module 21 MS abnormalities

Question 1

ankylosing spondylitis patho

Answer 1

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

Question 2

ankylosing spondylitis subjective

Answer 2

develops predominantly in men between 20 and 40

- begins with inflammatory low back and butt pain, hips and shoulders also

Question 3

ankylosing spondylitis objective

Answer 3

restriction in the lumbar flexion of the patient
limited ROM of shoulders, chest wall, hips, and knees may develop
uveitis may be present

Question 4

lumbosacral radiculopathy (herniated disk) patho

Answer 4

herniation of a lumbar disk that irritates the corresponding spinal nerve root

Question 5

lumbosacral radiculopathy subjective

Answer 5

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.

Question 6

lumbosacral radiculopathy objective

Answer 6

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

Question 7

lumbar stenosis patho

Answer 7

narrowing of the spinal column

Question 8

lumbar stenosis subjective

Answer 8

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

Question 9

lumbar stenosis objective

Answer 9

early stages: neuro exam is frequently normal
progression: lower extremity weakness and sensory loss
stooped forward gait may be present

Question 10

carpal tunnel patho

Answer 10

compression on the median nerve

Question 11

carpal tunnel subjective

Answer 11

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

Question 12

carpal tunnel objective

Answer 12

weakness of the thumb and flattening of the thenar eminence of the palm
reproduction of symptoms with provocation of the tineal and phalen maneuvers

Question 13

gout patho

Answer 13

form of arthritis resulting from chronically elevated serum uric acid
- monosodium urate crystal deposition in joints

Question 14

gout subjective

Answer 14

sudden onset of hot, swollen joint
exquisite pian
limited range of motion
primarily: men >40 and postmenopausal women

Question 15

gout objective

Answer 15

skin over swollen joint may be shiny and red or purple

uric acid crystals may from as tophi under the skin with chronic gout

Question 16

temporomandibular joint syndrome patho

Answer 16

painful jaw movement

- congenital anomalies, malocclusion, trauma, arthritis, and other joint diseases

Question 17

temporomandibular joint syndrome subjective

Answer 17

unilateral facial pain that usually worsens with joint movement
may be referred to any point on face or neck

Question 18

temporomandibular joint syndrome objective

Answer 18

muscle spasm, clicking, popping, or crepitus in the affected joint

Question 19

osteomylitis patho

Answer 19

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.

Question 20

osteomylitis subjective

Answer 20

dull pain develops insidiously at the involved site and progresses over days to weeks
limp or dec. movement in infants and children

Question 21

osteomylitis objective

Answer 21

edema, erythema, warmth at site
tenderness to palpation
pain with movement
signs of inflammation such as fevers

Question 22

bursitis patho

Answer 22

inflammation of the bursa

• due to repetitive movement and excessive pressure
• or infection or gout

Question 23

bursitis subjective

Answer 23

common: shoulder, elbow, hip, knee
pain and stiffness surrounding the joint around the inflamed bursa
pain usually worse during activity

Question 24

bursitis objective

Answer 24

limitation of motion cases by swelling
pain on movement 
point tenderness 
erythematous, warm site
soreness may radiate to tendons at site

Question 25

paget disease (osteitis deformans) patho

Answer 25

focal metabolic disorder of the bone

• > 45 years old
• excessive bone resorption and bone formation produce a mosaic pattern of lamellar bone

Question 26

paget disease subjective

Answer 26

vertigo and headache with skull involvement

progressive deafness from involvement of ossicles or neural elements may develop

Question 27

paget disease objective

Answer 27

bowed tibias
misshapen pelvis
prominent skull forehead
frequent fx

Question 28

osteoarthritis patho

Answer 28

deterioration of the articular cartilage covering the ends of bone in synovial joints
- bone surfaces are eventually exposed, with bone rubbing against bone

Question 29

osteoarthritis subjective

Answer 29

pain in hands, feet, hips, knees, and cervical lumbar spine

onset usually after 40, develops slowly over many years

Question 30

osteoarthritis objective

Answer 30

joints may enlarge due to bone growths

may have crepitus and limited, painful ROM

Question 31

rheumatoid arthritis patho

Answer 31

chronic systemic inflammatory disorder of the synovial tissue surrounding the joints
- polymorphonuclear leukocytes aggregate

Question 32

rheumatoid arthritis subjective

Answer 32

joint pain and stiffness, especially in the morning or after periods of inactivity
constitutional: fatigue, myalgias, wt loss, and low-grade fever

Question 33

rheumatoid arthritis objective

Answer 33

involved joints: hands, wrists, feet, ankles, hips, knees, cervical spine
synovitis, with soft tissue swelling and effusions
nodules and characteristic deformities

Question 34

muscle strain patho

Answer 34

can be due to excessive stretching or forceful contraction beyond the muscles functional capacity
- improper exercise warm-up, fatigue, or previous injury

Question 35

muscle strain subjective

Answer 35

muscle pain

severity ranges from a mild intrafibrous tear to a total rupture of a single muscle

Question 36

muscle strain objective

Answer 36

temporary muscle weakness, spasm, pain, and contusion

Question 37

dislocation patho

Answer 37

complete separation of the contact between two bones in a joint
- pressure of force pushing the bone out of the joint ( acute trauma)

Question 38

dislocation subjective

Answer 38

can occur more easily in pts with hyperextensibility conditions

Question 39

dislocation objective

Answer 39

deformity and inability to use the extremity or joint as usual

Question 40

frature patho

Answer 40

partial or complete break in the continuity of a bone

Question 41

fracture subjective

Answer 41

pain, limited movement, cannot bear weight, swelling
felt a pop or snap
can occur more easily in pt with bone disorders

Question 42

fracture objective

Answer 42

deformity
edema
pain
loss of function 
color change
paresthesia

Question 43

rotator cuff tear patho

Answer 43

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

Question 44

rotator cuff tear subjective

Answer 44

pain in the shoulder and deltoid area

awaken pt at night

Question 45

rotator cuff tear objective

Answer 45

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