Mobility Flashcards
What are clinical manifestations of fractures?
Immediate pain
Inability to bear weight
Crepitation (crunchy noise)
Edema/swelling
What is the healing process of a fracture?
- Fracture hematoma: Blood clot around first 72 hrs.
- Granulation tissue: Basis of new bone tissue (osteoid) at 3-14 days
- Callus formation: Mineralization and cartilage at 2 weeks
- Ossification: Stable enough to remove cast and limited mobility at 3 weeks to 6 months
- Consolidation: Distance between bone fragments closes, up to a 1
Remodeling: Complete union
What are risk factors for fractures?
Systemic disease (ex: diabetes)
Malunion (healed in incorrect position)
What are interdisciplinary managements for fractures? There are 3
Realignment
Immobilization
Restoration of function
What are your 5/6 P’s for fractures/compartment syndrome in neurovascular assessments?
Pain
Pulse
Pallor
Parenthesia
Paralysis
Pressure
What is compartment syndrome?
Swelling increases pressure in limited muscle space causing decreased capillary perfusion.
(T/F) You want to elevate and ice the affected area in compartment syndrome
False: DO NOT do that, will further decease perfusion
What is venous thromboembolism
Blood clot due to fracture, joint replacement, or immobility
What are the anticoagulants used to prevent venous thromboembolism? There are three
Enoxaparin (Lovenox): SQ
Warfarin (Coumadin): PO
Apixaban (Eliquis): PO
What are the risks for anticoagulants?
Increased bleeding:
Mental status changes
Mucosal/Cutaneous symptoms
Tea colored urine
What are the four fracture complications?
Compartment syndrome
Venous Thromboembolism
Fat Embolism Syndrome
Rhabomyolysis
What are clinical manifestations of fat embolism syndrome?
Rapid and acute clinical manifestations
Respiratory distress
Tachycardia
Petechiae
Pallor and cyanosis
Hypoxemia
What are clinical manifestations of hip fractures?
Severe pain and tenderness
External rotation
Shortening of affected leg
What is management for hip fractures?
IMMOBILIZATION
Patient education: hip precautions (no crossing leg or ankle, no bending)
What is osteoarthritis?
Slowly progressive noninflammatory disorder of synovial joints
What are clinical manifestations of osteoarthritis
Joint pain—worsens with activity
Joint stiffness—especially after rest and worse upon awakening
Asymmetric
Joint deformity (in Bouchard nodes and heberden nodes)
What is the diagnostic test for hip fracture?
X-ray
(T/F) You can use NSAIDs for hip fractures
True, along with tropical analgesics
What is osteoarthritis?
Slowly progressive noninflammatory disorder of synovial joints
What is the risk factor that differentiates osteoarthritis to rheumatoid arthritis?
Trauma to joints
(T/F) Joint pain worsens with activity for osteoarthritis
True
How long does it take for morning joint stiffness to get better after rest for osteoarthritis?
Worse upon waking, better in 30 minutes
Between osteoarthritis and rheumatoid arthritis, which one is asymmetric
Osteoarthritis
What is the diagnostic test for osteoarthritis?
X-ray (Joint space narrowing, osteophytes)
What are some managements for osteoarthritis?
Ice and heat
Frequent rest during ADLs
NSAIDs
Topical Analgesics
Intra-articular corticosteroid injections
What are diagnostic tests for rheumatoid Arthritis?
Rheymatoid factor blood titers
ANA, ESR, CRP testing (autoimmune and inflammatory makrers)
Synovial fluid analysis
What NSAID is used to manage Rheumatoid Arthritis?
Celecoxib (Celebrex)
What are clinical manifestations of multiple sclerosis?
Slow, gradual, vague
Coordination and valance problems
Speehc
Cognititive impairment
What drugs are used for Multiple Sclerosis?
DMD Disease Modifying Drugs Suppress the immune system and slow progression
What are clinical manifestations of Parkinsosn’s Disease
Bradykinesia
Rigidity
Tremor at rest aka pill rolling
Gait changes
Postural instability
What antiparkinsonian drugs are used to manage Parkinsons’s
Cardiopa/Levodopa (Sinemet): Dyskinesia, limit B6 and protein intake
Benztropine (cogentin): Dry mouth, urinary retention
