions only within 3 months
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24
Q

Bipolar Hemiarthroplasty

A

Break of Femoral neck

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25
Q

Bipolar Hemiarthroplasty: Need to Know

A
  • Displaced femoral neck fractures
  • Replace Femur only
  • Older / Frail low demand patients
  • Quicker and less blood loss
  • Less risk of dislocation than THA
  • Rapid Mobilization
  • High rate of failure in younger population so THA best
26
Q

Osteoarthritis: Primary Pathology

A
  • age
  • biochemical cellular alterations over time
  • genetic
27
Q

Osteoarthritis: Secondary Pathology

A
  • fractures
  • high impact loads
  • ligament injuries
  • dysplasia
  • infection
  • AVN
  • Pagets, Hemophilia
  • Charcot
28
Q

Osteoarthritis: Treatment

A
  • Treat cause for secondary cases
  • focus on non op means
  • NSAIDS CANE PT NUTRACEUTICALS
29
Q

Hip Dysplasia: Definition

A

Abnormal development of the Hip Joint

30
Q

Hip Dysplasia: Pathology

A
  • Cartilage dysplasia

- Developmental

31
Q

Muscle Strains: Treatment

A
  • Restoring Mobility / Strength / Function

- NSAIDS

32
Q

Slipped Capital Epiphysis:

A
  • Males 2x> Females

- Pain / Limp /

33
Q

Avascular Necrosis: Pediatrics Causes

A
  • Perthes Disease
  • SCFE and Rx
  • Osteomyelitis
  • Metabolic
  • Steroids
34
Q

Avascular Necrosis: Pediatrics Treatment

A
  • ATTEMPT non-OP
  • Contain and let Hip REMODEL
  • osteotomy
35
Q

Avascular Necrosis: Adult Causes

A
  • Steroids for Rx of various med conditions
  • ETOH
  • Deep Diving
  • Trauma
36
Q

Avascular Necrosis: Adult Treatment

A
  • Usually THA

- Core decompress

37
Q

Perthes Disease: Definition

A
  • AVN of Femoral Head in Children

- most common in kids

38
Q

Hip Arthroscopy: REMEMBER

A
  • Groin pain is hip joint pain until proven otherwise

- Medial Knee pain can be referred hip joint pain by OBTURATOR N.

39
Q

Labral Tears: Mechanism of Injury

A
  • Hyperextension

- ER

40
Q

Labral Tears: REHAB

A

Day 2-14: Bike, PROM, AAROM, PWB, isometric, thigh mm
Day 14-28: AROM, stretching, WBAT, PRE’s, core
Day 14— : functional activity as tolerated

41
Q

Osteochondritis Dissecans:

A
  • disease of subchondral bone
42
Q

Osteochondritis Dissecans: mechanism of injury

A
  • Trauma
  • ischemia
  • Abnormal ossification
  • endocrine abnormalities
43
Q

ACL: mechanism of injury

A

Passive: Valgus (clipping)
Active: sudden stop (supra maximal quad contraction) ***most common form

44
Q

ACL Insufficiency: Signs and Symptoms

A
  • Pop
  • pain w/ WB
  • Swelling
  • 85% of effusions in knee =ACL
  • feels like it “gives way”
45
Q

PCL: mechanism of injury

A
  • Pre-tibial trauma
  • Hyperextension
  • Knee Dislocation
46
Q

PCL Insufficiency: Signs and Symptoms

A
  • Patella pain
  • Medial Pain
  • Hyperextension
  • Pre-tibial pain
    • drop back
47
Q

Posterolateral Instability: MOI

A
  • same as ACL and PCL

- VIOLENT

48
Q

Posterolateral Instability: S/S

A
  • Acutely - same as ACL and PCL

- Chronic - repeated “giving way” / pain / swelling

49
Q

ACL: Treatment (low demand person)

A
  • brace
  • restrict activities (cutting, jumping, twisting)
  • 30% will develop OA
  • 75-80% will have menisci tear
50
Q

Lateral Ankle Sprains: Classifications (1-3)

A

1st - partial / complete tear of ATFL
2nd - ATFL and partial / complete CFL
3rd - ATFL, CFL , PTFL injury

51
Q

Lateral Ankle Sprains: Treatment

A
  • Functional Rehab
  • RICE
  • WBAT
  • ROM prn
  • early mobilization
52
Q

Lateral Ankle Sprains: need to know

A
  • 20% will develop chronic instability
  • Surgery IF:
    Direct repair
    tendon/graft augmentation
    realignment procedures
53
Q

Syndesmotic Injuries: History

A
  • ER injury
  • Pain anterolateral ankle
  • unable to play
54
Q

Syndesmotic Injury: Exam

A
  • Pain w/ DF
  • ER test
  • “squeeze” test
  • deltoid tenderness
55
Q

Syndesmotic Injury: Treatment (stable)

A
  • Functional Rehab
  • RICE
  • CAM walker w/ protected WB initially
  • Progress to strengthening, proprioception, functional activities as tolerated
56
Q

Syndesmotic Injury: Time frame

A
  • Minimum 6 weeks up to 3-6 months
57
Q

Syndesmotic Injury: Treatment (unstable)

A
  • screws
  • cast 6 weeks
  • CAM walker 6 weeks w/ Progressive WB
  • remove screw at 3 months
58
Q

Chronic Exertional Compartment Syndrome: definition

A
  • increased pressure within one or several of the 4 fascial compartments of the leg during or shortly after exercise
59
Q

Chronic Exertional CS: History

A
  • symptoms at specific distance / speed / duration
  • pain in leg or referred pain in foot following N.
  • Fatigue in leg or foot weakness
  • numbness or tingling
60
Q

Chronic Exertional CS: Treatment

A

Non-OP - Rest / NSAIDS / running mechanics / orthotics

Surgery - athletes / fasciotomies

PT-409 Pathology (3 decks)

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