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Ortho 1 > ortho 1 Test 1 > Flashcards

ortho 1 Test 1 Flashcards

1
Q

Synarthroses

A

bones in direct contact not separated by snyovial cavity and immovably connected.
ex bones of cranium and face

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2
Q

Amphiarthroses

A

bones connected by broad flattened discs of fibrocartilage

ex intervertebral joints

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3
Q

Diarthroses

A

two bones covered in cartilage, connected by ligaments and having a synovial sac

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4
Q

Synovial joint features

A
  1. Ends of articulating bones covered in hyaline cartilage
  2. Joint space is enclosed in a capsule, reinforced by ligaments
  3. Synovial membrane present on inside of capsule
  4. Synovial fluid, produced by synovial membrane
  5. LPP- point where articular surfaces are least congruent and the most amount of joint play possible. Opposite: CPP
  6. Menisci- only present at certain synovial joints.
    ex: TMJ, tibiofemoral, SC joint
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5
Q

Generalized Hypermobility

A

test is called the Beighton Scale; out of 9 points

ex. Eherlos Danlos Syndrome

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6
Q

Local hypermobility

A

due to a capsuloligamentous injury

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7
Q

5 factors that keep joint stable

A
  1. Joint geometry
  2. Passive Restraints
  3. Active restraints
  4. Negative intra-articular pressure
  5. Loads
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8
Q

Functional instability

A

subjective reporting that joint “gives way” during ADLs, recreation activity or sport

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9
Q

Mechanical Instability

A

Excessive joint mobility detected as part of the physical examination during passive mobility.
usually due to capsuloligamentous injury

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10
Q

Acute injury

A

Usually macrotraumatic, sudden onset injury.

Ex, fractures, contusion, sprains/strains, dislocations/subluxations, hemarthrosis.

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11
Q

Chronic injury

A

usually microtraumatic, gradual onset from overuse.

ex: Tendonitis, tenosynovitis, tendonosis, stress fracture,

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12
Q

5 contributing factors of microtraumatic injury

A
  1. Training error
  2. Weakness/ poor endurance
  3. Tightness
  4. Poor equipment
  5. Faulty technique
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13
Q

Ligaments

A

dense regular connective tissue, made of mostly collagen and some elastin.
have poor blood supply and good nerve supply
passive joint stabilizers, guide arthrokinematics, provide afferent information

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14
Q

Types of osteoarthritis

A
  1. Primary- no known cause
    A- Localized - affecting only one join
    B- Generalized- OA in 3-4 joints (common in post menopausal women)
  2. Secondary- has an identified underlying cause ex obesity, trauma
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15
Q

Clinical features of OA

A

patients over 50,
pain and stiffness local to affected joint
morning stiffness less than 30 min
systemic symptoms are absent
joint tenderness and crepitus with movement
osteophyte and swelling may be present

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16
Q

Osteoarthritis general info

A

aka Degenerative joint disease(DJD), chronic degenerative disorder characterized by loss of articular cartilage
usually affects hip and knee, Lumbar spine or DIP and lower cervical spine

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17
Q

Risk factors of OA

A

age- chances increase with age
trauma- damage to ligaments, menisci or articular surfaces increases chance of OA
Exercise
Age- under 50 more men, 50-80 more women, after genders are equally effected
Ethnicity- more in european and americans than asians
Genetics
Obesity- most modifiable factor
Diet- Excessive vitamin C and deficient in Vitamin D may increase chances of OA
Bone density- Patients w OA have higher bone density bc of osteophyte formation

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18
Q

Imaging OA

A

Radiographs are gold standard
Look for 1.Joint space narrowing
2. osteophyte formation in late stages
3. bone cysts- fluid filled sac that extrudes from the joint
4. Subchondral sclerosis- thickening of subchondral bone

19
Q

Interventions for OA

A
  1. Patient education
  2. Aerobic and anaerobic exercise- usually non impact
  3. Weight loss
  4. Physical therapy
  5. Appliances- braces, foot orthotics
  6. Assistive devices- cane or walker
20
Q

Drugs for OA

A
  1. NSAIDS
  2. Hyaluronic Acid- injected into joint to increase viscoelasticity of synovial fluid
  3. Capsaicin cream- helps w substance P
  4. Glucosamine Sulphate- contain glycosaminoglycans that are found in articular cartilage
21
Q

Surgical options for OA

A
  1. Debridement- clean out the joint
  2. Chondroplasty- reshaping condyles
  3. Osteomy- realignment of the bones
  4. Athrodesis- fusion of a joint
  5. Athroplasty- joint replacement
  6. Uni spacer- for medial compartment of tibio-femoral joint
22
Q

Rhuematoid arthritis general info

A

Chronic disease characterized by inflammation of synovium
about 1% of US population has RA
70% are women, onset is usually betw 30-50 years
characterized by periods of exacerbation and remission, duration of periods are highly variable

23
Q

Cause of RA

A

likely multifactorial, theories include genetics or infection
RA is considered an autoimmune disease bc cells from one’s own body attack other cells

24
Q

Stages of RA

A
  1. Swelling of synovial lining. causes joint to be red, stiff, painful, warm,and swolen
  2. Pannus formation- rapid division and growth of synovial cells or pannus, causes synovium to thicken. may grow and cover the articular cartilage which could lead to death of cartilage
  3. Erosion- the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment
25
Q

Common joints of RA

A

Can be in any joint
Most common in smaller joints of fingers and wrists, usually is bilateral. Most common joints: MCP, wrist, PIP, knee, MTP, shoulder, ankle, cervical spine, hip, elbow, and TMJ

26
Q

Symptoms of RA

A
  1. Symmetrical painful swelling usually starting in hands
  2. stiffness over an hour
  3. Rhuematoid nodules in 20%, can be movable or attached to tendons in fingers, hands, knuckles
  4. Flu like symptoms- fatigue, weakness, fever, loss of appetite
    Patients are prone to Sjogren’s syndome- disorder of immune system w dry eyes and mouth
27
Q

4/7 criteria must be met for at least 6 weeks to diagnose RA

A
  1. Morning stiffness at least an hour
  2. at least 3 joints simultaneously having swelling
  3. Swelling in the wrist, MCP or PIP
  4. Symmetrical arthritis
  5. Rheumatoid nodules
  6. Serum rheumatoid factor
  7. Radiographic changes including erosion in hand or wrist
28
Q

Lab test for RA

A
  1. Complete blood count- people w RA often have low red blood cell count - Anemia
  2. Erythrocyte Sedimentation Rate- speed at which RBCs fall to bottom of test tube. The faster the rate the more severe the RA.
  3. C reactive protein- elevated when infection in the body.
  4. Rheumatoid factor- 70-80% of people with RA test positive.
29
Q

RA imaging

A
  1. Xrays- good baseline for comparison with later xrays after disease has progressed.
  2. MRI good at seeing synovitis
  3. Joint ultrasound- joint inflammation
  4. Bone Densitometry (DEXA)- detects osteoporosis.
30
Q

Treating RA

A

tailored to the individual.
Medication: NSAIDs, glucocoticoids, antirhuematic drugs
discontinuing activities when discomfort/fatigue occurs. use frequent but short bursts of exercise.

31
Q

Strain

A

tearing of muscle tissue

32
Q

Degrees of strain

A

1st- minor swelling, little loss in strength and function
2nd- moderate pain and swelling, decreased strength, defect may be plapable, unable to function
3rd- severe pain/swelling, unable to continue. need surgery to repair tissue

33
Q

Strains most often occur

A
  1. muscle is in a lengthened position
  2. during an eccentric contraction
  3. primarily comprised of Type II fibers
34
Q

Contusion

A

a hematoma caused by the breaking of blood vessels from trauma to the muscle.

35
Q

Myositis Ossificans

A

abnormal formation of bone within the muscle. passive ROM is contraindicated, only active or active assisted ROM.

36
Q

Compartment Syndrome

A

Acute- following contusion of muscle the pressure in a compartment rises, if it exceeds the pressure of the venous and arterial supply a fasciotomy is required
Chronic- aka Chronic exertional compartment syndrome. pressure increases with exercise

37
Q

Delayed onset muscle soreness DOMS

A

soreness after exercising in a way that we are not used to. eccentric motions are responsible for damaging the sarcomeres. generally peaks 36 hours after activity. most effective treatment is gentle exercise

38
Q

Epineurium

A

coat of connective tissue (collagen) surrounding the entire nerve

39
Q

Perineurium

A

collagen surrounding each fasicle

40
Q

Endoneurium

A

coat around individual axons

41
Q

Neuropraxia

A 
nerve damage without any anatomical discontinuity
usually a compression injury
local conduction block & demyelination
thick myelinated nerves most affected
resolves itself in weeks
42
Q

Axonotmesis

A

microscopic division of nerve fibers without obvious discontinuity of the nerve sheath
usually a traction injury, could be severe compression
Wallerian degeneration occurs
worse with proximal injuries, limiting factor is distance of regeneration required

43
Q

Neurotmesis

A

complete severance of the nerve trunk

no recovery unless repair undertaken

Ortho 1 (1 decks)

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