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MS2 Exam 3 > Mobility > Flashcards

Mobility Flashcards

1
Q

Genetics/Lifespan Considerations

A
  • bones and muscles adapt as you age
  • some bones fuse during infancy while others grow as child develops
  • growth is then turned off in adulthood (bones undergo remodeling)
  • OA undergo physiologic changes: decrease strength and mobility
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2
Q

Alterations to Mobility

A
  • back problems
  • fractures
  • multiple sclerosis
  • OA
  • Parkinson
  • spinal cord injury
  • amputations
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3
Q

Back pain

A

most common medical problem in America

-may result in: decreased quality of life, decreased mobility, increased pain and frustration, loss of work hours

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4
Q

Possible causes of back pain

A
  • bas posture and sleeping habits
  • low fitness level
  • pregnancy
  • obesity
  • athletic injury
  • degenerative disorders
  • occupational risk factors
  • referred pain from GI/GU/AAA
  • backpack use
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5
Q

Prevention of back pain

A
  • posture
  • lifting
  • body mechanics
  • rest
  • exercise
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6
Q

Herniated disc

A
  • refers to a problem of the rubbery cushions between the individual bones that make up your spine
  • occurs when nucleus pulpous ruptures and protrudes
  • allowing fluids to leak out and irritate nerves
  • compression of the nerve roots and cord shrinking the disc
  • results in pain, numbness or weakness in arm or leg
  • most people do not need surgery
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7
Q

Abrupt Disc Herniation

A
  • nerve root compression
  • severe pain
  • muscle spasms
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8
Q

Gradual Disc Herniation

A
  • slow onset pain

- associated with neurological symptoms (weakness/tingling)

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9
Q

Risk Factors for Back Pain

A
  • most common between 30-50
  • heavy lifting
  • bending/twisting improperly
  • overweight
  • previous back problems
  • smoking
  • genetic factors
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10
Q

Clinical Manifestations of lumbar back pain

A
  • low back pain
  • radiating down the buttock and below the knee
  • sciatic nerve pain
  • weakness of the leg, foot, or toes
  • bowel and bladder incontinence
  • impotence
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11
Q

CES

A

Cauda Equina Syndrome

  • latin for horse’s tail
  • compression of the nerve roots of this part of the spine
  • may be permanent neurological impairment
  • urinary incontinence and paralysis
  • caused by massive lumbar disc herniation, spinal stenosis and trauma

***Medical emergency

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12
Q

Straight Leg Test

A

-back or leg pain may be reproduced by raising the leg and flexing at 90 degrees

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13
Q

Diagnostic Studies

A
  • L spine xray
  • MRI
  • CT
  • EMG
  • Myelogram
  • Blood tests
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14
Q

Tx for Chronic Low Back Pain

A
  • low back exercises/PT
  • Rest
  • Local heat/cold application
  • pain relievers
  • weight reduction
  • surgery
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15
Q

Non-Pharm Tx for Back Pain

A
  • brace
  • massage
  • traction
  • PT
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16
Q

Pharm Tx

A
  • Salicylates
  • NSAIDs
  • Skeletal muscle relaxants
  • Neuropathic pain meds
  • Corticosteroids
  • Epidural Injections
17
Q

Skeletal Muscle Relaxants

A
  • baclofen

- methocarbamol

18
Q

Neuropathic Pain Meds

A
  • gabapentin
  • pregabalin
  • duloxetine
19
Q

Intrathecal Morphine Pain Pump Implant

A
  • risks for the intrathecal pain pump procedure are low
  • method of giving medication directly to your spinal cord
  • symptoms can be controlled with a much smaller dose than is needed with oral meds
  • goal: better control your symptoms and to reduce oral meds; thus reducing their associated side effects
20
Q

Laminoectomy

A

surgical removal of part of the posterior arch of the vertebrae to allow for removal of the disk

21
Q

Disectomy

A

-micro surgical procedure that allows the surgeon to visualize the disk and disk space better for easier removal of the herniated portion

22
Q

Laser Disectomy

A
  • outpatient procedure

- laser is used on the herniated portion of the disk

23
Q

Spinal Fusion

A
  • used for unstable spinal areas by creating a connecting vertebrae with a bone graft
  • fibula or iliac crest
  • rods, plates, and screws
  • infuse bone graft/cage (regeneration)
  • TLSO while OOB
  • Surgical and graft site if used
  • Avoid sitting or standing for long periods of time
  • encourage walking, lying down, and shifting weight
  • no twisting the spine
24
Q

Vertebroplasty

A
  • outpatient

- used to stabilize vertebral bone fractures

25
Q

Postop Care

A
  • VS
  • Signs of circulation
  • signs of bleeding
  • position
  • pain
  • emotional support
  • safety
  • sterile technique
  • signs of infection
  • compression dressings
  • paralytic ileus common, start PO intake slowly
  • proper alignment at all times
  • log rolling
  • pain control
  • pillows under legs
  • neuro checks q 2-4 hours
  • paralytic ileus
  • TCDB/IS Q1 while awake
26
Q

Neurovascular assessment: Circulation

A
  • color/temp
  • cap refill
  • pulses
  • edema
27
Q

Neurovascular assessment: Motor Function

A
  • flexion
  • extension
  • abduction
28
Q

Discharge instructions

A
  • bathing/incision care
  • discomfort
  • restrictions
  • activity
  • when to call the doctor
29
Q

Scoliosis

A
  • diagnosed if the sideway curvature measures more than 10 degrees
  • congenital, acquired, idiopathic
30
Q

Clinical manifestations of Scoliosis

A
  • spinal curve to one side
  • uneven shoulders
  • differences in leg length
  • tiredness of spine
  • prominent shoulder blade and rib bump
  • severe scoliosis, heart and lung problems
31
Q

Diagnostic Tests

A
  • school screening for children age 10-15: adam forward bend test
  • observation
  • xray, cobb method
32
Q

Mild Scoliosis

A
  • Cobb angle of less than 20 degrees

- Observation every 3-6 months

33
Q

Moderate Scoliosis

A
  • Cobb angle between 25-45 degrees
  • bracing 12-23 hrs a day
  • TLSO/Milwaukee brace
34
Q

Severe Scoliosis

A
  • Cobb angle greater than 50 degrees

- surgical correction

35
Q

Surgery for Scoliosis

A
  • involves spinal fusion with insertion of metal rod

- infections can compromise outcome of the deformity correction and delay recovery

36
Q

Post op care for Scoliosis

A
  • TLSO Brace - Thoracolumbar Sacral Orthosis
  • Limit activity for 6-8 months post surgery
  • Learn to perform simple task without bending or twisting

MS2 Exam 3 (13 decks)

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