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MedPsych Exam 3 > Osteoarthritis > Flashcards

Osteoarthritis Flashcards

1
Q

what is arthritis?

A

inflammation of one or more joints

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2
Q

what does arthritis cause?

A

Pain
Swelling
Stiffness
Limited movement

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3
Q

what type of arthritis is Osteoarthritis?

A

Degenerative Joint Disease

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4
Q

why are ends of bones free to move in synovial joints?

A

b/c no connective tissue directly connects adjacent bony surfaces

Bones are INDIRECTLY connected by the JOINT CAPSULE that encloses joint

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5
Q

what are the features of a synovial joint?

A 
2 layered joint capsule
Joint cavity enclosed by capsule
Synovial TISSUE lines inner surface of capsule
Synovial FLUID over joint surfaces
Hyaline cartilage covers bone ends
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6
Q

what are the roles of ligaments and tendons?

A

Keep joints together, guide motion

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7
Q

what limits excessive joint separation?

A

PASSIVE TENSION of Ligaments, Fiborous capsule, Tendons (passive stability)

ACTIVE TENSION Provided by muscles (dynamic stability)

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8
Q

what are the “A-B-C’s” of synovial joint x-rays?

A 
A = Alignment according to normal anatomy
B = Bone Density should be opaque/solid whitenot spotty
C= Cartilage (space btwn bones is even)
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9
Q

how is osteoarthritis initiated?

A

local deterioration of cartilage and is characterized by progressive degeneration of the cartilage, hypertrophy & remodeling of sub- chondral bone with a secondary inflammation of the synovial membrane

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10
Q

what are incidence types of OA?

A

Primary (Idiopathic, genetic)

Secondary (due to injury)

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11
Q

what are OA risk factors?

A 
Increasing age
Genetics
Obesity 
Repetitive Stress
Occupation
Sports Injury
Crystalline deposit disease 
Previous inflammatory disease
Metabolic abnormalities
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12
Q

what are the modifiable risk factors of OA?

A

Excess body weight
Joint injury
Occupation
Structural mal-alignment or muscle weakness

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13
Q

what are the non-modifiable risk factors of OA?

A

Gender (women)
Age (older)
Race (non-Asian)
Genetic predisposition

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14
Q

what are causes of primary development of OA?

A

Excessive load on normal bone, cartilage

Normal aging resulting from metabolic, genetic, chemical & mechanical factors

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15
Q

what are causes of secondary development of OA?

A

Load on joint that is inferior or previously injured

Follows identifiable pre-disposing event (Trauma, Congenital deformity, Obesity)

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16
Q

why are older people likely to develop OA?

A

Cartilage has a very limited ability to regenerate, therefore degeneration process is irreversible & progressive

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17
Q

What is the order of affected structures in OA?

A

cartilage—>subchondral bone—>soft tissues

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18
Q

how does cartilage wear down?

A

Matrix of cartilage lessen with age

As matrix deteriorates, collagen fibers become shredded

Result: collagen is less effective shock absorber and lubricated surface

19
Q

what % of people over age of 50 demonstrate OA?

A

80%

20
Q

what are signs and symptoms of degenerative joint disease?

A

achy joint pain exacerbated by extensive use
Aggravated by movement (friction effect) –>Reduced ROM & crepitus
Stiffness during rest (articular gelling)
pain on rest
Tenderness

21
Q

what is crepitus?

A

ROM no longer smooth: squeaking, creaking, grating
Joint stiffness after period of rest: “articular gelling”
As ROM decreases so does pain but will lead to stiff joints

22
Q

what is swelling?

A

Moderate joint effusion but little synovial swelling

23
Q

what are examples of swelling?

A

Heberdon’s nodes on DIP joints

Bouchard’s nodes on PIP joints

24
Q

who is more likely to exhibit heberdon’s nodes?

A

women

25
Q

what joints are most commonly involved in OA?

A 
Hand (PIP & DIP joints not MCP)
Thumb
CMC joint
Hip 
Knee 
Spine
26
Q

what OA signs could be seen on a radiograph?

A

Narrowing of joint space
Subchondral sclerosis and cysts
Osteophyte formation
Joint remodeling and incongruity

27
Q

what OA signs could be seen on a lab test?

A

Usually no significant findings as this is non- systemic process (only rule out other arthritis + increased mucin)

28
Q

what are signs of advanced OA?

A

Severe loss of cartilage in the knee joints cause knees to curve out, creating a bow-legged appearance
Bony spurs along spine can irritate nerves, leading to pain, numbness, tingling

29
Q

What kind of OA affects primarily men?

A

spondylitis

30
Q

what is the progression of OA?

A

Primary: unable to determine
Secondary: will continue unless underlying cause is found, corrected

31
Q

what is the prognosis of OA?

A

If pt continues to use severely involved joint = progressive deterioration

If DJD effects weight bearing joints, prognosis bad, may lead to severe disability

32
Q

what are goals of OA tx?

A 
Relive pain & other symptoms
Educate pt, family, caregivers 
Provide psychological support
Prevent or correct existing deformity
Maintain/improve fx
Rehab
33
Q

what are examples of drugs to tx OA?

A 
Simple analgesics (Acetaminophen)
Non-steroidal Anti-Inflammatory (Ibuprofen)
34
Q

what are non-drug txs of OA?

A

Orthopedic appliances
OT PT
Surgery

35
Q

what are OT goals in OA tx?

A

Improve functional independence using Assistive equipment, Work simplification, Energy conservation and reduce pain

36
Q

how do OT’s maintain, increase strength?

A

Isometric exercise program

ROM daily

37
Q

what is an arthroplasty?

A

Total or partial replacement of deteriorated part of joint with prosthetic appliance

38
Q

what is an arthodesis?

A

Surgical bony fusion (usually spine)

39
Q

what is an osteoplasty?

A

Scraping & lavage of deteriorated

bone from joint

40
Q

what is an osteotomy?

A

Change of alignment of bone to relieve stress by excision of wedge of bone or cutting bone (usually lower leg)

41
Q

who is surgery reserved for?

A

patients who have severe disability or uncontrollable pain

42
Q

what does hip osteoarthritis look like?

A

Narrow joint space
Bony spurs
Sclerotic/whiter bone (bone density changes)

43
Q

what does a hip replacement look like?

A

2 parts to replacement: femoral head and acetabular piece

MedPsych Exam 3 (7 decks)

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