pathologies related to pelvis & hip II - exam 2 Flashcards
what does the colon do?
dehydrate food and form it into stool
bacteria feed on waste and break it down further
what does the rectum do?
stool stored prior to a bowel movement
colorectal cancer is the ___ most common cancer
it is the ____ leading cause of cancer death
most commonly metastasizes to the _____
3rd
2nd
thorax
what is the cause of colorectal cancer?
unknown
what are risk factors for colorectal cancer?
> 50
family hx
male
IBS
obesity
smoking/alcohol use
diets low in veggies and high in sugar and animal fats (SAD diet)
pathogenesis of colorectal cancer
malignant neoplasm that develops in the large intestines
S&S of colorectal cancer
cancer S&S
possible referred P! that is dull and diffuse to left lower quadrant in T10-S2 distribution
change in bowel function, even obstruction
bloody (hallmark sign) or black stools
wavelike motion in lower left quadrant if obstruction
fever (check vitals)
what would you feel with palpation of lymph nodes in someone with colorectal cancer?
> 2 cm, firm, immobile
non-tender due to limited inflammation with typical slow growth of MOST cancer
P! w palpation and percussion in lower left quadrant with inflammation
what are PT implications of colorectal cancer?
ensure routine screening (colonoscopy beginning at 45 years old)
exercise helps bowel function and transit time
what referral for colorectal cancer?
urgent
what is the function of the cervix?
sex cell motility
protection from bacteria and foreign objects
path for birthing
true or false. cervical cancer is largely preventable
true
what are risk factors/causes of cervical cancer?
HPV (PRIMARY risk factor)
drug and alcohol use that inhibits judgement
> 5 sexual partners
what is the 3rd most common female cancer behind breast and colorectal?
cervical cancer
pathogenesis of cervical cancer
HPV limits neoplasm suppressors in the cervix and allows malignant neoplasm to develop
S&S of cervical cancer
cancer S&S
pelvic or LBP
excessive and untimely bleeding
bowel/bladder and/or sexual dysfunction due to pressure from enlarged cervix
fever (check vitals)
what would you feel with palpation of lymph nodes with cervical cancer?
> 2 cm, firm, immobile
non-tender due to limited inflammation with typical slow growth of MOST cancer
PT implications of cervical cancer
ensure regular OB/GYN visits
HPV vaccine at 11-12 years of age
radiation decreases estrogen so decreased bone density may be side effect
referral for cervical cancer
urgent
what is chondrosarcoma?
slow growing malignant neoplasm
thickening of cortex
destruction of medullary and cortical bone
soft tissue mass
what is the cause of chondrosarcoma?
sporadic and unknown
where is chondrosarcoma most common and in who?
pelvis and femur
middle aged males
pathogenesis of chondrosarcoma
chromosomal abnormalities lead to malignant cartilage neoplasm and possible bony changes
S&S of chondrosarcoma
progressive and local swelling and pain
cancer S&S
possible fracture S&S if advanced
potential mechanical symptoms because of space occupying potential but it won’t match orthopedic conditions
possible sign of buttock
palpation of lymph nodes - >2 cm, firm, immobile, nontender
fever (check vitals)
referral for chondrosarcoma
urgent
what is appendicitis
inflammation of appendix
unknown function
- possibly storehouse of good bacteria
who is more likely to get appendicitis/
most common in late adolescence
males
rare in older adults but half of all deaths due to rupture are in those > 70 years old
cause of appendicitis?
unknown in 50% of cases
obstruction due to neoplasm, infection, foreign body preventing normal drainage
pathogenesis of appendicitis?
inflammation that can result in infection, necrosis and rupture
what is the classic sequence of someone who has appendicitis?
periumbilical to right lower quadrant pelvic P!
may also have right hip or groin pain
not eating
possible infection or cancer S&S
what makes symptoms of appendicitis worse?
increased abdominal pressure
- forward bending or knees to chest
- valsalva maneuver (coughing, laughing, straining)
what would you find in your scan/biomechanical exam of someone with appendicitis?
- observation
- ROM
- palpation
- abdominal quadrant assessment
- vitals
- redness and swelling with infection
- P! and limitation with hip and trunk flexion at end ranges
- lymph nodes
–> if infection due to acute onset: > 2 cm, firm, tender
–> if cancer: > 2 cm, firm, immobile, non tender - tenderness or “pinch an inch” at McBurney point. rebound tenderness is most accurate predictor of inflammation. hot and swollen in right lower quadrant
- fever
referral for appendicitis
urgent unless severe P! then emergent
what is an inguinal hernia?
congenital or acquired weakness/tearing in the abdominal organ covering that allows portions of organs to move out of their boundary or herniate
causes of inguinal hernia
age - can occur at any age
obesity/pregnancy
abdominal muscular weakness
trauma like surgery or heavy lifting
what is the most common type of hernia?
inguinal
S&S of inguinal hernia
painless and small at first
progressively bulges and becomes painful in groin area
worse with increased abdominal pressure (forward bending, knees to chest, valsalva maneuver)
burning or pinching sensation
may radiate into thigh or pelvic midline
- herniating organ may become constricted and dysfunctional and may develop systemic S&S of the respective organ that is herniated
what would you find in ROM and palpation with abdominal assessment in lower quadrants in someone with inguinal hernia?
ROM: P! and limitation with hip and trunk flexion at end ranges
Palpation: P! with palpation and percussion
palpable bulge, esp w trunk flexion
referral for inguinal hernia
urgent
what is septic or infective arthritis?
an active local infection on a weakened or compromised joint at the site of the primary infection
risk factors/causes of septic or infective arthritis
penetrating trauma - stabbing
total joint replacement
chronic joint damage (RA, age related jt changes)
diabetes
immunosuppression
infectious disease
substance abuse
sickle cell disease
renal failure affects immunity
where is septic or infective arthritis most common and in who is at an increased risk?
LE joints, particularly the hip and knee
infants, children, older adults
pathogenesis of septic or infective arthritis
microorganism invasion that could be bacterial, viral or fungal
multiplies rapidly due to weakened and compromised jt/health and moist nature of synovial fluid in jt
bacteria activates clotting factors that may lead to a thrombosis
massive inflammation or pannus erodes articular cartilage and subchondral bone in a few weeks
what would you see in the hx/observation of someone with septic or infective arthritis
acute and sudden onset of infection and antalgic and asymmetrical gait if they can bear weight at all
other infection S&S
what would you find in your scan of someone with septic or infective arthritis
- ROM/resisted
refusal to move or allow affected joint to be moved - P!, limited ROM, weakness in multiple if not all directions
possible sign of the buttock
what are you palpating for in someone with septic or infective arthritis?
severe TTP
abnormal lymph nodes
- > 2 cm, firm, tender due to rapid onset of inflammation with infection
heat
swelling
referral for septic or infective arthritis
- what is critical of this condition?
emergency
early dx is critical to avoid permanent joint and bone damage
treatment within 4 days of infection can prevent damage
