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MSK exam 1 Flashcards

1
Q

Standardized assessments for OA/RA

A

COPM, DASH, HAQ, FCE, MAP-HAND

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2
Q

Acute stage

A

focus on genelt prom.arom, no stretch, education limit stress to joints

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3
Q

subacute stage

A

PROM/AROM gentle stretch, graded isometic/isotnic limit stress to joints

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4
Q

chronic active and inactive

A

strecth at end range

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5
Q

pressure injury stage 1

A

skin intact, underlying tissues unfaccected, localized area non blanch, redness in skin , may be tender to touch

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6
Q

stage 2 pressure sore

A

involves epidermis adn potentially dermis ; open are break in skin, may present as blister

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7
Q

stage 3 pressure sore

A

deep wound, full thickness tissue loss with possible exposure to subcutaneous fat, bone, tendon and muscle not exposed; slugh may be present

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8
Q

Stage 4 pressure sore

A

full thickness tissure loss; muscle tendo n or bone exposed, sliugh or eschar showing

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9
Q

Stage 5 pressure sore

A

unstageable– extent of skin adn tissue loss , obscured by slugh and eschar

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10
Q

Selective debridment

A

sharp
autolytic
enxymatic

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11
Q

Sharp debridment

A

use of forceps, scissors, or a scalpel to slectively remove devitalized tissue, foreign matieral and debris

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12
Q

Autolytic debridment

A

maintaining a warm, moist wound environment to allow endogenous enzymes to digest necrotic material

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13
Q

enzymatic debridment

A

the use of exogneous enzymes to remove devilzed tissue

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14
Q

non selctive debridement

A

mechanical - use of force (water)

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15
Q

Phases of burns

A

Emegent phase – initoial to 4-6 days post brun
acute phase – 1 weeks to 28 days
rehab phase – 1 month phase to 2 years post injury

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16
Q

Ultrasound parameters 1MhZ

A

1 MHz is low frequency , used for deeper tissues - 2cm or deeper

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17
Q

acute/ inflammatory parameters for non thermal

A

0.2 10-20% duty cycle

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18
Q

3MHz ultrasound

A

consider higher frequency - treats superficial tissues

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19
Q

subacute mild heating

A

0.2-0.8 W/cm2 50% duty cycle

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20
Q

chronic thermal

A

100% duty cycle 0.8-2.5 w/cm2

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21
Q

thermal heating ultrasound used for

A

joint contracute, scar tissue softening, chronic inflammation, increase tissue extensibility, pain, increased blood flow, soft tissue healing descreases muscle spams

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22
Q

non thermal uses

A

pusled settings

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23
Q

depth of lesion for superficial

A

2cm 0r less 3 MHZ

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24
Q

depth of 2-5cm or greater

A

1MHz

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25
pulse ratio and intensity for acute
20, 25%// 0.1-0.3
26
pulse ratio and intensity for subacute
33%, 50% // 0.2- 0.5
27
pulse ratio and intensity for chronic
continous, 50%-100% // 0.3-1.0
28
cervial mobility special tests
cervical flexion test, sharp-purser test , cervical proprioception test, alar ligamen t test
29
cervical radiculapthy test
spurlings b test; distraction; valscvalva test
30
thoracic outlet syndrome test
adson's test; ROOS test ; cervial rotation lateral flexion test; costclavicular test; first rib spring test
31
Cervical sprain assess
cervical ROM; pain at end range with rotation; mmt of pecs and levator scap
32
cervical sprain associated impairment
thoracic mobility screen, pecs length trap MMT, cervical prpprioception
33
cervical sprain differnetial
upper cervical ligamentous instability assessment (sharp p test, alar ligament) vertebral artery insuffciency test
34
RA siease process
tends to impact smaller joints first MCP, MTP joints; higher synovium to cartilage ratio Often spreads to larger joints as it progresses: wrists → knees → ankles → elbows → hips → shoulders Most often symmetrical involvement Alternating periods of exacerbation and remission Onset may be sudden or gradual; mild to severe Single joint or polyarticular involvement
35
defining differences of OA vs RA
OA -- Degenerative disease, morning stiffness lasting less than 30 minutes, heberden’s nodes, asymmetrical, cartilage loss RA - Autoimmune disease, morning stiffness lasting more than 30 minutes, extra-articular involvement, symmetrical, inflamed defining differencessynovium
36
GOUT
most common inflammatory arthritis; often associated with excessive lifestyle–rich foods, and alcohol consumption; “disease of kings;”
37
gout progress
Caused by crystallization of uric acid within affected joints – monosodium urate crystals 1. High diet in purines: leads to elevation of blood uric acid levels – alc beverages; some fish, seafood, shellfish; some meat, turkey, bacon, veal; venison Hyperuricemia: synthesis & excretion imbalance of uric acid; excess uric acid within the blood Chronic elevation of urate: causes permeation & crystallization within joint
38
systemic lupus erthematosuse
Swelling in legs, around eyes Raynaud phenomenon Skin problems: sunlight sensitivity; “butterfly rash;” more pronounced in sunlight Prolonged fatigue, fever, mouth sores, hair loss, swelling in legs & around eyes, etc. Disease process Periods of exacerbation & remission: symptoms vary from mild to life-threatening; symptoms may come and go and change Gradually worsens over time Difficulty to pin down a certain course & prognosis, as it varies a great deal from person to person
39
NSAIDS
5 A’s – Analgesic, Anti-inflammatory, Antipyretic, Anticoagulant, Anticancer Potential for GI irritation, increased risk for MI & CBA, potential to impair bone & cartilage repair NSAIDs = ibuprofen (advil) & naproxen (aleve)
40
Analgesics: nonopioid & opioid
Nonopioid: acetaminophen – designed specifically for pain management, no GI irritation, no anticoagulant effects, high doses may cause liver toxicity Acetaminophen (Tylenol) Opioids: alter the perception of main & may elicit a state of euphoria, side effects: sedation, confusion, constipation, fluid retention, potential for abuse/addiction, hyperalgesia (rare) Oxycodone (OxyContin, Percocet), Hydrocodone (Vicodin when combined with acetaminophen), Codeine, Tramadol, Fentanyl, Dilaudid
41
RA meds
NSAIDS/ dmars// BIOLOGICS// STERIOIDS CORTICO STEROIDS //
42
OA meds
OTC pain relievers – NSAIDs for inflammation & pain; acetaminophen for pain; glucosamine & chondroitin supplements for increased cartilage regeneration
43
gout meds
NSAIDs, Colchicine; corticosteroids (PO or injection) Chronic medications to prevent gout complications: block uric acid production = Allopurinol, Febuxostat; improve uric acid removal = Probalan
44
Gabapentin (Neurontin)
Originally developed as an anti-seizure drug Used to treat spasticity, peripheral neuropathy, nerve pain, etc. Side effects include: drowsiness/fatigue, dizziness, unusual thoughts, memory problems
45
Anticoagulation therapy
Aka “blood thinners” Examples include: heparin (must be taken by injection, fastest-acting, key player in DVT management); Warfarin/coumadin; Apixaban (Eliquis); Lovenox
46
DMARDs: disease modifying antirheumatic drugs
Used to treat autoimmune disorders: idea is to modify immune process that is causing destruction & suppress immune response Examples: methotrexate, cyclosporin, hydroxychloroquine (anti-malarial)
47
Biologics (a subset of DMARDs)
More selective: targets specific components of immune response Decreased risk of severe side effects Examples: Enbrel (Etanercept); Humira (Adalimumab); Cosentyx (Secukinumab) Often times multiple DMARDs used in combination
48
balcofen
MUSCLE RELAXENT pain and spascity
49
hip fracture locations
femoral neck intertrochanteric subtrochanteric femoral head
50
zone of coagulation
area exposed to the most amount of heat and the most amount of damage; irrevesible tissue destruction
51
zone of stasis
damamge results in decreased tissue perfusion; tissue may be salvageable
52
zone of hyperemia
tissue is damaged, proper care could be recoverded
53
lumbar radiculopathy
Sciatic nerve root compression as a result of disc herniation, osteophyte formation, etc.
54
lumbar radicupolathy symptoms
Muscle weakness, pain, tinging, “shooting” sensation; unilateral involvement
55
herniated disc etiology
Vertebral pressure above/below ICD forces annulus to rupture; inner core extends through and applies pressure nearby nerve roots
56
herinated disc symptoms
Localised pain, radiating pain from level of injury, paresthesias in legs/feet
57
spondylothesis
spinal instability, one vertebral body slips over another; frequently occurs between L4-S1; may be degenerative or traumatic
58
spondylothesis symptoms
Often asymptomatic; may present as radiating burn from low back to buttocks/thights, lumbar stiffness; weakness, tingling, numbness in foot
59
facet joint syndrome
Malignant of vertebral column causes wear/degeneration of facet cartilage
60
spinal stenosis
Narrowing of spinal opening (canal versus foramina) causing increased pressure on cord/nerve roots; degenerative condition **Spinal stenosis = vertebral foramen is impacted
61
facet syndrome symptoms
Lock pain pain; pain in buttocks and thights; stiffness; difficulity with transitions (sit to stand); forward flexed posture
62
spinal stenosis symptoms
Radicular pain, weakness, tingling, numbness; generally unilateral; symptoms intermittent and usually relived with rest and lying supine

MSK (3 decks)

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