Management of Patients With Musculoskeletal Disorders Flashcards
*Caused by lumbosacral strain, unstable ligaments and weak muscles
*Osteoarthritis of the spine, spinal stenosis, intervertebral disk problems, and unequal leg length.
*Obesity, stress, and depression may contribute to low back pain. usually is aggravated by activity
Low Back Pain
Pain radiating down the leg
(radiculopathyor sciatica)
*May occur in a joint as a result of articular cartilage wear and bone erosion.
*Interfere with joint movement, locking the joint, resulting in painful movement.
*Removed by arthroscopic surgery.
LOOSE BODIES
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General term that describes all lesions that involve the rotator cuff of the shoulder
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Usually occurs from repetitive overhead movement of the arm
IMPINGEMENT SYNDROME
help identify carpal tunnel syndrome
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Elicited by percussing lightly over the median nerve, if the patient reports tingling, numbness or pain, the test is positive.
Tinel’s sign
*Results in a slowly progressive contracture of the palmar fascia
*Causes flexion of the fourth and fifth fingers, and middle finger.
*Caused by an inherited autosomal dominant trait and occurs most frequently in men who are older than 50 years
*This condition starts in one hand, but eventually both hands are affected.
*Fingerstretchingexercises or intranodularinjections of corticosteroids may prevent contractures
*Palmar and digital fasciectomies are performed to improve function.
*Finger exercises are begun on postoperative day 1 or 2.
DUPUYTREN’S DISEASE
Collection of gelatinous material near the tendon sheaths and joints, appears as a round, firm, cystic swelling, usually on the dorsum of the wrist.
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Most frequently occurs in women younger than 50 years.
Treatment may include aspiration, corticosteroid injection, or surgical excision.
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After treatment, a compression dressing and immobilization splint are used.
GANGLION
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Entrapment neuropathy that occurs when the median nerve at the wrist is compressed by a thickened flexor tendon sheath, skeletal encroachment, edema, or a soft tissue mass.
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Most commonly occurs in women between 30 and 60 years of age.
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Caused by repetitive hand and wrist movements, but it may also be associated with arthritis, diabetes, tumors, or trauma
*Night pain is common.
mgt: corticosteroids, wrist splint, open releaase surgery, cutting the carpal ligament
CARPAL TUNNEL SYNDROME
*Inflammation of the foot-supporting fascia, presents as an acute onset of heel pain experienced with the first steps in the morning
*The pain is localized to the anterior medial aspect of the heel and diminishes with gentle stretching of the foot and Achilles tendon.
PLANTAR FASCIITIS
*Area of hyperkeratosis (overgrowth of a horny layer of epidermis) produced by internal pressure (underlying bone is prominent
*Congenital or acquired abnormality, commonly arthritis) or external pressure (ill-fitting shoes)
*Fifth toe is most frequently involved, but any toe may be involved.
CORN
*Discretely thickened area of the skin that has been exposed to persistent pressure or friction.
*cb Faulty foot
*Felt padding with an adhesive backing is also used to prevent and relieve pressure.
*Orthotic devices can be made to remove the pressure from bony protuberances
CALLUS
*Commonly called a bunion
*Deformity in which the great toe deviates laterally
*Marked prominence of the medial aspect of the first metatarsophalangeal joint.
HALLUX VALGUS
*Free edge of a nail plate penetrates the surrounding skin
*Improper self-treatment, external pressure (shoes or stockings), internal pressure (deformed toes, growth under the nail), trauma, or infection.
INGROWN TOENAIL (onychocryptosis)
*Flexion deformity of the interphalangeal joint, which may involve several toes
*Usually an acquired deformity
*Tight socks or shoes may push an overlying toe back into the line of the other toes.
*Corns develop on top of the toes, and tender calluses develop under the metatarsal area.
HAMMER TOE
Osseous enlargement of the medial side of the first metatarsal head
*Acute bursitis symptoms include a reddened area, edema, and tenderness.
*Heredity, ill-fitting shoes, and aging
(exostosis)
*Clawfoot
*Refers to a foot with an abnormally high arch and a fixed equinusdeformity of the forefoot
*Shortening of the foot and increased pressure produce calluses
PES CAVUS
*Aka pes planus
*Common disorder in which the longitudinal arch of the foot is diminished.
*Congenital abnormalities or associated with bone or ligament injury, muscle and posture imbalances, excessive weight, muscle fatigue, poorly fitting shoes, or arthritis.
FLATFOOT
*Aka plantar digital neuroma or neurofibroma
*Swelling of the third (lateral) branch of the median plantar nerve.
*Microscopically, digital artery changes cause an ischemia of the nerve.
MORTON’S NEUROMA
Reduced bone mass, deterioration of bone matrix, and diminished bone architectural strength.
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Normal homeostatic bone turnover is altered
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Osteoclasts (resorption) is greater than osteoblasts (bone formation)
Osteoporosis
*A metabolic bone disease characterized by inadequate bone mineralization
*Softening and weakening of the long bones causes pain, tenderness, and deformities caused by the bowing of bones and pathologic fractures
*Deficiency of activated vitamin D causes lack of bone mineralization and low extracellular calcium and phosphate
*Causes include gastrointestinal disorders, severe renal insufficiency, hyperparathyroidism, and dietary deficiency
Osteomalacia
osteomalacia that affects children
-seen in developing countries
rickets
*Infection of the bone
*Bone becomes infected in one of three ways:
*1. extension of soft tissue infection
*2. direct bone contamination
*3. Hematogenous spread from other sites of infection
Osteomyelitis
*Manifestations include skeletal deformities, mild to moderate aching pain, and tenderness and warmth over bones
*Symptoms may be insidious and may be attributed to old age or arthritis; most patients do not have symptoms
*Disorder of localized bone turnover: skull, femur, tibia, pelvic bones, and vertebrae
*Incidence: 2% to 3% of the population older than age 50 years
*More common in men, and risk increases with aging; familial predisposition has been noted
*Pathophysiology: excessive bone resorption by osteoclasts is followed by increased osteoblastic activity; bone structure disorganized, weak, and highly vascular
*Cause is unknown
Paget Disease
*Joints can become infected thru spread of infection from other parts of the body or directly thru trauma or instrumentation
*With warm, painful, swollen joint, with decreased ROM, systemic chills, fever, and leukocytosis
Septic (Infectious) Arthritis
: benign for long periods but may invade local tissue and cause destruction
Osteoclastomas
: Painful tumor in children and young adults
Osteoid osteoma
