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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
Q

Post-op Nerve Repair Rehab Basics

A
  • Edema control
  • AROM
  • Nerve gliding
  • Tendon gliding
  • Strengthening
  • Sensory Reeducation
26
Q

Pronator Teres Syndrome definition and symptoms

A
  • 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
Q

Conservative intervention for Pronator Teres Syndrome

A
  • Elbow splint at 90 degrees with forearm in neurtral
  • Avoid activities that include repetitive forearm pronation/supination
28
Q

Post-op intervention for pronator teres syndrome

A
  • Nerve repair basics
  • Strengthening 2 weeks post-op
29
Q

Guyon’s canal syndrome definition and symptoms

A
  • 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
Q

Conservative treatment of Guyon’s canal syndrome

A

Wrist splint in neurtral and activity modification

31
Q

Post-op treatment of Guyon’s canal syndrome

A
  • Nerve repair basics
  • strengthening at 2-4 weeks focusing on power grip
32
Q

Cubital tunnel syndrome definition and symptoms

A
  • 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
Q

Conservative treatment of cubital tunnel syndrome

A
  • Elbow splint to prevent positions of extreme flexion (especially while sleeping)
  • Elbow pad to decrease compression while leaning
  • Activity modification
34
Q

Post-op treatment for cubital tunnel syndrome

A
  • Nerve repair basics
  • MCP flexion splint if clawing noted
35
Q

Radial nerve palsy definition and symptoms

A
  • Saturday night palsy
  • Weakness or paralysis of extensors to the wrist, MCPs and thumb; wrist drop
36
Q

Conservative treatment of radial nerve palsy

A
  • Dynamic extension splint
  • Work/activity modification
  • Strengthening wrist and finger extensors when motor function returns
37
Q

Post-op treatment of radial nerve plasy

A
  • Nerve repair basics
  • strengthening at 6-8 weeks post-op
38
Q

Median nerve laceration sensory loss

A
  • 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
Q

Median nerve laceration motor loss

A

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
Q

OT intervention for Median Nerve Laceration

A
  • 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
Q

Ulnar nerve laceration sensory loss

A
  • ulnar aspect of palmar and dorsal surfaces
  • ulnar 1/2 of ring and little finger on palmar and dorsal surfaces
42
Q

Ulnar nerve laceration motor loss

A

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
Q

Ulnar nerve laceration deformity

A
  • Claw hand
  • Flattened metacarpal arch
  • Positive Froment’s sign
  • Loss of power grip
  • Decreased pinch strength
44
Q

OT intervention for Ulnar Nerve Laceration

A
  • 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
Q

Radial nerve laceration sensory loss

A

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
Q

Radial nerve laceration motor loss

A

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
Q

OT intervention for radial nerve laceration

A
  • Dynamic extension splint
  • ROM
  • sensory reeducation
  • home program
  • activity modification

NBCOT Exam (19 decks)

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