Musculoskeletal IV- Pathologies Flashcards
1
Q
Achilles tendonitis snapshot
A
- repetitive overuse disorder resulting in microscopic tears of collagen fibers on the surface or in the substance of the achilles tendon
- tendon most often impacted in an avascular zone located two to six centimeters above the insertion of the tendon
2
Q
Achilles tendonitis etiology
A
- overload of tendon often caused by changes in training intensity or faulty technique
- limited flaxibility and strength in gastroc and soleus complex and/or pronated or cavus foot are at increased risk
- activities fx associated- running, basketball, gymnastics, and dancing
- history of increased chance of tendon rupture later in life
3
Q
Achilles tendonitis s/s
A
- aching or burning in the posterior heel, tenderness of achilles tendon, pain with increased activity, swelling and thickening in the tendon area, muscle weakness due to pain, morning stiffness
4
Q
Achilles tendonitis tx
A
- Initially RICE, and anagesics as needed
- heel lift and cross training may be used to limit the amount of tensile loading through the tendon
- prevention includes heel cord stretching, use of appropriate solft soled footwear, eccentric strengthening or gastroc and soleus, and avoid sudden changes to exercise intensity
5
Q
Adhesive capsulitis snapshot
A
- results in loss of ROM in active and passive shoulder motion due to soft tissue contracture
- condition causes by adhesive fibrosis and scarring between the capsule, rotator cuff, subacromial bursa, and deltoid
6
Q
Adhesive capsulitis etiology
A
- onset may be related to a direct injury to the shoulder or may begin insidiously
- peak incidence occurs in individuals between 40 and 60 years of age with females more affected than males
- increased risk with diabetes
- self-limiting and typically resolves in 1-2 years
7
Q
Adhesive capsulitis s/s
A
- incidious onset of localized pain often extending down the arm, subjective reports of stiffness, night pain, restricted ROM in a capsular pattern
8
Q
Adhesive capsulitis tx
A
- focus of treatment is increasing ROM with glenohumeral mobilization, range of motion exercises, and palliative modalities
- avoid overstretching and elevating pain since can result in further loss of motion
- can have suprascapular nerve block and closed manipulation under anasthesia
9
Q
ACL sprain snapshot
A
- ACL runs from anterior intercondylar area of the tibia to the medial aspect of the lateral femoral condyle in the intercondylar notch
- ligament prevents anterior displacement of the tibia in relation to the femur
- the extent of he sprain is classified according to extent of ligament damage
- grade 1=microscopic tears
- grade 3=completely torn
10
Q
ACL etiology
A
- noncontact twisting injury
- associated with hyperextension, varus or valgus stress to the knee
- ACL sprain often invoves injury to other knee structures such as medial capsule, MCL, and menisci
11
Q
ACL s/s
A
- patient may report a loud pop or feeling the knee “giving way” or “buckling” followed by dizziness, sweating, and swelling
- ST- anterior drawer, lachman, lateral pivot shift
12
Q
ACL tx
A
- Initially RICE, NSAIDs, and analgesics as needed
- Conservative includes:
- LE strengthening emphasizing quads and hamstrings.
- Surgery often warranted for complete ACL tear (grade III)
- intra articular reconstruction using patellar tendon, iliotibial band, or hamstring tendon
13
Q
Congenital hip dysplasia snapshot
A
- AKA developmental dysplasia
- condition characterized by malalginment of the femoral head within the acetabulum
- develops during late trimester in utero
14
Q
Congenital hip dysplasia etiology
A
- cultural predisposition, malposition of utero, environmental and genetic influences
15
Q
Congenital hip dysplasia s/s
A
- clinical presentation includes
- asymmetrical hip abduction with tightness and apparent femoral shortening of the involved side
- testing for this condition may include the Ortolani’s test, Barlo’s test, and Diagnostic ultrasound
16
Q
Congenital hip dysplasia tx
A
- focus of treatment is dependent on age, severity, and initial attempts to reposition the femoral head within the acetabulum through the constant use of a harness, bracing, splinting or traction
- PT may be indicated after cast removal for stretching, strengthening, and caregiver education
17
Q
Congenital limb deficiencies snapshot
A
- malformation that occurs in utero, secondary to an altered developmental course
- classified as longitudinal or transverse
- longitudinal refers to a reduction or absence of an element or elements within the long axis of the bone
- transverse limb deficiency refers to a limb that has developed to a particular level beyond which no skeletal elements exist
18
Q
Congenital limb deficiencies etiology
A
- majority ae idiopathic or are genetic in origin
- others include poor blood supply, constricting amniotic bands, infection, and maternal drug exposure
19
Q
Congenital limb deficiencies s/s
A
- structural or acquired abnormality of a limb, phantom limb pain
20
Q
Congenital limb deficiencies tx
A
the focus of treatment is on symmetrical movements, strengthening, range of motion, weight bearing activities, and prosthetic training when appropriate
21
Q
Congenital torticollis snapshot
A
- “wry neck”
- chracterized by unilateral contacture of the SCM muscle
- condition is most often identified in the first two months of life
22
Q
Congenital torticollis etiology
A
- cause is unknown
- may be associated with malpositioning in utero and birth trauma
23
Q
Congenital tortocollis s/s
A
- lateral cervical flexion to the same side as the contracture, rotation toward the opposite side, and facial asymmetries
24
Q
Congenital torticollis tx
A
- initially, conservative tx with emphasis on stretching, AROM, positioning, and caregive education
25
Q
Glenohumeral instability snapshot
A
- refers to excessive translation of the humeral head on the glenoid during active rotation
- involved varying degrees of injuries to dynamic and static structures that function to contain the humeral head in the glenoid
- subluxation refers to joint laxity, allowing more than 50% of the humeral head to passively translate over the glenoid rim without dislocation
- dislocation is complete seperation of the articular surfaces of the glenoid and the humeral head
- approx 85% of disocations detach the glenoid labrum (ie Bankart lesion)
26
Q
Glenohumeral instability etiology
A
- combination of forces stress the anterior capsule, GH ligament, and RC, causing the humerus to move anteriorly out of the glenoid fossa
- ant disloc is the most common and usually assoc with shoulder ABD and ER
27
Q
Glenohumeral instability s/s
A
- subluxation-
- feeling the shoulder “popping” out and back into place, pain, paresthesias, sensation of the arm feeling “dead”, positive apprehension test, capsular tenderness, swelling
- dislocation-
- severe pain, parethesias, limited ROM, weakness, visible shoulder fullness, arm supported by contralateral limb
28
Q
Glenohumeral instability tx
A
- initial mobilization with a sling for 3-6 weeks
- RICE and NSAIDs often in early phase
- following immob, ROM and isometric strengthening should be initiated followed by progressive resistive exercises emphasizing the IR and ER as well as large scap muscles
29
Q
Impingement syndrome snapshot
A
30
Q
Impingement syndrome etiology
A
31
Q
Impingement syndrome s/s
A
32
Q
Impingement syndrome tx
A
33
Q
Juvenile RA snapshot
A
34
Q
Juvenile RA etiology
A
35
Q
Juvenile RA s/s
A
36
Q
Juvenile RA tx
A
37
Q
Lateral epicondylitis snapshot
A
38
Q
Lateral epicondylitis etiology
A
39
Q
Lateral epicondylitis s/s
A
