Musculoskeletal | I love you Flashcards
The Skeletal System:
How many bones are there in the skeletal system excluding the boner you give me?
206
The Skeletal System:
The two types of bones
Compact bone & Spongy bone
The Skeletal System:
4 functions of bones
Locomotion/movement
Protection
Support and lever
Hematopoiesis
The Skeletal System:
Blood formation starts on one part of the body specifically on the iliac crest
Hematopoiesis
The Skeletal System:
Mineral deposition of Bones | Basic minerals found in the bone
Calcium (98%) & phosphorus (2%)
The Skeletal System:
Responsible for the breakdown of bones
Osteoclasts
The Skeletal System:
The building blocks of the bone
Osteoblasts
The Skeletal System:
Biochemical Characteristics of Bone (_____ Law)
Wolff’s Law
The Skeletal System:
Stiffness of the bone due to lack of usage (movement); is common among elderly and comatose patients.
Contractures
The Skeletal System:
Promotes release of calcium that is reabsorbed from bone by osteoclasts
Parathyroid Hormone
The Skeletal System:
Promotes calcium absorption in the bone in cases of hypercalcemia wherein there are high levels of calcium in the bloodstream.
Calcitonin Hormone
The Skeletal System:
Also known as ossification.
Bone Formation
The Skeletal System:
the process by which the bone matrix is formed and hard mineral crystals composed of calcium and phosphorus (e.g., hydroxyapatite) are bound to the collagen fibers.
Ossification
The Skeletal System:
Two types of bone formation
Intramembranous and Endochondral
The Skeletal System:
Type of bone formation that makes the irregular bones of the body,
also as flat bones.
Intramembranous
The Skeletal System:
Type of bone formation that is responsible for long bone formation
Endochondral
The Skeletal System:
Occurs when there is bone fracture or injury
Bone Remodeling
The Skeletal System:
If we have fractures, there will be debris, which is why ______ will “clean” them, then _______ will start with the bone remodeling
osteoclasts, osteoblasts
The Skeletal System:
In bone remodeling they are the ones who help repair and protect the area
Mononuclear cells (e.g. Phagocytes, monocytes,
terms ending with “cytes”)
The Skeletal System :
Responsible for range of motion; Where 2 bones meet
Joents XD Joints BABE! I LOVE YOU HEHEHE
The Skeletal System:
Is joined by dense irregular connective tissue that is rich in collagen fibers
Fibrous joint
The Skeletal System:
A joint joined by cartilage
Cartilaginous joint
The Skeletal System:
A joint that is not directly joined
Synovial joint
The Skeletal System:
Joints that are immovable or no movement (e.g. skull sutures and gomphosis) - same with fibrous
Synarthrosis (fibrous joints)
The Skeletal System:
In infants, the skull seems soft due to the presence of _____(made up of cartilage). As the child grows, these parts of the skull harden as the fontanels close.
Fontanels
The Skeletal System:
Joints that have little movement like vertebrae
Amphiarthrosis (cartilaginous joints)
The Skeletal System:
A joint with full movement (e.g.synovial joints - shoulder, hip, elbow)
Diarthrosis(synovial joints) -
The Skeletal System:
6 types of joints
- Ball and socket
- Saddle
- Condyloid
- Pivot
- Gliding
- Hinge
The Musculoskeletal System:
It connects bone to muscle
Tendon
The Musculoskeletal System:
It connects bone to bone
Ligament (miss ko na monay mo T_T)
The Musculoskeletal System | Musculoskeletal Assessment:
Demographics give me what I want, give me the 3 factors under demographics
Age
Sex (ta? AUGHY)
Race
The Musculoskeletal System | Musculoskeletal Assessment:
Initital Assessment: What is the meaning of ABCDE
Airway, breathing, circulation, disability, and environment
The Musculoskeletal System:
What are the 6 P’s in the initial assessment?
Pain
Pallor
Paresthesia
Pulses
Paralysis
Poikilothermia
Pitoy ko AHE
The Musculoskeletal System:
The first thing to be verbalized by the patient
Pain on palpation, on movement, and is constant
The Musculoskeletal System:
tingling and/or numbing sensation; sensations of burning, tingling,
or numbness. These sensations may be caused by pressure on nerves or by circulatory impairment.
Paresthesia
The Musculoskeletal System:
Inability to regulate body temperature correctly; people with fractures are usually cold.
Poikilothermia
The Musculoskeletal System:
Grating sensation of those person having fracture (popping, clicking or crackling sound in a joint)
Crepitus
The Musculoskeletal System:
“nag-uslo” ang bones | Shortening of the limb
Dislocation
The Musculoskeletal System:
there is a break in the continuity of bone
Fracture
The Musculoskeletal System:
Contraction of muscle fibers
the length of the muscles remains constant but the force generated by the muscles is increased; an example of this is pushing against an immovable wall
Isometric contraction
The Musculoskeletal System:
Contraction of muscle fibers
characterized by the shortening of the muscle without an
increase in tension within the muscle; an example of this is flexing the forearm.
Isotonic contraction
The Musculoskeletal System | Radiologic Studies:
Uses electromagnetic radiation
X-RAYS
The Musculoskeletal System | Radiologic Studies:
a non-invasive procedure that uses an x-ray beam to
scan body parts at different angles, compute tissue
densities, and record a cross-sectional image on
paper; may be performed with or without the use of
oral or intravenous (IV) contrast agents
COMPUTED TOMOGRAPHY or CT Scan
The Musculoskeletal System | Radiologic Studies:
Two types of CT Scan
With contrast media & Without contrast media
The Musculoskeletal System | Radiologic Studies:
a procedure that involves injection of a radio-opaque dye to check for tumors or other problems in the spinal canal.
Myelography
The Musculoskeletal System | Radiologic Studies:
Radiopaque or contrast medium is injected into the joint cavity to outline problems in specific areas such as bone erosion or to detect bone fragments (produces black and white, 2D image); similar to x-ray
Arthrography
The Musculoskeletal System | Radiologic Studies:
endoscopic direct visualization of joints, especially knee (produces a colored, 3D image)
Arthroscopy
The Musculoskeletal System | Radiologic Studies:
injection of a bone-seeking radioactive isotope to diagnose and track bone disease.
Bone Scanning
The Musculoskeletal System | Radiologic Studies:
used to measure bone mineral content and density (osteoporosis).
Bone Densitometry
The Musculoskeletal System | Radiologic Studies:
graphic presentation of the electrical potentials of muscles with the use of low-voltages electricity.
Electromyography
The Musculoskeletal System | Radiologic Studies:
uses magnetism and radiofrequency waves to produce cross-sectional images of body tissues on a computer screen
MAGNETIC RESONANCE IMAGING (MRI)
wala ko ga pangakig ha gin copy paste ko lang ni sa PDF I love you babe I miss you na HUHU
The Musculoskeletal System | Radiologic Studies:
involves aspiration of synovial fluid, which provides lubrication in between bones with the use of large bore needles
Arthrocentesis
The Musculoskeletal System | Radiologic Studies:
it involves the removal of a sample from bone or muscle.
Bone or muscle biopsy
The Musculoskeletal System | Radiologic Studies:
used to assess color of synovial fluid and amount of WBCs present in the fluid to rule out possibility of infection.
SYNOVIAL FLUID DETERMINATION
The Musculoskeletal System | Radiologic Studies:
Laboratory Studies
-For patients with gout or arthritis.
Uric acid
The Musculoskeletal System | Radiologic Studies:
Laboratory Studies
- For patients with rheumatoid arthritis, other autoimmune diseases, SLE, or problems in the liver.
Antinuclear antibody
The Musculoskeletal System | Radiologic Studies:
Laboratory Studies
- used to detect specific antibody-antigen in patients with rheumatoid arthritis.
Complement fixation (IgG)
The Musculoskeletal System | Radiologic Studies:
Laboratory Studies
can indicate certain bone conditions.
Serum Calcium
The Musculoskeletal System | Radiologic Studies:
Laboratory Studies
can indicate liver or bone disorders.
Alkaline Phosphatase
TRAUMATIC INJURIES
4 classifications of fractures
open (compound)
closed (simple)
complete / incomplete (greenstick)
comminuted and compressed (spinal)
TRAUMATIC INJURIES
A fracture where bone breaks through the skin and can be seen outside the leg.
Open (compound)
TRAUMATIC INJURIES
A fracture where there is no opening in the skin but there is a break in the continuity of the bone inside.
Closed (simple)
TRAUMATIC INJURIES
A fracture where there is a complete break of the bone
Complete
TRAUMATIC INJURIES
A fracture where a bone bends and breaks but does not separate into two separate pieces; Only one part of the bone is damaged, not completely broken
Incomplete (greenstick)
TRAUMATIC INJURIES
A fracture where it is very common in elderly because of osteoporosis, sudden movement generates a break in the bone and compression in the nerves
Compressed (spinal)
TRAUMATIC INJURIES
horizontal break in the bone
Transverse
TRAUMATIC INJURIES
angle break in the bone
Oblique
TRAUMATIC INJURIES
spiral/break in the bone that turns around
Spiral
TRAUMATIC INJURIES
divides bone into two large pieces
Segmental
TRAUMATIC INJURIES
one part of the bone attached to the tendon and because of too much
pressure, a part of the bone is removed due to the force of the tendon
Avulsed
TRAUMATIC INJURIES
there’s also a break but because of too much pressure, instead of separating, from the bone, it was pushed further
Impacted
TRAUMATIC INJURIES
very fine fracture, also known as buckle fractures, are incomplete fractures of the shaft of a long bone that is characterized by bulging of the cortex as it heals (belt-shaped)
Torus
Musculoskeletal Care Modalities:
Used to immobilize a reduced fracture; Correct deformity/support and stabilize weakened joints
CASTS
Musculoskeletal Care Modalities:
can be defined as having two splits, in such a way as to leave a resting gutter for the injured limb.
bivalved surgical cast
Musculoskeletal Care Modalities:
Contoured splints of plaster or pliable thermoplastic materials may be used for conditions that do not require rigid immobilization, for those in which swelling may be anticipated, and for those that require special skin care.
Splinting
Musculoskeletal Care Modalities:
Do nurses perform closed reduction?
No
Musculoskeletal Care Modalities:
BOARD EXAM QUESTION:
Interventions for applying cast include:
-Support extremity or body part to be casted.
-Support cast during hardening/drying with palms of
hands
-Leave cast uncovered and exposed to air (casts are
usually air dried)
-Encourage passive ROM exercise of joints not
casted (finger exercises) to maintain joint flexibility,
prevent contractures, and prevent muscle atrophy
-Observe for signs of infection
-Monitor circulation, motion, sensation
Musculoskeletal Care Modalities:
A type of casting material that is commonly used and made out of gypsum.
Plaster of Paris
Musculoskeletal Care Modalities:
A type of casting material that is more colorful
Fiberglass Cast
Musculoskeletal Care Modalities:
BOARD EXAM QUESTION:
It is the most common complaint of patients with
casts. Relieved by light tapping or by using a blower in a low
setting mode.
Itchiness
Musculoskeletal Care Modalities | Cast Complications:
increased tissue pressure within a limited space compromising the
circulation
Compartment syndrome
Musculoskeletal Care Modalities | Cast Complications
Pain and tightness in the area, especially on the bony prominences
Pressure ulcers
Musculoskeletal Care Modalities | Cast Complications
Muscle atrophy; bivalving of the cast reduces the limb size and weakens the bone
Disuse syndrome
Musculoskeletal Care Modalities | Cast Complications
fat emboli enter circulation following orthopedic trauma, especially long bone; common in long bone fractures
Fat embolism
Musculoskeletal Care Modalities | Cast Complications
Pain on calf upon dorsiflexion of foot.
positive Homan’s sign
Musculoskeletal Care Modalities | Cast Complications
fat embolism on lungs creating obstruction
Pulmonary embolism
Musculoskeletal Care Modalities | Cast Complications
healing does not occur within the expected time frame for the location and type of fracture.
Delayed union
Musculoskeletal Care Modalities | Cast Complications
unaligned bone remodeling/healing
Malunion
Musculoskeletal Care Modalities | Cast Complications
no bone healing
Nonunion
Musculoskeletal Care Modalities
Uses a pulling force to promote and maintain alignment to an injured part of the body.
Tractions
Musculoskeletal Care Modalities | Tractions
Uses only bandages; Not an invasive procedure
Skin Traction
Musculoskeletal Care Modalities | Tractions
It is often used when continuous traction is desired to immobilize, position, and align a fracture of the femur, tibia, and cervical spine; Invasive procedure because it requires an incision of the skin (uses pins such as Steinmann pins), screws, or wires) longer-term traction requiring heavier weights.
Skeletal Traction
Musculoskeletal Care Modalities | Tractions
an external appliance that provides support, prevents or corrects joint deformities, and improves function; reduces the effects of weight-bearing on the body, or prevent movement of a joint or limb in a given
direction.
Orthopedic Brace
Musculoskeletal Care Modalities | Tractions
involves passing a metal pin or wire through the bone under local
anesthesia, avoiding nerves, blood vessels, muscles, tendons, and joints.
Skeletal Tractions
Musculoskeletal Care Modalities | Tractions
prescribed for short-term use to stabilize a fractured leg, control muscle spasms, and immobilize an area before surgery.
Skin Tractions
Musculoskeletal Care Modalities | Tractions
4 types of skin tractions
Buck’s traction
○ Buck’s Traction
○ Russel’s Traction
○ Bryant’s Traction
○ Cotrel’s Traction
Musculoskeletal Care Modalities
Correction and alignment of the fracture after surgical dissection and
exposure of the fracture
Open Reduction
Musculoskeletal Care Modalities
Stabilization of the reduced fracture by the use of metal screws, plates, wires, nails, and pins
Internal fixation
Musculoskeletal Care Modalities
Replacement of all or part of the joint surface just like damages in ligaments or cartilage - uses titanium to lessen the reject of the body from the for ring material.
Arthroplasty
Musculoskeletal Care Modalities
immobilizing fusion of a joint where fracture cannot work as an
individual bone so this procedure will fuse it all together, movement will be affected (cannot be bent anymore) but can be the best way to save the case.
Arthrodesis
Musculoskeletal Care Modalities
incision and diversion of the muscle fascia, if there’s the possibility of
compartment syndrome where too much inflammation decreases the blood supply/circulation in that area or distal to the injury, ______will be done.
Fasciotomy
Musculoskeletal Care Modalities
movement of tendon from one place to another in order to improve function, to relieve pressure in tendons, movement will be affected
Tendon transfer
Musculoskeletal Care Modalities
replacement of a severely damaged hip with an artificial
joint.
Total hip replacement
Musculoskeletal Care Modalities
who have severe pain and functional disabilities related to
the destruction of joint surfaces by bleeding into a joint.
Total knee replacement-
Musculoskeletal Care Modalities
Removal of a body part usually an extremity wherein all conditions will be met first before proceeding to this procedure
Amputation
Musculoskeletal Care Modalities
a Level of Amputation where it is performed with the goal of preserving
maximal functional length. The prosthesis is fitted early to ensure maximum function.
AKA- Above-the-knee amputation
Musculoskeletal Care Modalities
Indications of amputation
-Irreversible ischemia in a diseased or traumatized
limb
-Peripheral vascular diseases
-Burns
-Frostbite
-Malignant tumors
-Gangrene
-Crushed injury
Musculoskeletal Care Modalities | Complications of amputation
A common possibility when there is an opening on the skin. This is why physicians would advise the patient to take antibiotic medications.
Infection
Musculoskeletal Care Modalities | Complications of amputation
This is a common occurrence that is mostly psychological than physiological.
Phantom limb syndrome/Phantom Pain
si stan
dako buto
Management of Acute Low back Pain
- Avoid strenuous physical activity
● Heat or ice (ice for the first 48-72 hours, then use heat)
● Ibuprofen (Advil, Motrin IB) or acetaminophen
(Tylenol).
● Curled-up, fetal position with a pillow between leg if sleeping.
● Pillow or rolled towel under when sleeping on back
● Stretching and strengthening exercise
caused by a sudden injury to the muscles and
ligaments supporting the back. Pain by muscle spasms or a strain or tear in the
muscles and ligaments
Upper Extremity Problems
inflammation (swelling, heat) or irritation of a bursa.
Bursitis
small sacs between bone and other moving
parts, such as muscles, skin, or tendons which
allows smooth gliding between moving parts
bursae
inflammation or irritation of a tendon
Tendinitis
thick, fibrous cords that connect
muscles to bone that send power caused by muscle contraction to move a bone
Tendons
Management of Tendinits
- Reduce/avoid particular activity
● Right body position during activities
● Warm-up before/correct posture during exercise
● Splint, applying moist heat or ice
NSAIDs to control inflammation and pain
● Steroid injections for short-term and rapid
movement of the shoulders but not for long-term.
PAGET’S DISEASE
Paget’s disease is also known as:
Osteitis Deformans
fragments of bone/cartilage that freely float in the joint space
Loose Bodies (Joint Mice)
2 classifications of loose bodies
Stable (1 area only) & Unstable (moves freely)
PAGET’S DISEASE
The four factors of Paget’s disease
● Genetics/hereditary factors
● Hereditary
● Virus
● Environmental factors
PAGET’S DISEASE
PANICS:
○ Pain in bone
○ Arthralgia (pain in the joints)
○ Neural deafness/nerve compression
○ Increased bone density
○ Cardiac failure
○ Skull or sclerotic vertebrae
PAGET’S DISEASE
Assessment:
● Elevated serum alkaline phosphatase.
○ This type of test is used to determine if a
person has a bone disorder or not
● Urinary hydroxyproline excretion reflects increased
osteoblastic activity
● X-ray confirms Paget’s disease that shows
characteristics of mosaic pattern.
PAGET’S DISEASE
Management:
● No cure
● Pain is responsive to NSAIDS such as Ibuprofen
● Walking aids, shoe lifts, and physical therapy for
gait problems
○ Because our px has deformed bones and
extremities, they have problem with balance
and coordination
● Weight control
○ If our px is big, this causes pressure on our
weight bearing bones.
PAGET’S DISEASE
Three phases of Paget’s Disease:
● Lytic Phase
● Mixed Phase
● Sclerotic Phase
3 types of loose bodies
- Fibrinous- joint bleeding/death od synovial membrane
- Cartilaginous- fragments of cartilage
- Osteocartilaginous- bone and cartilage
BONE TUMORS
A lump or mass of tissue that forms when cells divide uncontrollably
Bone Tumor(s)
BONE TUMORS
Type of bone tumor that is:
○ Most common
○ Malignant tumor of bone marrow
○ Affects approximately 5-7 people per 100,000
each year
○ Most common cases are seen between 50-70
years old
Multiple Myeloma
BONE TUMORS
Type of bone tumor that is:
○ Second most common bone cancer
○ Occurs in 2-3 new people per million people
each year
○ Most cases occur in teenagers
○ Occur around the knee, hip, and shoulder
(mostly long bones)
Osteosarcoma
BONE TUMORS
Type of bone tumor that is:
○ Most common occurs between 5-20 years of age
○ Common locations (upper and lower leg, pelvis,
upper arm, and ribs)
Ewing’s Sarcoma
BONE TUMORS
Type of bone tumor that is:
○ Occurs most commonly in px between 40 - 70
y.o.
○ Most cases occur around the hip and pelvis, or
the shoulder
Chondrosarcoma
BONE TUMORS
Type of bone tumor that is:
○ Non-ossifying fibroma unicameral (simple)
bone cyst
○ Osteochondroma
○ Giant cell tumor
○ Enchondroma
○ Fibrous dysplasia
○ If this increases in size and compromises our
nerves and tissues, then they have to be
removed.
Benign bone tumors
BONE TUMORS
Clinical Manifestations
● Dull and achy pain in the area of the tumor.
● Pain may or may not get worse with activity.
● Fevers and night sweats
● Painless mass
● Benign tumors may be discovered incidentally
when X-rays are taken for other reasons (sprained
ankle or rotator cuff problem)
● Weak bones
Tendons of the rotator cuff become irritated and
inflamed as they pass through the subacromial
space, the passage beneath the acromion
Impingement Syndrome
Type of balloon filled-lump which shows up next to a joint/tendon. Exists when there is trauma or injury on a particular part of the body specifically in the hands.
Ganglion
These small cysts will try to lump together creating a balloon-filled lump which shows up next to the joint or tendon. Soft or hard, may or may not be painful, and may get bigger or smaller on its own
Ganglion
thickened skin on the top or side of a toe,
usually from shoes that do not fit properly.
Corn
thickened skin on hands and soles of feet.
Callus
BONE TUMORS
Diagnostics
● Medical history
● Physical exam
● Imaging
○ X-ray
○ MRI/CT scan
● Needle biopsy
● Open biopsy
SPRAIN and STRAIN
Complete separation of the articular surfaces of a joint
DISLOCATION
SPRAIN and STRAIN
is a partial dislocation and does not cause as much deformity as complete dislocation (Brunner & Suddarth, 2018).
Subluxation
SPRAIN and STRAIN
Complication of a dislocation or subluxation that is not reduced is called _______ which is necrosis of the bone cells due to the absence of oxygen (Brunner & Suddarth, 2018).
avascular necrosis
SPRAIN and STRAIN
complete/incomplete tear in supporting ligament of a joint due to twisting motion
SPRAIN
SPRAIN and STRAIN
overstretching injury to a muscle and tendon due to excessive vigorous movement
STRAIN
SPRAIN and STRAIN
Manifestations of SPRAIN:
○ Pain and discomfort especially on joint
movement
○ Edema, possibly ecchymoses
○ Decreased joint movement
○ Feeling of joint looseness with severe sprain
SPRAIN and STRAIN
Manifestation of STRAIN:
○ Pain (sudden, severe, and incapacitating)
○ Edema
○ Ecchymoses developed several days after
injury.
SPRAIN and STRAIN
The degree of a SPRAIN where there are tears in some fibers of the ligament and mild, localized hematoma formation.
First-degree/ Mild Grade
Management of Corns and Callus
- Prevent friction.
● Wear shoes that fit. Avoid shoes with rigged
structures.
● Use of donut-shaped corn pads.
● Orthotic devices can be made to remove pressure
from bony prominences.
● Use of a pumice stone to gently wear down the
corn. Use with caution since it may create an
opening or wound in that particular area.
● Wear gloves during activities that cause friction
(gardening and weight lifting).
● Corns are treated by a podiatrist by soaking and
scraping off the horny layer, by application of a
protective shield or pad, or by surgical - modification of the underlying offending osseous
structure.
Curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin,
creating pain, redness, swelling, and warmth in the
toe.
Ingrown toenails
deformity of the proximal interphalangeal joint of the second, third, or fourth toe causing it to be permanently bent, resembling a hammer.
Hammer toe
Type of hammer toe: distal
Mallet toe
Type of Hammer Toe: distal and proximal
Claw toe
Type of Hammer Toe: Proximal
Hammer toe
surgical cutting of the bone to remove
the deformity.
Osteotomy
Visible bump that changes the bony framework of the front parts of the foot. Big toe leans toward the second toe, rather than pointing straight ahead which throws the bones out of alignment
Hallux Vagus (Bunion)
SPRAIN and STRAIN
The degree of a SPRAIN where there is partial tearing of the
ligament.
Second-degree/ Moderate
Grade
SPRAIN and STRAIN
The degree of a SPRAIN where there the ligament is completely torn or
ruptured. This is also associated with avulsion fractures.
Third-degree/ Severe Grade
SPRAIN and STRAIN
The degree of a STRAIN where there is mild stretching of muscle or tendon with no loss of ROM.
First-degree
SPRAIN and STRAIN
The degree of a STRAIN where there is moderate stretching and or partial stretching of the muscle or tendon with increased pain with passive ROM.
Second-degree
SPRAIN and STRAIN
The degree of a STRAIN where there is severe muscle or tendon stretching with rupturing and tearing of involved tissue. An
avulsion fracture may be associated with this degree of strain.
Third-degree
Flat feet, Arch of the foot collapses, with the entire sole of the foot in complete contact with the ground.
Pes Planus
SPRAIN and STRAIN
PRICE acronym
○ Protection: protect from further injury
through support of the affected area (e.g.
sling) and/or splinting.
○ Rest: this prevents additional injury and
promotes healing.
○ Ice: intermittent application of cold packs
during the first 24 to 72 hours after injury
produces vasoconstriction. The cold packs
should not be placed for longer than 20
minutes.
○ Compression: an elastic compression
bandage controls bleeding, reduces
edema, and provides support for the
injured tissues.
○ Elevation: elevate at or just above the level
of the heart to control swelling.
(support, foot gymnastics) for Pes Planus
Orthoses
High arch. Human foot type in which the sole of the foot is distinctly hollow when bearing weight
Pes Cavus
can cause inflammation in
the plantar fascia and tendons
Talocalnaneal Coalition
ROTATOR CUFF TEARS
Occur in supraspinatus muscle/tendon
ROTATOR CUFF TEARS
ROTATOR CUFF TEARS
Tear damages the soft tissue, but does not completely sever it
Partial Tear
A benign neuroma of an intermetatarsal plantar
nerve, most commonly of the 3rd and 4th
intermetatarsal spaces (nerve swelling and
inflammation in that area can create localized pain)
Morton’s Neuroma
A minimally invasive procedure for Morton’s neuroma during which the affected nerve is exposed to cold (-50 or -70 degrees) or frozen
Cryogenic neuroblation
Painful inflammation of the joint due to infection
Septic Athritis
ROTATOR CUFF TEARS
Splits the soft tissue into two pieces; Hole in the tendon
Full-thickness tear (complete tear)
usually comes from tuberculosis of the
lungs
Tuberculosis of the bone/ Pott’s disease
ROTATOR CUFF TEARS
Symptoms
● Pain at rest and at night, particularly if lying on the
affected shoulder
● Pain when lifting and lowering arm
● Aching pain that is typically insidious in nature
unless related to an acute injury (Brunner &
Suddarth, 2018).
● Weakness when lifting or rotating arm
● Crepitus or crackling sensation - bones maipit sa
rotator cuff (sorry guys sa phone lang ko haahaa) <– XD
ROTATOR CUFF TEARS
Diagnostics
● X-ray
● Magnetic Resonance Imaging
ROTATOR CUFF TEARS
relieves pain/improves function on the shoulder
○ Rest
○ Activity modification
○ Non-steroidal anti inflammatory medication
(ibuprofen and naproxen)
○ Strengthening exercises and physical therapy
○ Steroidal injection
Nonsurgical treatment
ROTATOR CUFF TEARS
Modification of acromium by using arthroscope
- Post-operatively, the shoulder
immobilizer for several days to 4
weeks (Brunner & Suddarth,
2018). - The course of rehabilitation is
lengthy (i.e. 3 to 6 months)
(Brunner & Suddarth, 2018).
Arthroscopic Acromioplasty
6 Smart facts about antibiotic use by CDC
- life-saving
- only treat bacterial infections
- some ear infections do not require antibiotic
- more sore throats do not require antibiotic
- green mucus do not need antibiotic
- there are risks
Top 10 natural antibiotics
- Olive leaf extract
- Honey
- Garlic
- Oil of oregano
- Ginger
- Turmeric
- Echinacea
- Goldenseal
- Grapefruit seed extract
- Neem
Infection and inflammation of the bone due to
bloodstream infection (hematogenous) or
penetrating trauma (contiguous-focus)
Osteomyelitis
Most common agent in osteomyelitis
Staphylococcus aureus
bone abscess cavity which
contains dead bone tissue
Sequestrum
New bone growth forms _____
Involcrum
removal of involucrum (to remove sequestrum)
Sequestrectomy
Different from septic arthritis, rheumatoid arthritis: Degenerative joint disease or “wear and tear” arthritis
Osteoathritis
EPICONDYLITIS
Cumulative trauma injury that occurs over time from repeated use of the muscles of the arm and forearm; also known as “tennis elbow”
EPICONDYLITIS
Occurs when the cartilage or cushion between
joints breaks down
Osteoathritis
excessive iron in body
Hemochromatosis
due to the loss of cartilage, the body will create more bones, increasing osteoblastic activity
(compensatory mechanism of the body), problem is that it is irregular, still making the bones rub against each other
Bone spur
small bony growths that appear
on the joint closest to the tip of your finger
○ Distal interphalangeal
Heberden’s nodes
swelling affecting the proximal
interphalangeal finger joint
○ in the proximal interphalangeal
Bouchard’s nodes
EPICONDYLITIS
associated with someone who frequently extends the wrist and supination of the forearm.
Lateral epicondylitis
TRUE OR FALSE: Osteoarthritis has NO CURE. Once the cartilage is gone, it will not be
restored
TRUE
Topical product, Comes from chili, Expensive, Rubbed on the knees/ affected area among osteoarthritis
Capsaicin cream
damaged bone and cartilage in
the acetabulum (hip socket) is removed and
replaced with a metal shell
Hip resurfacing
EPICONDYLITIS
associated with repetitive wrist flexion and supination of the forearm.
Medial epicondylitis
Disorder of bone metabolism
Osteoporosis
eating food rich in gluten (garlic, wheat,
bread, rye) the villi in the small intestine
gets damaged which there will be less
absorption of calcium
Celiac disease
low hormone (estrogen,
testosterone, progesterone), causing low
calcium
Hypogonadism
ACCESS leads to osteoporosis:
Alcohol use
Corticosteroid use
Calcium low
Estrogen low
Sedentary lifestyle
Smoking
“DEXA” spell out
Dual Energy X-ray
EPICONDYLITIS
Occupational Causes
● Repeated or forceful rotation of the forearm/bending or straightening of the wrist
● Impact activity or jerky, throwing motions
● Awkward positioning of the racket/mouse
EPICONDYLITIS
Symptoms
● Tenderness over the bony protuberances
● Pain radiate from the elbow down the forearm and upper arm
● Activity makes the pain worse
● Loss of elbow and wrist motion due to pain
● Weakness
● Elbow will be swollen over the bony protuberances
EPICONDYLITIS
Prevention & Early Treatment
- Counterforce bracing (tennis elbow strap)
- Splinting (custom made or prefabricated) with the wrist held slightly back for lateral epicondylitis or in neutral position or slightly bent towards the palm for medial epicondylitis
- Avoid activities which cause pain
- Ergonomic tools - tools which will adhere to the supposed position of the hand
a. Suited to the body - Extracorporeal shock wave therapy - apply shock on the particular joint to promote proper healing
- Steroids Injection
- Platelet Rich Plasma (PRP) - promote proper healing
- Equipment Check
EPICONDYLITIS
Treatment
- Hand therapy techniques
- Supervised exercise program to stretch tight muscles, strengthen weak muscles promote postural balance (forearm stretches, tendon, and nerve gliding exercises)
- Ice massage
- First Line of Treatment: rest through cessation of aggravating movements (Brunner & Suddarth, 2018).
- Other identified treatments include (Brunner & Suddarth, 2018):
a. Intermittent application of ice
b. Administration of NSAIDs
c. Immobilization in a molded splint
d. Local injection of corticosteroids (ONLY
FOR SEVERE CASES)
ACL Injury
Miss mo na rin ba ako?
Kase miss na miss na kita Amy ko :<
ACL Injury
Occurs through a twisting force being applied to the knee whilst the foot is firmly planted on the ground or upon landing; Common knee injury amongst sports people
ACL Injury
Diet among osteoporosis: has the highest amount of calcium
Tofu
An autoimmune disease. Attacks synovial joints, produces synovitis secondary to hyperplasia of synovial cells, excess synovial fluid (causes inflammation), and formation of pannus (hyperplasia of synovial cells) in the
synovium
Rheumatoid Athritis
Fusion of bones
Ankylosis
decrease in bone density
Osteopenia
ACL Injury
Direct impact to the front of the tibia itself; occurs when the foot is firmly planted and the leg sustains direct backward force.
POSTERIOR CRUCIATE LIGAMENT INJURY
ACL Injury
Signs and Symptoms
- Pain at the time of impact/felt in the calf region
- Swelling
- Posterior draw test
- Pain and laxity when a “Reverse Lachman’s test” is
performed - Instability of the joint/feeling of the knee giving way
ACL Injury
One of a number of tests used to help diagnose a positive ACL
injury/rupture. It is used to compare to the non-symptomatic leg
Lachman Test
ACL Injury
Treatment | RICE
Rest, Ice, Compression, and Elevation.
Gout when big toe in involved
Podagra
caused by elevated levels of uric acid which
crystallize and are deposited in joints, tendons, and surrounding tissues
Gout
the blood which crystallize and are deposited in joints, tendons, and surrounding tissues
Tophi (Tophaceous gout)
AKA Osteitis Deformans
Paget’s disease
Idiopathic bone disorder characterized by
abnormal and accelerated bone resorption.
Paget’s disease
ACL Injury
Treatment
● RICE - Rest, Ice (to prevent inflammation; don’t apply directly to skin), compression (to prevent bleeding) and elevation (to control bleeding; placing a pillow)
○ Immediate post-injury management includes PRICE and stabilization of the joint until it is elevated for a fracture (Brunner & Suddarth, 2018).
● Anti-inflammatory/NSAIDS medication - reduce pain
● Physical Therapy - regain/build muscle strength over time
● Surgical ACL or PCL Reconstruction may be scheduled after near-normal joint ROM is achieved and includes tendon repair with grating (Brunner & Suddarth, 2018).
Elevated uric acid levels
Hyperuricemia
Meniscal Injury
is a crescent-shaped cartilage located on either the right and left side of the proximal tibia, between the tibia and the femur
Meniscus
Meniscal Injury
Signs and Symptoms
● Feeling a “pop” during meniscus tear
● Knee gradually becomes stiffer and swollen
● Pain
● Stiffness and swelling
● Catching or locking of the knee
● Sensation of the knee “giving way” during walking or running.
● Limited range of motion.
Meniscal Injury
Diagnostics
● Physical examination and history
● Imaging tests
● X-ray
● Magnetic resonance imaging (MRI)
○ This is the diagnostic tool used to detect a
torn meniscus (Brunner & Suddarth, 2018).
● McMurray Test.
Meniscal Injury
Examiner will let the client lie down and rotate the lower leg then extend and rotate from time to time. If you could hear some clicking sound it’s possible that there is a meniscal tear or injury.
McMurray Test
When to use hot vs cold for pain management:
Uses of Hot therapy (warm compress)
○ Tight muscles/stiff joints
○ Pinched nerves
○ Muscle pain
○ Arthritis discomfort
○ To soothe or relax body
When to use hot vs cold for pain management:
Uses of cold therapy
○ Sprains/strains
○ Bumps/bruises
○ Fresh injuries
○ Torn muscles
○ Workout recovery
When to use hot vs cold for pain management:
Effects of hot therapy:
■ Increases blood flow to the area
■ Aids in the repair of damage tissue
■ Soothes patient discomfort
■ Allows area to heal faster
When to use hot vs cold for pain management:
Effects of cold therapy
○ Numbs the affected area
○ Decreases the blood flow
○ Reduces swelling and inflammation
○ Reduces bruising
When to use hot vs cold for pain management:
Cautions of hot and cold therapy
○ 20 minutes. Never apply hot or cold therapy for more than 20 minutes at a time
○ Wrap in a towel. Wrap compress in a towel or cloth when applying to your skin to protect against burns
A miniature camera is inserted through a small incision which provides a clear view of the inside of the knee
Knee Arthroscopy
Carpal Tunnel Syndrome
Heavy use of computer mouse due to postures of the hands and wrist, can result in a strain injury to the wrist.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
Signs and Symptoms (Brunner & Suddarth, 2018):
● Pain
● Numbness
● Paresthesia
● Weakness along the median nerve distribution(thumb, index, and middle fingers)
● Night Pain
● Fist clenching upon awakening
● Postive Tinel Sign
Carpal Tunnel Syndrome
(percussing lightly over the median nerve - located on the inner aspect of the wrist- the patient reports pain, numbness, and tingling).
Postive Tinel Sign
Carpal Tunnel Syndrome
Treatment:
● Based on the cause;
○ Wrist splints
○ Avoidance of repetitive flexion of the wrist
○ NSAIDS
○ Carpal canal cortisone (methylprednisolone) injections
● Traditional open nerve release / endoscoping laser
surgery
Spine Curvature Disorder
the spine curves significantly inward at the lower back.
Lordosis
Spine Curvature Disorder
is characterized by an abnormally rounded upper back (more than 50 degree of curvature) WTVR!
Kyphosis
Spine Curvature Disorder
sideways curve to their spine. The curve is often S-shaped or C-shaped
Scoliosis
Spine Curvature Disorder
A disorder in which bones do not grow normally. Common in patients with dwarfism
Achondroplasia
Spine Curvature Disorder
vertebrae slips forward
Spondylolisthesis
Spine Curvature Disorder
compression fractures. Bones become so brittle that upon small movements, it creates a compression fracture on the anterior part
of the vertebra.
Osteoporosis
Spine Curvature Disorder
Causes of Kyphosis WTVR
● Congenital kyphosis
● Poor posture or slouching - ME
● Scheurmann’s disease - causes vertebrae to be misshapen
● Spina bifida - common in infants due to folate deficiency.
● Spine infections/spine tumors
Spine Curvature Disorder
Causes of scoliosis
● Hereditary
● Injury/infection (too much usage and compression)
Types of Braces
(Boston Overlap Braces or Thoracolumbar Sacral Orthosis [TLSO])
○ Are form-fitting plastic braces
○ Limits 50% of the motion in the spine
○ Heavy and hot, uncomfortable
Rigid braces
Types of Braces
○ Work by limiting motion and acting as a reminder to use proper body posture when lifting
○ May not be able to breathe as deeply with brace on
Corset braces
Instruments such as hooks, rods, and wire are attached to the spine to realign the bones.
Spinal instrumentation
Degenerated discs in the spine are replaced with artificial devices.
Artificial disc replacement
A balloon is inserted inside the spine to straighten and stabilize the affected area and relieve pain.
Kyphoplasty
Acute Low Back Pain
caused by a sudden injury to the muscles and ligaments supporting the back.
Acute Low Back Pain
Acute Low Back Pain
Clinical Manifestations
● tingling or burning sensation, dull achy, or sharp
● weakness of legs or feet.
● pain mild or severe
● pain in your leg, hip, or bottom of foot
● Acute back pain is back pain lasting fewer than 3 months and chronic back pain is back pain lasting 3 months or longer without treatment (Brunner &
Suddarth, 2018).
● The patient may report pain radiating down the leg known as radiculopathy (pain radiating from a diseased spinal nerve root) or sciatica (pain radiating from inflamed sciatic nerve) (Brunner &
Suddarth, 2018).
Acute Low Back Pain
Diagnosis
● Physical examination
● X-ray
● CT scan of the lower spine
● MRI of the lower spine
Acute Low Back Pain
Management
● Heat or ice (ice for the first 48-72 hours, then use heat)
● Ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
● Curled-up, fetal position with a pillow between leg if sleeping.
● Pillow or rolled towel under when sleeping on back
● Stretching and strengthening exercise
I LOVE YOU BOO!
I believe in you, my future topnotcher! MWAAA!
