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NBCOT Exam > Musculoskeletal Disorders > Flashcards

Musculoskeletal Disorders Flashcards

1
Q

OT evaluation of arthritis

A
  • AROM - avoid PROM
  • Strength for funtion, avoid MMT unless ordered
  • Grip strength
  • ADL and role activities
  • Pain
  • Edema
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2
Q

Deformities caused by Rheumatoid Arthritis

A
  • Boutonniere deformity
  • Swan neck deformity
  • Ulnar deviation and sublux of wrists and MCPs
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3
Q

Boutonniere Deformity

A

Flexion of PIP and hyperextension of DIP. Silver ring splint.

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4
Q

Swan neck deformity

A

Hyperextension of PIP and flexion of DIP. Silver ring splint.

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5
Q

OT intervention for arthritis

A
  • joint protection techniques
  • energy conservation techniques
  • AROM
  • heat modalities if not inflamed
  • strengthening if not inflamed, avoid deformity positions
  • occupation-based activities
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6
Q

OT intervention for Osteogenesis Imperfecta

A
  • Activity adaptation/ assistive devices
  • Modify environment for safety
  • Postioning
  • Muscle strengthening
  • Weightbearing activities for bone growth
  • Family education
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7
Q

Austin Moore technique

A

Partial hip replacement where only the femoral head is replaced

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8
Q

Hip precautions

A
  • No flexion past 90
  • No adduction (crossing legs)
  • No internal rotation (for anteriolateral approach, no ER)
  • No pivoting
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9
Q

Forequarter Amputation

A

Loss of clavicle, scapula, and entire upper extremity. Also called interscapulothoracic.

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10
Q

Terminal Devices (TDs)

A

Function to grasp and maintain hold of an object to assist UE amputees. Can be voluntary opening or voluntary closing.

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11
Q

Neuroma

A

Nerve endings adhered to scar tissue

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12
Q

Preprosthetic Treatment of Amputation

A
  • Change of dominance if needed
  • ROM of uninvolved joints
  • Desinsitization
  • Wrapping to shape and shrink (distal to proximal, decrease tension the more proximal)
  • ADL trainin
  • Education in skin care
  • Supportive counsesing
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13
Q

Prosthetic Treatment for Amputations

A
  • Functional training with prosthesis
  • Donning and doffing
  • Increase wear tolerance
  • Individualized treatment
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14
Q

First degree burn

A

Superficial; involved the epidermis only. Minimal pain and blisters, but no edema. Heals in 3 to 7 days.

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15
Q

Second degree burn

A

Superficial partial thickness; involves the epidermis and upper portion of dermis (e.g. sunburn). Appears red, blistery, and wet. No grafting necessary. Heals in 7 to 21 days.

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16
Q

Third degree burn

A

Full thickness; involves epidermis, dermis, hair follicles, sweat glands, and nerve endings. Appears white, waxy, leathery Sensation is absent, requires a graft. Healing can take months.

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17
Q

Fourth degree burn

A

Involved fat, muscle, and bone. If electrical, destroys nerves along the pathway.

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18
Q

Splints for burns

A
  • Splint to prevent contracture deformities
  • Burns to hands: wrist in 20-30 degrees extension, MCP in 50-70 degrees flexion, IP full extended, Thumb abducted and extended. (if volar, 0-30 wrist extension, MCB in neutral and abduction)
  • Web space burn: C splint
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19
Q

Hypertrophic scar treatment

A
  • Compression garments worn 24/7 for 1-2 years
  • ROM
  • Skin care
  • ADLs
  • Education
20
Q

Structures in the subacromial space

A

subdeltoid bursa, supraspinatus tendon, infraspinatus tendon, biceps tendon

21
Q

Conservative OT intervention for rotator cuff tendonitis

A
  • avoid above shoulder activities until pain is gone
  • avoid sleeping iwth arm overhead or combined add. and IR
  • Decrease pain: positioning, modalities, rest
  • Restore pain free ROM
  • Strengthening below shoulder level
  • Occupation/role specific training
22
Q

Carpal Tunnel Syndrome definition and symptoms

A
  • Median nerve compression
  • Numbness and tingling of thumb, index, middle, and radial half of ring fingers
  • Complaint of dropping things
  • Positive Tinel’s sign at wrist
  • Positive Phalen’s sign
  • If advanced, atrophy of thenar eminence
23
Q

Conservative OT intervention for carpal tunnel syndrome

A
  • Neutral wrist splint worn at nght and during repetitive activities
  • Median neve gliding exercises
  • Differential tendon gliding exercises
  • Avoid extreme wrist flexion, wrist flexion with repetitive finger flexion, and wrist flexion with a static grip
  • Appropriate workstation design
24
Q

Post-op OT interventions for carpal tunnel syndrome

A
  • (Nerve repair basics)
  • Strengthen thenar muscles - 6 weeks post-op
25
Post-op Nerve Repair Rehab Basics
* Edema control * AROM * Nerve gliding * Tendon gliding * Strengthening * Sensory Reeducation
26
Pronator Teres Syndrome definition and symptoms
* A medial nerve compression between the two heads of pronator teres in the proximal volar forearm * Same symptoms at CTS, but with aching in proximal forearm * Positive Tinel's sign at forearm
27
Conservative intervention for Pronator Teres Syndrome
* Elbow splint at 90 degrees with forearm in neurtral * Avoid activities that include repetitive forearm pronation/supination
28
Post-op intervention for pronator teres syndrome
* Nerve repair basics * Strengthening 2 weeks post-op
29
Guyon's canal syndrome definition and symptoms
* Ulnar nerve compression at the wrist * Numbness and tingling in the ulnar nerve distribution of the hand * Motor weakness of ulnar nerve-innervated musculature * Positive Tinel's sign at Guyon's canal
30
Conservative treatment of Guyon's canal syndrome
Wrist splint in neurtral and activity modification
31
Post-op treatment of Guyon's canal syndrome
* Nerve repair basics * strengthening at 2-4 weeks focusing on power grip
32
Cubital tunnel syndrome definition and symptoms
* Ulnar nerve compression at the elbow * Numbess and tingling along ulnar aspect of the forearm * Pain at elbow with extreme flexion * Weakness of power grip * Positive Tinel's sign at elbow
33
Conservative treatment of cubital tunnel syndrome
* Elbow splint to prevent positions of extreme flexion (especially while sleeping) * Elbow pad to decrease compression while leaning * Activity modification
34
Post-op treatment for cubital tunnel syndrome
* Nerve repair basics * MCP flexion splint if clawing noted
35
Radial nerve palsy definition and symptoms
* Saturday night palsy * Weakness or paralysis of extensors to the wrist, MCPs and thumb; wrist drop
36
Conservative treatment of radial nerve palsy
* Dynamic extension splint * Work/activity modification * Strengthening wrist and finger extensors when motor function returns
37
Post-op treatment of radial nerve plasy
* Nerve repair basics * strengthening at 6-8 weeks post-op
38
Median nerve laceration sensory loss
* Central palm (thumb to radial 1/2 of ring finger) * Palmar surface of thumb, index, middle, and radial 1/2 of ring fingers * Dorsal surface of index, middle, and aradial 1/2 of ring fingers
39
Median nerve laceration motor loss
Wrist lesion * Lumbricals I and II * Opponens pollicis * Abductor pollicis brevis * Flexor pollicis brevis * "ape hand" Lesion above elbow * All above * FDB to index and middle fingers * FPL * Beneiction sign
40
OT intervention for Median Nerve Laceration
* Dorsal protection splint with wrist in 30 degrees flexion. * If high lesion, splint should include elbow in 90 degrees flexion * C-bar splint to prevent thumb adduction contracture * A/PROM of digits with wrist flexed at 2 weeks * Scar managment * AROM of wrist and elbow at 4 weeks * Strengthening at 9 weeks * Sensory reeducation
41
Ulnar nerve laceration sensory loss
* ulnar aspect of palmar and dorsal surfaces * ulnar 1/2 of ring and little finger on palmar and dorsal surfaces
42
Ulnar nerve laceration motor loss
Wrist lesion * palmar and dorsal interossei * lumbricals III and IV * FPB and adductor pollicis * ADM, ODM, FDM High lesion * All above * FCU * FDP IV and V
43
Ulnar nerve laceration deformity
* Claw hand * Flattened metacarpal arch * Positive Froment's sign * Loss of power grip * Decreased pinch strength
44
OT intervention for Ulnar Nerve Laceration
* MCP flexion block splint * A/PROM of digits with wrist in flexed postition at 2 weeks * Scar management * Sensory reeducation * AROM of wrist at 4 weeks * Strengthening at 9 weeks
45
Radial nerve laceration sensory loss
Lesion at humerus * Medial aspect of dorsal forearm * Radial aspect of dorsal palm, thumb, and index, middle, and radial 1/2 of ring fingers
46
Radial nerve laceration motor loss
Forearm lesion * Loss of wrist extension due to impaired innervation of ECU * EDC, EI, EDM * EPB, EPL, APL Humerus lesion * All above * ECRB, ECRL, Brachioradialis * if at axilla, loss of triceps causes difficulty releasing objects, wrist drop
47
OT intervention for radial nerve laceration
* Dynamic extension splint * ROM * sensory reeducation * home program * activity modification

NBCOT Exam (19 decks)

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