Musculoskel Diagnoses

Question 1

Achilles Tendon Rupture

Answer 1

Microscopic tears in Achilles tendon from repetitive overuse
(usually 1-2 inch from insertion)

Question 2

Achilles Tendon Rupture - etiology

[long and short term causes]

Answer 2

Long term:
1) Degenerative changes with hypovascularity

Short term:

1) pushing off with ext knee
2) sudden df while weight bearing
3) forceful eccentric contraction of plantar flexors

Question 3

Achilles Tendon Rupture - risk factors

Answer 3

Sports: running, basketball, gymnastics, dance

Changes in training intensity

Achilles tendinopathy

> 30 y.o.

Question 4

Achilles Tendon Rupture - sxs

Answer 4

Aching/burning posterior heel

Achilles swollen, thickened, tender

Morning stiffness

Weakness

Question 5

Achilles Tendon Rupture - tests and confirmation

Answer 5

Thompson test

Heard a snap or pop
Palpable defect (partial) or gap (complete)
Weak/pain with pf

X-ray to rule out avulsion, MRI for severity/location

Question 7

Achilles Tendon Rupture - recovery time (pfs)

Answer 7

6-8 months

• conservative methods have higher chance of re-rupture (40% chance)
• sx has higher rate of return to pfs

Question 8

Achilles Tendon Rupture - differential dx

Answer 8

Achilles Tendon tendinopathy: aching sensation after activity, progresses to pain with walking

Question 9

Achilles Tendon Rupture - tx and prevention

Answer 9

Tx: heel lift, sx w/ cast for 6-8 wks, immobilization, serial casting,

Prevention: heel cord stretches, soft-soled shoes, eccentric gastroc/soleus, progressive intensity training

Question 10

Parkinson’s Disorder

Answer 10

• degenerative

- dec dopamine in substancia nigra w/i basal ganglia (vol mvmt)

Question 11

Parkinson’s Disorder - etiology

Answer 11

Unknown

-contributing: genetics, carbon monoxide poisoning, certain compounds/chemicals, encephalitis, Huntington’s or Alzheimer’s

Question 12

Parkinson’s Disorder - risks

Answer 12

50-79 y.o.

Question 13

Parkinson’s Disorder - early sxs

Answer 13

• RESTING tremor, pill rolling

- balance, bed mobility, writing, bathing, dressing

Question 14

Parkinson’s Disorder - late sxs

Answer 14

• hypokinesia, bradykenesia, akinesia (difficulty initiating)
• festinating/shuffling, freezing
• poor posture, dysphagia, cogwheel/lead pipe rigidity
• expression mask

Question 15

Parkinson’s Disease - tx/rx

Answer 15

Tx: OT, PT, SLP

Rx: dopamine replacement Levadopa for mvmt disorder

Question 16

Parkinson’s Disease - PT

Answer 16

Endurance, strength, funct mobility

Verbal cueing and visual feedback