module 21 MS abnormalities Flashcards
ankylosing spondylitis patho
chronic inflammatory disease of the spine
genetic predisposition associated with HLA-B27
may affects: cervical, thoracic, and lumbar spine along with sacroiliac joints
- inflamed intervertebral disks and longitudinal ligaments ossification
-> fusion and severe deformity of the vertebral column
ankylosing spondylitis subjective
develops predominantly in men between 20 and 40
- begins with inflammatory low back and butt pain, hips and shoulders also
ankylosing spondylitis objective
restriction in the lumbar flexion of the patient
limited ROM of shoulders, chest wall, hips, and knees may develop
uveitis may be present
lumbosacral radiculopathy (herniated disk) patho
herniation of a lumbar disk that irritates the corresponding spinal nerve root
lumbosacral radiculopathy subjective
can be assoc. with lifting heavy objects
low back pain w/ radiation to butt and posterior thigh or down the leg in the distribution oft he dermatome
pain relief is often achieved by lying down.
lumbosacral radiculopathy objective
spasm and tenderness over the paraspinal musculature may be present
potential difficulty with heel walking (L4, L5) or toe walking (S1)
numbness, tingling, or weakness in involved extremity
lumbar stenosis patho
narrowing of the spinal column
lumbar stenosis subjective
pain with walking or standing upright that often seems to originate in the buttocks any may radiate down the legs
relief may occur with sitting or bending forward
worsened by prolonged standing, walking, or hyperextending the back
lumbar stenosis objective
early stages: neuro exam is frequently normal
progression: lower extremity weakness and sensory loss
stooped forward gait may be present
carpal tunnel patho
compression on the median nerve
carpal tunnel subjective
numbness, burning, tingling in the hands often occur at night
can be elicited by flexion/extension movements of the wrist
pain may radiate to arms
carpal tunnel objective
weakness of the thumb and flattening of the thenar eminence of the palm
reproduction of symptoms with provocation of the tineal and phalen maneuvers
gout patho
form of arthritis resulting from chronically elevated serum uric acid
- monosodium urate crystal deposition in joints
gout subjective
sudden onset of hot, swollen joint
exquisite pian
limited range of motion
primarily: men >40 and postmenopausal women
gout objective
skin over swollen joint may be shiny and red or purple
uric acid crystals may from as tophi under the skin with chronic gout
temporomandibular joint syndrome patho
painful jaw movement
- congenital anomalies, malocclusion, trauma, arthritis, and other joint diseases
temporomandibular joint syndrome subjective
unilateral facial pain that usually worsens with joint movement
may be referred to any point on face or neck
temporomandibular joint syndrome objective
muscle spasm, clicking, popping, or crepitus in the affected joint
osteomylitis patho
infection in the bone
- usually from open wound or systemic infection
- purulent matter spreads through the cortex of the bone and into the soft tissue
- dec. blood flow to bone may lead to bone necrosis.
osteomylitis subjective
dull pain develops insidiously at the involved site and progresses over days to weeks
limp or dec. movement in infants and children
osteomylitis objective
edema, erythema, warmth at site
tenderness to palpation
pain with movement
signs of inflammation such as fevers
bursitis patho
inflammation of the bursa
- due to repetitive movement and excessive pressure
- or infection or gout
bursitis subjective
common: shoulder, elbow, hip, knee
pain and stiffness surrounding the joint around the inflamed bursa
pain usually worse during activity
bursitis objective
limitation of motion cases by swelling pain on movement point tenderness erythematous, warm site soreness may radiate to tendons at site
paget disease (osteitis deformans) patho
focal metabolic disorder of the bone
- > 45 years old
- excessive bone resorption and bone formation produce a mosaic pattern of lamellar bone
paget disease subjective
vertigo and headache with skull involvement
progressive deafness from involvement of ossicles or neural elements may develop
paget disease objective
bowed tibias
misshapen pelvis
prominent skull forehead
frequent fx
osteoarthritis patho
deterioration of the articular cartilage covering the ends of bone in synovial joints
- bone surfaces are eventually exposed, with bone rubbing against bone
osteoarthritis subjective
pain in hands, feet, hips, knees, and cervical lumbar spine
onset usually after 40, develops slowly over many years
osteoarthritis objective
joints may enlarge due to bone growths
may have crepitus and limited, painful ROM
rheumatoid arthritis patho
chronic systemic inflammatory disorder of the synovial tissue surrounding the joints
- polymorphonuclear leukocytes aggregate
rheumatoid arthritis subjective
joint pain and stiffness, especially in the morning or after periods of inactivity
constitutional: fatigue, myalgias, wt loss, and low-grade fever
rheumatoid arthritis objective
involved joints: hands, wrists, feet, ankles, hips, knees, cervical spine
synovitis, with soft tissue swelling and effusions
nodules and characteristic deformities
muscle strain patho
can be due to excessive stretching or forceful contraction beyond the muscles functional capacity
- improper exercise warm-up, fatigue, or previous injury
muscle strain subjective
muscle pain
severity ranges from a mild intrafibrous tear to a total rupture of a single muscle
muscle strain objective
temporary muscle weakness, spasm, pain, and contusion
dislocation patho
complete separation of the contact between two bones in a joint
- pressure of force pushing the bone out of the joint ( acute trauma)
dislocation subjective
can occur more easily in pts with hyperextensibility conditions
dislocation objective
deformity and inability to use the extremity or joint as usual
frature patho
partial or complete break in the continuity of a bone
fracture subjective
pain, limited movement, cannot bear weight, swelling
felt a pop or snap
can occur more easily in pt with bone disorders
fracture objective
deformity edema pain loss of function color change paresthesia
rotator cuff tear patho
microtrauma and tearing of the rotator cuff muscles
- degeneration of the muscle and tendon from repeated overhead lifting and compression under the acromion
- acute tear
rotator cuff tear subjective
pain in the shoulder and deltoid area
awaken pt at night
rotator cuff tear objective
inability to maintain a lateral raised arm against resistance may develop
tenderness over the acromioclavicular joint
grating sound on movement, crepitus, and weakness in external shoulder rotation
