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NPTAE Musculoskeletal > Musculoskeletal Pathologies > Flashcards

Musculoskeletal Pathologies Flashcards

1
Q

Adhesive Capsulitis Etiology

A

onset related to direct injury of shoulder/begin insidiously. Most prevalent in females 40 to 60 yrs, pts w/ diabetes. Self-limiting, resolves in 1 to 2 years, some pts have residual loss of motion

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2
Q

ACL Sprain Etiology

A

Noncontact twisting injury W/hyperextension, varus/valgus stress to knee. Usually includes injury to other knee structures, medial capsule, MCL, menisci

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3
Q

Congenital Torticollis Etiology

A

unilateral contracture of sternocleidomastoid, seen 0-2 mos old
etiology unknown, associated w/ malpositioning in utero, birth trauma

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4
Q

Glenohumeral instability Etiology

A

Combination of forces stress anterior capsule, glenohumeral ligament, rotator cuff = humerus moves interiorly out of glenoid fossa. Anterior dislocation most common, associated with shoulder ABD & lat rotation

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5
Q

Juvenile Rheumatoid Arthritis Etiology

A

unknown, theorized that external source = virus/ infection/ trauma triggering autoimmune response in child w/ genetic predisposition

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6
Q

Impingement Syndrome Etiology

A

humeral head & associated rotator cuff attachments migrate approximately, become impinged on undersurface of acromion & coracoacromial ligament

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7
Q

Lateral epicondylitis Etiology

A

Microtrauma to EXT carpi radialis brevis from eccentric loading. Most common 30 to 50 years old

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8
Q

MCL sprain Etiology

A

contact/noncontact, fixed-foot, external tibial rotation injury w/ valgus force
Associated w/ football, skiing, soccer

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9
Q

Meniscus tear Etiology

A

fixed foot rotation + weight bearing on the flexed knee produces compression & rotation force on meniscus

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10
Q

Osgood-Schlatter disease Etiology

A

repetitive tension to patellar tendon over tibial tuberosity in young athletes = small avulsion of tuberosity & swelling

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11
Q

Osteoarthritis Etiology

A

unknown. Appears in middle age, affects nearly all individuals by 70 yrs. More common in men than women up to 55, more common in women 55+ yrs. Risk factors = overweight, fractures/other joint injuries, occupational/athletic overuse

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12
Q

Osteogenesis imperfecta Etiology

A

connective tissue disorder that affects formation of collagen during bone development: 4 classes
genetic inheritance- types I and IV = autosomal dominant , types II and III = autosomal recessive

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13
Q

Patellofemoral syndrome Etiology

A

pain/discomfort in anterior knee a.k.a. chondromalacia patella
increased force @patellofemoral joint = repetitive over use disorder.
Factors = decreased quad strength, decreased LE flexibility, patellar instability, increased tibial torsion/femoral anteversion.
Increased risk = females, growth spurts, runners w/recently increased mileage, overweight

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14
Q

Plantar fasciitis Etiology

A

acute injury from excessive loading of foot/chronic irritation from excessive pronation. Most common 40-60 yrs

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15
Q

PCL sprain Etiology

A

most common = landing on tibia W/flexed knee/hitting dashboard in MVA w/ flexed knee. Usually involve other knee structures like ACL, MCL, LCL, menisci

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16
Q

Achilles Tendonitis Etiology

A

repetitive overload of Achilles tendon caused by changes in training intensity/faulty technique.
Activities associated = running, basketball, gymnastics, dancing

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17
Q

Rheumatoid arthritis Etiology

A

unknown. 1 to 2% of American population affected. Women affected 3X more than men, most common age onset = 40 to 60 years

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18
Q

Rotator cuff tear Etiology

A

intrinsic factors = impaired blood supply to tendon resulting in degeneration. Extrinsic factors = trauma, repetitive microtrauma, postural abnormalities

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19
Q

Scoliosis Etiology

A

idiopathic, usually diagnosed between 10-13 yrs- girls have greater risk of acquiring curve > 30 degrees

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20
Q

Total hip arthropasty Etiology

A

elective surgery to treat osteoarthritis, rheumatoid arthritis, osteomyelitis, a vascular necrosis

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21
Q

Total Knee Arthroplasty Etiology

A

elective surgery to treat osteoarthritis, osteomyelitis

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22
Q

Adhesive Capsulitis Signs/Symptoms

A

localized pain extending down arm, reported stiffness, night pain, restricted ROM in capsular pattern

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23
Q

Adhesive Capsulitis Treatment

A

increase ROM w/ Glenohumeral mobilizations, ROM exercises, palliative modalities. Avoid overstretching, elevating pain = further loss of motion.
Surgical options = subscapular nerve block, closed manipulation

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24
Q

ACL Sprain Signs/Symptoms

A

reported loud pop/feeling of knee “giving way,” “buckling,” dizziness, sweating, swelling. Use anterior drawer test, Lachman test, lateral pivot shift test to diagnose

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25
Q

ACL Sprain Treatment

A

RICE, NSAIDs, analgesics.
Conservative: LE strengthening W/emphasis on quads and hamstrings.
Surgery for complete ACL tear= intra-articular reconstruction using patellar tendon/ IT band/ hamstrings tendon.
Derotation brace for patient with ACL deficient knee, limited benefit for patient post surgery

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26
Q

Congenital Torticollis Signs/Symptoms

A

lateral cervical flexion to same side as contracture, rotation toward opposite side, facial asymmetry

27
Q

Congetinal Torticollis Treatment

A 
Conservative = emphasis on stretching, AROM, positioning, caregiver education. 
Surgical= conservative options fail, child is 1 yr+ old. Surgical release + physical therapy for ROM and proper alignment
28
Q

Glenohumeral Instability Signs/Symptoms

A

subluxation – feeling shoulder “popping” in & out, pain, paresthesia, sensation of arm feeling “dead”, positive apprehension test, capsular tenderness, swelling. Dislocation – severe pain, paresthesia, limited ROM, weakness, visible shoulder fullness, arm supported by contralateral limb

29
Q

Glenohumeral Instability Treatment

A

1st- immobilization W/sling for 3 to 6 weeks. RICE, NSAIDs. 2nd-immobilization, ROM, isometric strengthening, Progressive resistance W/emphasis on internal/external rotators +large scapular muscles

30
Q

Juvenile Rheumatoid Arthritis Signs/Symptoms

A

10 to 20% = Systemic- acute onset, high fevers, rash, enlargement of spleen & liver, inflammation of lungs & heart.
30 to 40% = Polyarticular- high female incidence, significant rheumatoid factor, arthritis in 4+ joints with symmetrical joint involvement.
40 to 60% = Oligoarticular- affects less than 5 joints w/ asymmetrical joint involvement

31
Q

Juvenile Rheumatoid Arthritis Treatment

A

relieve inflammation w/ NSAIDs, corticosteroids, anti-rheumatics, immunosuppressants
PT: passive/active ROM, positioning, splinting, endurance training, WB activity, postural training, functional mobility
Pain management: paraffin, ultrasound, warm water, cryotherapy
Surgery 2ndary to pain/contracture/irreversible joint damage

32
Q

Impingement Syndrome Signs/Symptoms

A

discomfort/mild pain deep in shoulder, pain with overhead activity, painful arc of motion (70 to 120° ABD), positive impingement sign, tenderness over the greater tuberosity & bicipital groove

33
Q

Impingement Syndrome Treatment

A

1st RICE, NSAID, activity modification.

2nd rotator cuff strengthening, scapular stability exercise, improved biomechanics

34
Q

Lateral Epicondylitis Signs/Symptoms

A

pain anterior/distal to lateral epicondyles of humerus. Pain increases w/repetition, resisted wrist extension

35
Q

Lateral Epicondylitis Treatment

A

1st RICE, NSAIDs, activity mod. 2nd PT = increase strength, flexibility, endurance of wrist EXT. Strap placed 2-3” distal to elbow can reduce muscle tension placed on at the condyle, may diminish/eliminate symptoms

36
Q

MCL Sprain Signs/Symptoms

A

knee pain, swelling, antalgic gait, decreased ROM, feeling of instability. Use valgus stress test to diagnose

37
Q

MCL Sprain Treatment

A

1st RICE, NSAIDs, analgesics
2nd conservative = decrease inflammation, protect knee joint & ligament, ROM, strengthening as tolerated.
Surgery rarely required, MCL = well vascularized

38
Q

Meniscus Tear Signs/Symptoms

A

joint line pain, swelling, catching/locking sensation. Special test = Apley’s compression test, bounce home test, McMurray test

39
Q

Meniscus Tear Treatment

A

1st RICE, NSAIDs, analgesics
2nd conservative = palliative modalities & strengthening exercise.
Surgery = partial meniscectomy – meniscal repair for active individuals.
Repairs for outer edge of meniscus due to increased vascularity

40
Q

Osgood-Schlatter Disease Signs/Symptoms

A

point tenderness over patellar tendon @ insertion on tibial tubercle, antalgic gait, pain w/increasing activity

41
Q

Osgood-Schlatter Disease Treatment

A

conservative = education, icing, flexibility, eliminating activities that place strain on patella tendon a.k.a. squatting, running, jumping

42
Q

Osteoarthritis Signs/ Symptoms

A

gradual onset of pain @ affected joint, increased pain post exercise, increased pain w/weather change, enlarged joints, crepitus, stiffness, limited ROM, Heberden’s nodes & Bouchard’s nodes.

43
Q

Osteoarthritis Treatment

A

GOAL: reduce pain, promote joint function, protect joint.
Drugs = acetaminophen, NSAIDs, corticosteroids.
PT = passive/active ROM, Hot/cold agents, pt education, strengthening, TENS, energy conservation, weight-loss, body mechanics, joint protection, bracing.
Surgery = from arthroscopic – total joint arthroplasty

44
Q

Osteogenesis Imperfecta Signs/Symptoms

A

pathological fractures, osteoporosis, hypermobile joints, bowing of long bones, weakness, scoliosis, impaired respiratory function

45
Q

Osteogenesis Imperfecta Treatment

A

begins at birth w/caregiver education on proper handling/facilitation of movement.
PT= AROM w/emphasis on symmetrical movement, positioning, functional mobility, fracture management, orthotics

46
Q

Patellofemoral Pain Syndrome Signs/ Symptoms

A

anterior knee pain, pain w/prolonged sitting, swelling, crepitus, pain w/ ascend/descend stairs

47
Q

Patellofemoral Pain Syndrome Treatment

A

depends on contributing factors.
Possible treatment = modalities to decrease inflammation/pain, increase LE flexibility, medial patella glides, biofeedback, patellar taping. LE strengthening should emphasize quads, vastus medialis oblique, minimize patellofemoral compressive force

48
Q

Plantar Fascitiis Signs/Symptoms

A

tenderness at insertion of plantar fashion, heel spur, pain that’s worse in morning/post prolonged inactivity, difficulty W/prolonged standing, pain in bare feet

49
Q

Plantar Fasciitis Treatment

A

1st RICE, NSAIDs, analgesics.
2nd Heel cup, massage w/tennis ball/rolling pin, medial longitudinal arch taping, joint mobilization.
Prevention = heel cord stretch, soft sold footwear, avoid sudden change in intensity of training, orthotics

50
Q

PCL Sprain Signs/ Symptoms

A

reported femur sliding off tibia, swelling/mild pain, patient mostly asymptomatic.
Special tests = posterior drawer test, posterior sag sign

51
Q

PCL Sprain Treatment

A

1st RICE, NSAIDs, analgesics.
2nd PT = LE strengthening, functional progression.
Surgical procedure not evolved as ACL – post op, isolated hamstring exercise avoided for 6+ weeks

52
Q

Achilles Tendonitis Signs/ Symptoms

A

aching/ burning in posterior heel, tenderness of Achilles tendon, pain w/ increased activity, swelling/ stiffness in tendon area, muscle weakness due to pain, morning stiffness

53
Q

Achilles Tendonitis Treatment

A

RICE, NSAIDs, analgesics.
Heel lift/cross training used to limit amount of tensile loading.
Prevention = heel cord stretching, use of soft-soled footwear, eccentric strengthening of gastroc/ soleus, avoid sudden changes in training intensity

54
Q

Rheumatoid arthritis Signs/Symptoms

A

onset = gradual/immediate, symmetrical involvement, pain/tenderness of affected joints, morning stiffness, warm joints, decreased appetite, malaise, increased fatigue, swan neck/boutonniere deformity, low-grade fever

55
Q

Rheumatoid Arthritis Treatment

A 
GOAL = reduce inflammation/pain, promote joint function, prevent joint destruction/deformity. 
Drugs = NSAIDs, corticosteroids for severe flareups/patient not responding to NSAIDs. 
Anti-rheumatics = slow acting, take weeks/months to be effective, can slow progression of joint destruction/deformity. 
PT = passive/active ROM, hot/cold agents, splinting, patient education, energy conservation, body mechanics, joint protection techniques
56
Q

Rotator Cuff Tear Signs/Symptoms

A

arm @ IR &ADD, point tenderness @ greater tubercle & acromion, marked limitation in shoulder flex & ABD w/upper trapezius recruitment evident, increased tone in anterior shoulder structures

57
Q

Rotator Cuff Tear Treatment

A

conservative= RICE, NSAID, analgesics.
PT= prevent adhesive capsulitis, strength and UE musculature, PROM, gradually moves to AAROM, AROM & isometrics w/surgeon approval. Return to functional activity w/dynamic overhead motion = 9 to 12 months
Surgery= arthroscopic/ mini–open W/arthroscopic assist/ traditional open approach to repair tendon.
Post op = immobilization time depends on surgeon preference, surgical procedure, & size of tear (large tear = 4 to 6 weeks)

58
Q

Scoliosis Signs/Symptoms

A

shoulder level asymmetry, with or w/out rib hump. Pain = result of abnormal forces places on body due to curve

59
Q

Scoliosis Treatment

A

determined based on magnitude of curve/ degree of progression- if no progression, no formal action.
PT = strengthening/ flexibility, shoe lifts, bracing. Orthoses for curve 25-40 degrees. Curve >40 = surgery

60
Q

Total Hip Arthroplasty Signs/Symptoms

A

prior to surgery= severe pain w/ WB, loss of mobility, failure of non-operative Tx/ previous surgery

61
Q

Total Hip Arthroplasty Treatment

A

PT= 1st, decrease inflamm/ allow for healing, adherence to Hip precautions, minimize atrophy, regain PROM.
2nd, regain strength/ endurance, attaining independence in home

62
Q

Total Knee Arthroplasty Signs/Symptoms

A

prior to surgery= severe pain w/ WB, loss of mobility, gross instability/ limited ROM, marked deformation of knee, failure of non-operative management/ pervious surgery

63
Q

Total Knee Arthroplasty Treatment

A

PT= 1st, decrease inflamm/ allow for healing, adherence to knee precautions, minimize atrophy, regain PROM (Functional ROM= 90 for ADLS, 105 for sit-stand)
2nd, regain strength/ endurance/ independence @ home

NPTAE Musculoskeletal (13 decks)

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