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Gerontology > Module 9 > Flashcards

Module 9 Flashcards

1
Q

The primary factor in women developing osteoporosis is

A

Declining estrogen production

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2
Q

Estrogen effects on osteoclasts and osteoblasts

A

Reduces life span of osteoclasts and lengthens lifespan of osteoblasts

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3
Q

Primary osteoporosis is associated with

A

Aging process

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4
Q

Secondary osteoporosis is associated with

A

Chronic disease, nutritional deficiency and medications

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5
Q

Use of prednisone greater than _ months causes increased

A

3, bone breakdown and decreased bone replacement

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6
Q

Smoking ____ risk of an osteoporotic fracture compared to non smoker

A

Doubles

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7
Q

In activity is also a factor causing

A

Bone loss

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8
Q

The chronic diseases that may cause osteoporosis

A

RA, diabetes, hyperthyroidism, addisons, or liver disease

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9
Q

Gold standard for osteoporosis

A

DEXA

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10
Q

T score measures

A

BMD by comparing it with young healthy women

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11
Q

Z score measures

A

BMD by comparing it with age and gender match controls

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12
Q

Both t score and z score are _______ measured ___ and ____ the average BMD value

A

Standard deviations, above and below

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13
Q

BMD of 2.5 ore more below the mean is indicative of

A

Osteoporosis

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14
Q

BMD of between 1 Nd 2.5 is indicative of

A

Osteopenia

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15
Q

_____ osteoporosis related fractures occur each year

A

1.5 million

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16
Q

The amount of fractures related to osteoporosis is almost ____ the amount of heart attacks and strokes

A

Double

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17
Q

__ in __ women and _ in __ men will have an osteoporosis related fracture in their lifetime

A

1 in 2 and 1 in 8

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18
Q

FRAX calculates

A

10 year risk factor for osteoporosis related fracture via questionnaire

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19
Q

The greatest amount of bone density is loss in women occurs within

A

The first 5 years of menopause

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20
Q

Only _ out of _ women with vertebral compression fracture have symptoms

A

1 out of 4

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21
Q

Multiple wedge fractures causes spine to curve known as

A

Gibbus or dowagers hump

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22
Q

Vertebral compressions fractures cause

A

Loss of height, distended abdomen and stooped posture, increased kyphosis that worsens over time, breathing difficulties, abdominal pain, digestive discomfort, decreased QOL, mobility and energy, pain and deterioration of physical function, increased long term morbidity and mortality

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23
Q

Bisphosphonates decrease

A

Osteoclasts activity

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24
Q

Three types of bisphosphonates

A

Alendronate (Fosamax), risedronate (actonel) and calcitonin (miacalcin)

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25
Q

Selective estrogen receptor modulators is an ____ _____, example is

A

Estrogen agonist, Raloxifene (Evista)

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26
Q

These two procedures are used to treat patients with intractable pain who have vertebral fractures

A

Vertebroplasty and kyphoplasty

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27
Q

In vertebroplasty and kyphoplasty, ____ is injected into the ____ which ____

A

Methylmethacrylate, vertebral body, restores some vertebral height and stabilizes fracture

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28
Q

Kyphoplasty involves inserting a

A

Balloon tamp into the vertebral body prior to injecting the cement

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29
Q

Studies have shown a significant relief of pain in __% to _% in patients with compression fracture that get kyphoplasty , even 5 years later they still have pain relief

A

90-95

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30
Q

Combined resistance training protocols in one study is defined as

A

The combination of resistance training and high impact or weight bearing exercise

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31
Q

Combined resistance training protocols were effective in improving BMD in the

A

Femoral neck and lumbar spine

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32
Q

A high load exercise is

A

80% of 1RM

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33
Q

Exercise protocol to increase BMD

A

Weight bearing / heavy loading with few repetitions and high strain

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34
Q

Within ______ of stopping exercise there can be a measurable decrease in BMD

A

One month

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35
Q

Low load, high rep may lead to

A

Low bone mass

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36
Q

Osteopenia is a t score between

A

-1 and - 2.5

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37
Q

Osteomalacia is

A

Bone disorder caused by a failure of calcification of bone matrix

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38
Q

Osteomalacia is diagnosed by

A

Bone biopsy and blood test

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39
Q

Osteomalacia causes ___ of bones

A

Softening

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40
Q

Osteomalacia is a dysfunction in

A

Metabolizing vitamin. d

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41
Q

Most common cause of osteomalacia In older adults is

A

Vitamin d deficiency as a result of inadequate intake, lack of exposure to sun, GI malabsorption, extensive burns, chronic diarrhea, drugs such as Dilantin

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42
Q

Artery most effected in femoral AVN

A

Circumflex

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43
Q

Signs and symptoms of AVN

A

Natal gif gait pattern, groin pain radiating to pelvis knee and back,later muscle atrophy and joint mobility restriction

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44
Q

Paget’s disease or ___

A

Osteitis deformans

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45
Q

Paget’s disease most often effects

A

The pelvis, long bones, spine, ribs, sternum and cranium

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46
Q

Symptoms of Paget’s disease

A

Bone pain, joint pain or stiffness, bowing of the femur and tibia, thoracic kyphosis, enlarged head and skull deformity, fracture, gait deviations

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47
Q

Drug therapy options for Paget’s

A

Calcitonin-salmon (mialcin), NSAIDs, bisphosphonates

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48
Q

Arthritis is

A

Degeneration of articular cartilage and inflammation of synovium

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49
Q

OA most often occurs in

A

CMC joint, knee and hip

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50
Q

OA exercise program

A

Low load, prolonged stretching performed several times per day

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51
Q

Over __% of THA And TKA are performed in older adults with OA

A

70

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52
Q

RA is

A

A systemic inflammatory autoimmune disease and disabling condition

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53
Q

RA effects women __ times more than men

A

3 times

54
Q

Joints most effected in RA

A

Distal, bilateral joints

55
Q

Blood test findings in RA

A

DecreasedRBCs, increased erythrocytes sedimentation rate and (+) rheumatoid factor

56
Q

Drug therapy for RA

A

Disease modifying anti rheumatic drugs (DMARDs), in combo with NSAIDs, or corticosteroids in low doses

57
Q

Cervical RA is typically in these areas of the c spine

A

Posterior and mid cervical

58
Q

Spindylosis of c spine results from

A

Disc degeneration, facet arthropathy, osteophyte formation, ligamentous thickening and loss of cervical lordosis, loss of disc height

59
Q

Radiculitis into the UE from spondylosis happens in ___ of patients

A

25%

60
Q

Vertebral artery syndrome is characterized by

A

Vertigo attacks, dizziness, tinnitus, blurred vision, nausea, nystagmus, and ataxia induced by head rotation

61
Q

VAS is due to

A

Compression of the vertebral artery terminating in the posterior inferior cerebellar artery

62
Q

Ossification of the PLL will limit

A

Flexion

63
Q

____ is responsible for 90% of all adult spinal surgeries

A

DDD

64
Q

Decrease in disc height of ____ can overload facet joints

A

3 mm

65
Q

Initial spine instability with aging is caused by the

A

Dehydration Of the IV disc

66
Q

Spine attempts to counter dehydration with

A

Bone modeling

67
Q

Facet Artois and degeneration does not occur without the presence of

A

Adjacent disc degeneration

68
Q

The most common cause of neurological leg pain in older adult is

A

Spinal stenosis

69
Q

End feel in shoulder OA

A

Hard with limited mobility

70
Q

PT joint mob treatment of shoulder OA or adhesive capsulitus

A

Grade 1-2 oscillations or sustained

71
Q

Most common shoulder pathology is

A

Rotator cuff issue

72
Q

Most common site of impingement

A

Subacromial space

73
Q

Most common cause of shoulder pain in active older adult iOS

A

Impingement and rotator cuff

74
Q

Symptoms of shoulder pathology

A

Can’t lay on painful side, crepitus or catching sensation and positive Impingement sign

75
Q

Shoulder pathology will present with weakness in

A

Shoulder ABD and flexion

76
Q

Problem that may occur after rotator cuff issue in elderly

A

Adhesive capsulitus

77
Q

Tendinopathy vs bursitis: passive rotation test in full flexion and ADD is less in

A

Tendinopathy

78
Q

Tendinopathy vs bursitis : greater pain in resisted test in full flexion, ADD and ER

A

Tendinopathy

79
Q

Tendinopathy may benefit with

A

Transverse friction applied at insertion

80
Q

Bursitis will worsen with

A

Massage

81
Q

Persistent bursitis may indicate

A

Calcific tendinitis or tear, reflecting an inflammatory reaction in adjacent basal tissue k

82
Q

How do you differentiate subacromial contractile vs non contractile issues

A

If a resisted static contraction of a muscle causes pain in neutral, repeat test with slight subacromial distraction, assess difference in pain response. If pain lessens or contraction power increases it is other structures in subacromial space. If pain unchanged most likely rotator cuff tendon

83
Q

Which occurs more commonly bursitis or OA of the shoulder

A

Bursitis

84
Q

Symptoms of bursitis include

A

Palpable tenderness, pain with movement of muscle effected by bursa and symptom relief with rest

85
Q

Bursitis patients typically have a history of

A

Overuse

86
Q

In asymptomatic older adults aged 50-59 ultrasound found rotator cuff tears in

A

13%

87
Q

In asymptomatic older adults aged 60-69 ultrasound found rotator cuff tears in

A

20%

88
Q

In asymptomatic older adults aged 70-79 ultrasound found rotator cuff tears in

A

31%

89
Q

In asymptomatic older adults aged 80+ ultrasound found rotator cuff tears in

A

51%

90
Q

Less than ____ is diagnostic RTC tear on x Ray

A

5mm

91
Q

Strength deficit in RTC

A

Shoulder elevation and ER

92
Q

Adhesive capsulitis is more common in females or males

A

Females

93
Q

Adhesive capsulitis is a possible complication of

A

DM and thyroid disease

94
Q

Adhesive capsulitis occurs because of the presence of

A

Cytokine levels a minor insult could initiate an inflammatory healing respond resulting in exaggerated and sustained inflammation and fibrosis response

95
Q

What is Milwaukee shoulder syndrome

A

A rare and destructive form of arthropathy characterized by pain, joint or bursa effusion and deposition of calcium hydroxyapatite crystals

96
Q

Weeks 1-3 after humeral fracture

A

Sling, no PROM, codmans pendulum , scapular retraction and AROM distal joints

97
Q

Weeks 4-8 after humeral fracture

A

Gentle isometrics, AROM flexion in supine, progress with weights , elevation in standing with stick or pulleys with eccentric lowering of involved arm

98
Q

Week 8 humeral fracture

A

Resistive exercises : standing forward press, therabamd resisted flexion, IR, ER, ABD and rowing . Self stretching

99
Q

Total shoulder arthropathy is indicated for

A

Post traumatic or severe arthritis, AVN, severe fracture, complete RCT, previous TSA failure

100
Q

TSA shoulder immobilizer is worn for how long

A

Daytime for one week and nighttime for a month

101
Q

PROM for shoulder after TSA is initiated

A

Day one post op and continued for 5 weeks

102
Q

If sunscapularis was released in TSA then no

A

ER

103
Q

3 weeks post op TSA consists of

A

Assisted elevation

104
Q

5 weeks post op TSA consists of

A

AAROM and stretching , isometrics

105
Q

Radial head fractures in elbow are __ of all traumas and ___ of elbow fractures

A

1/4 and 1/3

106
Q

Full elbow rom after fracture will return ________

A

12-15 weeks

107
Q

Colle’s fracture is

A

A distal radius fracture with dorsal and radial displacement of wrist and hand referred to as dinner fork deformity

108
Q

Colle’s fracture in common in

A

Osteoporosis

109
Q

Average age of onset of dupuytrens contracture is

A

60

110
Q

Dupuytrens is when

A

Longitudinal bands of the palmar aponeurosis undergo fibrosis, MCP and PIP joints are flexed

111
Q

Swan neck deformity is when

A

DIP flex and PiP extend

112
Q

Swan neck does not occur in the

A

Thumb

113
Q

Boutonnière deformity is also called

A

Button hole deformity

114
Q

Boutonnière deformity is when

A

Middle phalanx central slip is unstable or torn and the flexor tendon flexes the PIP joint without resistance and the laters, bands begin to slide down along side the finger where they continue to extend the DIP

115
Q

Most common hip joint disease

A

OA

116
Q

___ pain is most common hip joint complaint

A

Groin pain

117
Q

Posterolateral hip pain along the greater trochanter suggests

A

Trochanteric bursitis, gluteal insertion Tendinopathy or component loose in THA

118
Q

The chronological sequence of degeneration seen on x Ray and CT

A

Joint space narrowing, development of osteophytes, subchondral demineralization, sclerosis and cyst formation, loose bodies,, joint malalignment and deformity.

119
Q

Osteonecrosis is

A

Process of creeping substitution where there is resorption of dead trabeculae and woven bone laid Down on dead trabeculae resulting in collapse of bone

120
Q

AVN is associated with

A

Long term use of corticosteroids, excessive alcohol intake, diabetes, obesity, gout and cushings disease

121
Q

Platelet rich plasma

A

Enhances neovascularization, accelerated healing and promotes better scar tissue quality

122
Q

95% of hip fractures are

A

Intertrochanteric or femoral neck fractures

123
Q

Remaining 5% of hip fractures are

A

Subtrochanteric fractures usually results of high velocity fall

124
Q

Cemented THA allows ___ post op

A

FWB

125
Q

Cement less THA more appropriate for

A

Younger and active people with better bone quality

126
Q

Hybrid THA is

A

Cemented femoral component and a cementless ace tabular component

127
Q

Leading cause of disability in the U.S. is

A

Knee OA

128
Q

___ weakness has been implicated in the development and progression of knee joint degeneration

A

Quadriceps

129
Q

The strongest single predictor of functional limitations in patients with knee OA is

A

Quad strength

130
Q

Ability to volitionally control quadriceps muscle force activation after TKA ranges from

A

17-67%

131
Q

High intensity NMES has been shown effective in augmenting quadriceps strength true or false

A

True

132
Q

Knee prosthesis failure rate increases _% each year from about _% at _ years to _% at _ years

A

1%, 10% , 10 years, 20%, 20 years

Gerontology (12 decks)

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