Final Review Flashcards

Question

Stress fractures

Answer 1

- females > males - common in the 2nd & 5th metatarsal shaft, navicular, & rhythmic overload - risk factors: foot posture and inappropriate footwear

Answer 2

- Symptoms: progressive symptoms/overuse, stiffness/soreness after activity, mild soreness/pain during & after activity, pain during activity that alters performance, and pain during & after does not subside with complete rest - Intervention: immobilization for 4-6 wks and maintain cardiovascular fitness

Answer 3

- medial heel pain, tenderness medial toward heel, and AM pain - intervention: calf stretches, plantar fascia stretch, orthotics, and night splints

Answer 4

- Fracture = acute - Exertional = acute: no trauma and chronic: sx arise after set distance, duration, or speed of activity & progressive tightness, cramping, aching, or deep stabbing pain - release = fasciotomy - Intervention: functional & biomechanical factors, maintain CV, similar to stress fracture

Answer 5

- femoral neck = subcapital - extracapsular = trochanteric - proximal femoral shaft = subtrochanteric area

Answer 6

- swelling - erythema - pain - Homan's sign (but not on it's own/discomfort in calf with forced DF and knee straight) - point tenderness in calf

Answer 7

- DVT - malunion - delayed union - nonunion - avascular necrosis (AVN)

Answer 8

- physical & mental health before surgery is a predictor of postoperative success - mortality ~20% at 1 year, 50% at 2, 60% at 6, 77% at 10 - 15-40% require institutionalized post-op care for > 1 year - 50-83% require AD to ambulate - 20-30% of patients regain their pre injury level of independence

Answer 9

- pain - decrease mobility - deformity

Answer 10

- BMD 2.5 standard deviation below normal for age 30, peak bone mass at age 30 - estrogen loss - corticosteroids - loss of weight bearing/bed rest - hyperparathyroidism, hyperthyroidism, & chronic renal failure

Answer 11

- hip is most common joint - men age 30-60 - trauma - long term steroid use - RA/Lupus - Alcoholism

Answer 12

- antalgic gait - pain in the groin down to medial knee - throbbing deep hip pain - restricted hip internal rotation, flexion, & abduction

Answer 13

- infection of the bone - Causes: open injury to the bone, bacteremia, septsis, pre-existing infection, chronic open wound or soft tissue infection

Answer 14

- diabetes - hemodialysis - immunosuppression - sickle cell disease - intravenous drug abuse - elderly - renal/hepatic failure - alcohol abuse

Answer 15

- pain/tenderness in the infected area - swelling & warmth in the infected area - fever - nausea secondarily from being ill with infection - drainage of pus through the skin

Answer 16

- prevention of infections - screening - diagnosis: often late due to lack of signs/symptoms and/or being mistaken for something else, need imaging & ID specific pathogen - Treatment: immediate & aggressive treatment, high-dose antibiotics, possibly surgery

Answer 17

- focal loss of articular cartilage with variable subchondral bone reaction - joint pain and functional impairment seen - Treatment goals: relieve Sx, minimize disability, education, modification of activities, & maintain ROM - consider footwear or use of AD

Answer 18

- gait & balance training - manual therapies - systematically progressed therapeutic strengthening, flexibility, & endurance - use of AD can improve function associated with WBing activities

Answer 19

- number of fragments - fragment orientation - approach used to restore alignment - method used to maintain reduction - involvement of articular surfaces

Answer 20

- radial fracture with dorsal displacement of the distal fragment & possible radial shaft of the carpal bones - falling onto palm of hand - greater the extension of the wrist at impact results in greater injury including a comminuted fracture

Answer 21

- management ranges from closed reduction with cast or external fixation to surgical reduction & internal fixation - fracture healing takes 5-8 wks with expected full functional recovery in 4 mo

Answer 22

- distal portion of radial fracture dislocates palmarly - falling onto dorsal side of hand - surgery usually required - fracture healing in 5-9 wks with expected full functional recovery in 6 mo to 1 year

Answer 23

- While casted: ROM digits, elbow, and shoulder with the goal to reduce edema, prevent capsular/tendinous tightness - Cast removed: gentle ROM thumb & wrist (pain free range) for edema control - If continued limited ROM: joint mobs may need to be incorporated - Once full ROM: strengthening exercises can be added

Answer 24

- most common fracture of carpal bones - FOOSH Hx - Complications: non-union or necrosis due to blood flow interruption

Answer 25

- During immobilization focus to reduce edema, maintain ROM of uninvolved distal joints - Cast removed with use of a thumb spica splint: exercises for differential gliding of the wrist & fingers, strengthening with putty, sustained grip, & gradual closed chain activities - return to full activity within 12 wks after cast removal

Answer 26

- Splint 2-4 wks - AROM at 2-4 wks - PROM 5-6 wks - PRE (progressive resistance exercise) 7-8 wks

Answer 27

- splinting for 3 wks - AROM when non painful - PROM 4-6 wks - PRE 6-8 wks

Answer 28

- buddy tape (unless intra-articular) - AROM immediately - PROM 6-8 wks

Answer 29

- wrist extension - MCP flexed to 60-70 degrees - IPs fully extended

Answer 30

- abnormal formation of bone within a muscle following a muscle contusion injury - may develop in as many as 70-75% of moderate to severe quadriceps contusions

Answer 31

- prolonged disability - severe pain - a significant loss of function

Answer 32

- any person licensed to practice medicine or any of the healing arts - any professional staff person, not previously enumerated, employed by a private or state-operated hospital, institution or facility to which children have been committed or where children have been placed for care & treatment

Answer 33

- in place of a report you can immediately notify the person in charge of the institution or department, or his designee, who shall make such report forthwith - report to local department of the county or city wherein the child resides or wherein the abuse or neglect is believed to have occurred or to the departments toll free child abuse & neglect hotline

Answer 34

- any person who makes a report shall be immune from any civil or criminal liability on account of such report, records, information, photographs, video recordings, appropriate medical imaging or testimony, unless such person acted in bad faith or with a malicious purpose

Answer 35

- identified by sharply delineated water lines - often seen as glove or stocking distribution patterns that result from holding the hands or feet in very hot water

Answer 36

- when young children pull pots of hot liquid off a stove - first point of contact occurs on the face, chin, neck, & axilla and the flow pattern lessens along the torso - when hot liquids are thrown at a child the burns are usually not present on the neck & axillary area

Answer 37

- superficial because of the tendency to pull away when something hot is encountered - brushing against a hot object such as a cigarette causes a burn pattern that is shallow & irregular

Answer 38

- symmetrical - deep

Answer 39

- shaking is a prevalent form of abuse seen in very young children - SBS generally occurs when a frustrated caregiver shakes an infant vigorously usually in an attempt to stop crying or other unwanted behaviors - violently shaking an infant can cause the brain to move within the skull resulting in cerebral contusions, bleeding in the eyes, and SCI

Answer 40

- Stage 1: young (<25 y/o), edema and hemorrhage, & pain with >90 degrees abduction - Stage 2: age 25-40 y/o, fibrosis, irreversible changes in supraspinatus or bicep tendon, & pain at night, difficulty positioning shoulder for comfort - Stage 3: operative?, age >40 y/o, tendon degeneration/supraspinatus tears, history of shoulder pain, & muscle weakness/atrophy

Answer 41

- avulsion of capsule & glenoid labrum off anterior glenoid rim - result of traumatic anterior shoulder dislocation

Answer 42

- a compression or "impaction fracture" of the posteromedial aspect of the humeral head after anterior shoulder dislocation

Answer 43

- Type I: degeneration of superior labrum with loss of horizontal ABD w/ER - Type II: detachment of labrum & biceps tendon anchor with loss of stability - Type III: vertical tear of labrum with biceps intact - Type IV: tear of labrum into biceps tendon

Answer 44

- frozen shoulder - GH joint hypomobility due to development of dense adhesions, capsular restrictions, & thickening - insidious onset b/w 40-60 y/o - associated with trigger points, guarding or subscapularis - probably but not conclusively inflammatory - Primary = iidopathic - Secondary = Systemic (diabetes), Extrinsic (cardiopulmonary, CVA, fractures), or Intrinsic (tendinopathy)

Answer 45

- Freezing (2-3 wks): continuous pain, severe limitation of movement soon after onset - Frozen (4-12 mo): atrophy, pain (although less & occurring primarily with movement), loss of ROM - Thawing (12-24+ mo): decreased pain and restricted ROM

Answer 46

- direct force to acromion or when force is transmitted proximally to AC from FOOSH - 1st degree/Grade 1: minimal loss of function - 2nd degree/Garde 2: moderate pain, some dysfunction - 3rd degree/Grade 3: AC w/coracoclavicular ligament injury, may have significant dysfunction

Answer 47

- lymph transport is impaired but there is no clinical evidence of swelling - may last months or years - Sx progression from stage 0 to stage 1: sensation of heaviness, fatigue, ache, or pain in the limb at risk

Answer 48

- chronic inflammatory response to the excessive protein in the interstitium - pitting on pressure - reverses with elevation - Progression from stage 1 to stage 2: subcutaneous tissues begin to fibrose due to protein buildup

Answer 49

- non-pitting - does not reduce on elevation of the limb - clinical fibrosis is present = skin is thick and rigid - clear, sticky lymph fluid may ooze from pores - chronic inflammation can lead to recurrent bacterial and fungal infections

Answer 50

- AKA lymphostatic elephantiasis - severe non-pitting - large lobular folds - fibrotic edema with atrophic skin changes such as thickened, leathery, keratotic skin, skin folds with tissue flaps, papillomas (warty like overgrowth)

Answer 51

- lymphatic load is too great to transport the fluid from the interstitium - lymph collectors will work overtime with a functional reserve to mobilize the lymph fluid to lymph node groups - if functional reserve is used up = damage to the lymph collector walls and valves = reduced transport capacity & low output failure

Answer 52

- lymphatic system has difficulty transporting a minimal amount of high protein fluid from the interstitium due to damage in the lymph vessels or lymph nodes - lymphatics are mechanically insufficient causing the transport capacity to drop below the normal lymph load - lymph becomes stagnant in the interstitium = increased colloid osmotic pressure, high protein in the interstitium, & decreased absorption - swelling is produced in the extracellular space

Answer 53

- combination of a high output failure & a low output failure - high output failure due to infection, trauma, or surgery - low output failure due to previous injury to lymph vessels or nodes (ei radiation therapy)

Answer 54

- prostate - breast - lung - kidney - thyroid - GI

Answer 55

- primary Sx are pain & neurological findings - spine involved 50% pf the time = cord compression - x-ray for early diagnosis but bone scan is preferred (1/3 pos. scan with neg. x-ray) - treatment is mostly palliative

Answer 56

- from lungs, breasts, prostate, kidney - goes to thoracic lumbosacral, cervical spine - initial diagnosis = radiography &neurological exam - Symptoms: weakness, sensory loss, bowel & bladder sphincter disturbance - Treatment: radiotherapy to reduce pain, compress tumor, & restore neurological function

Answer 57

- pain for several months: not as severe os osteoid osteoma, less likely to be relieved with NSAIDs, poorly localized - possible scoliosis - nerve root impingement

Answer 58

- slow growing tumor usually at epiphyseal plate usually femur/tibia/humerus - benign but locally aggressive & usually bust be excised - Symptoms: localized pain, limited joint motion, swelling at end of long bones, & tenderness at end of long bones

Answer 59

- 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 40-60 y/o

Answer 60

- disabling instability - frequent knee buckling - high risk of re-injury - rule of 3rds

Answer 61

- inactive lifestyles - advanced arthritis in the knee - poor compliance

Answer 62

- go through 10 sessions of a progressive exercise therapy program over 5 weeks before deciding if ACL reconstruction is warranted - without proper guidance results may be poor - individuals who avoid high risk activity or mitigate their activity seem to be more successful without surgery

Answer 63

- NWB & WB exercises can be incorporated as long as undue strain on the healing graft is avoided: limit knee ROM to 90-45 degrees NWB and progress to 90-10 degrees by wk 12 - eccentric strengthening - NMES: freq. 35-80, duration 350-400 or Russian - neuromuscular training

Answer 64

- closed chain example: wall slides and step ups in pain free ranges typically 0-60 degrees - mix of open and closed chain exercises are safe as long as undue strain on the healing graft is avoided - limited knee ROM to only 90-45 degrees for NWB exercises early on - Progress to knee ROM from 90-10 degrees by wk 12