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MSK > MSK exam 1 > Flashcards

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
Q

pulse ratio and intensity for acute

A

20, 25%// 0.1-0.3

26
Q

pulse ratio and intensity for subacute

A

33%, 50% // 0.2- 0.5

27
Q

pulse ratio and intensity for chronic

A

continous, 50%-100% // 0.3-1.0

28
Q

cervial mobility special tests

A

cervical flexion test, sharp-purser test , cervical proprioception test, alar ligamen t test

29
Q

cervical radiculapthy test

A

spurlings b test; distraction; valscvalva test

30
Q

thoracic outlet syndrome test

A

adson’s test; ROOS test ; cervial rotation lateral flexion test; costclavicular test; first rib spring test

31
Q

Cervical sprain assess

A

cervical ROM; pain at end range with rotation; mmt of pecs and levator scap

32
Q

cervical sprain associated impairment

A

thoracic mobility screen, pecs length trap MMT, cervical prpprioception

33
Q

cervical sprain differnetial

A

upper cervical ligamentous instability assessment (sharp p test, alar ligament) vertebral artery insuffciency test

34
Q

RA siease process

A

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
Q

defining differences of OA vs RA

A

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
Q

GOUT

A

most common inflammatory arthritis; often associated with excessive lifestyle–rich foods, and alcohol consumption; “disease of kings;”

37
Q

gout progress

A

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
Q

systemic lupus erthematosuse

A

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
Q

NSAIDS

A

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
Q

Analgesics: nonopioid & opioid

A

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
Q

RA meds

A

NSAIDS/ dmars// BIOLOGICS// STERIOIDS CORTICO STEROIDS //

42
Q

OA meds

A

OTC pain relievers – NSAIDs for inflammation & pain; acetaminophen for pain; glucosamine & chondroitin supplements for increased cartilage regeneration

43
Q

gout meds

A

NSAIDs, Colchicine; corticosteroids (PO or injection)

Chronic medications to prevent gout complications: block uric acid production = Allopurinol, Febuxostat; improve uric acid removal = Probalan

44
Q

Gabapentin (Neurontin)

A

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
Q

Anticoagulation therapy

A

Aka “blood thinners”
Examples include: heparin (must be taken by injection, fastest-acting, key player in DVT management); Warfarin/coumadin; Apixaban (Eliquis); Lovenox

46
Q

DMARDs: disease modifying antirheumatic drugs

A

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
Q

Biologics (a subset of DMARDs)

A

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
Q

balcofen

A

MUSCLE RELAXENT
pain and spascity

49
Q

hip fracture locations

A

femoral neck
intertrochanteric
subtrochanteric
femoral head

50
Q

zone of coagulation

A

area exposed to the most amount of heat and the most amount of damage; irrevesible tissue destruction

51
Q

zone of stasis

A

damamge results in decreased tissue perfusion; tissue may be salvageable

52
Q

zone of hyperemia

A

tissue is damaged, proper care could be recoverded

53
Q

lumbar radiculopathy

A

Sciatic nerve root compression as a result of disc herniation, osteophyte formation, etc.

54
Q

lumbar radicupolathy symptoms

A

Muscle weakness, pain, tinging, “shooting” sensation; unilateral involvement

55
Q

herniated disc etiology

A

Vertebral pressure above/below ICD forces annulus to rupture; inner core extends through and applies pressure nearby nerve roots

56
Q

herinated disc symptoms

A

Localised pain, radiating pain from level of injury, paresthesias in legs/feet

57
Q

spondylothesis

A

spinal instability, one vertebral body slips over another; frequently occurs between L4-S1; may be degenerative or traumatic

58
Q

spondylothesis symptoms

A

Often asymptomatic; may present as radiating burn from low back to buttocks/thights, lumbar stiffness; weakness, tingling, numbness in foot

59
Q

facet joint syndrome

A

Malignant of vertebral column causes wear/degeneration of facet cartilage

60
Q

spinal stenosis

A

Narrowing of spinal opening (canal versus foramina) causing increased pressure on cord/nerve roots; degenerative condition

**Spinal stenosis = vertebral foramen is impacted

61
Q

facet syndrome symptoms

A

Lock pain pain; pain in buttocks and thights; stiffness; difficulity with transitions (sit to stand); forward flexed posture

62
Q

spinal stenosis symptoms

A

Radicular pain, weakness, tingling, numbness; generally unilateral; symptoms intermittent and usually relived with rest and lying supine

MSK (3 decks)

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