osteoarthritis, degenerative disc disease Flashcards

1
Q

synovial joints are composed of

A

outer fibrous capsule
interior synovial membranes
articular cartilage
synovial fluid

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2
Q

why do the bones move easily in synovial joints

A

smooth surfaces of articular cartilage and lubricating synovial fluid

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3
Q

osteoarthritis (OA)

A

degeneration of joint by aging and stress

obesity and aging are increasing incidence of OA

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4
Q

commonly affected joints by OA

A
cervical spine
L-spine
hip
knee
hand
Big toe ( 1st metatarsal phalangeal joint)
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5
Q

which joints are spared in OA?

A

wrist, elbow and ankle

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6
Q

r/f of OA

A
age (40 and up)
obesity
team sports
trauma
over use of joint
heavy occupational work
misalignment of pelvis, hip, knee, ankle
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7
Q

what causes OA?

A
stress applied to joints
breakdown of cartilage
excessive weight on healthy joints
pressure on injured joints
chronic disease
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8
Q

pathophysiology of OA

A

excessive pressure on joint wearing down cartilage and develops cysts
cysts move in cartilage destroying tissue
causing swelling
localized inflammation
osteoblasts cause bony spurs and synovial fluid leaking
loss of cartilage and narrowing of joint space
(problem with bone, cartilage, synovial fluid)

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9
Q

proteoglycans

A

chondrocytes that synthesize fluid in an effort to repair cartilage

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10
Q

localized joint inflammation is caused by

A

cytokines and mediators

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11
Q

where do osteophytes form?

A

at the margin of cartilage loss

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12
Q

what are osteophytes?

A

small bony projections that develop along the rim of bone adjacent to cartilage loss

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13
Q

what is an important hallmark of OA?

A

osteophytes

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14
Q

symptoms of OA

A
deep, achy joint with movement and weight bearing, relieved with rest
worse during cold weather 
stiff in morning
crepitus in afternoon
joint swelling
altered gait
limited ROM
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15
Q

OA physical exam

A
joint deformity, tenderness
decreased ROM
fingers
herbedens nodes
bourchards nodes
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16
Q

herbeden’s nodes

A

swelling at distal interphalangeal joint (DIP)

1st knuckle

17
Q

Bouchards nodes

A

swelling at interphalangeal joint (PIP)

2nd knuckle

18
Q

OA treatment goals

A

manage pain
maintain mobility
minimize disability

19
Q

OA pharmacology for mild-mod pain

A

acetaminophen
topical capsaicin
NSAIDS

20
Q

OA pharmacology for mod-severe pain

A
NSAID ( RX strength)
Nsaids + colchicine
NSAID + tramadol
opioids
steroid injections
21
Q

how do NSAIDS work?

A

reduce the production of prostaglandins

22
Q

what are prostaglandins?

A

promote inflammation, pain and fever

23
Q

glucosamine sulfate

A

OA dietary supplement
naturally occurs in body
maintains cartilage health
decrease amounts with age

24
Q

chondroitin sulfate

A

naturally occurring chemical in cartilage

can slow down cartilage breakdown

25
Q

DDD is a common cause of

A

pain, motor weakness, neuropathy

most often occurs in L and C spine

26
Q

what is DDD

A

intravertebral disc compression
with age discs dehydrate, bones become compressed, impinging the entering and exiting nerves
impedes movement and sensation in the extremities
may see weakness and paresthesia

27
Q

Lumbar symptoms of DDD

A

low back pain, sciatica
pain in butt and thigh
pain worse with sitting, bending, lifting, or twisting
pain eases with walking, position changes, lying down
numbness, tingling, weakness in legs
foot drop

28
Q

cervical symptoms of DDD

A

chronic neck pain

radiates to shoulders, down arms