Pathologies Related to the Pelvis and Hip Flashcards
function of colon and rectum
colon = dehydrate food and form into stool; bacteria feed on waste and break down further
rectum = stool stored prior to bowel movement
incidence/prevalence of colorectal cancer
3rd most common cancer
2nd leading cause of cancer death
most commonly metastasizes to thorax
risk factors for colorectal cancer
> 50
family hx
male
IBS
obesity
smoking/alcohol
diets low in veggies and high in sugar and animal fat
pathogenesis of colorectal cancer
malignant neoplasm that develops in large intestines
possible Hx for colorectal cancer
cancer S&S
possible referred pain that is dull/diffuses to L lower quadrant (T10-S2)
change in bowel/bladder function; possible obstruction
bloody (hallmark) or black stool
observation for colorectal cancer
wavelike motion in lower L quadrant if obstructed
lymph node findings for cancer
abnormal
> 2cm
firm/immobile
Non tender
signs that you may find with colorectal cancer
pain with palpation and percussion in lower left quadrant with inflammation
vital signs = fever
PT implications for colorectal pain
ensure routine screening i.e. colonoscopy beginning at 45
exercise helps bowel function and transit time
urgent referral to MD
function of cervix
sex cell motility
protect from bacteria/foreign objects
path for birthing
risk factors and etiology for cervical cancer
human papillomavirus (HPV) is primary risk factor
drug and alcohol use that inhibits judgement
> 5 sexual partners
has become very preventable
incidence/prevalence for cervical cancer
3rd most common female cancer behind breast and colorectal
increasing in younger females
how does HPV create a pathogenesis for cervical cancer
HPV limits neoplasm surpressors in cervix and allows malignant neoplasm to develop
Hx possible for cervical cancer
cancer S&S
pelvic/LBP
excessive and untimely bleeding
bowel/bladder and or sexual function due to pressure from enlarged cervix
PT implications if cervical cancer is suspected
ensure regular OB/GYN visits
HPV vaccine at 11-12; less effective after sexual activity
radiation decreases estrogen so decreased bone density may be a side effect; think about bony ramifications and diseases
URGENT REFERRAL
what is a chondrosarcoma (etiology, common locations and populations)
slow growing malignant neoplasm
sporadic and unkown etiology
common in pelvis/femur
middle aged males most affected
what happens with a chondrosarcoma
thickening of the cortex
destruction of the medullary and cortical bone
soft tissue mass
pathogenesis: chromosomal abnormalities lead to malignant cartilage neoplasm and possible bony changes
possible Hx for chondrosarcoma
progressive/localized pain and swelling
cancer S&S
possible fx S&S if advanced
exam findings for chondrosarcoma
potential mechanical symptoms because of space occupying potential but it wont match orthopedic conditions
possible sign of the buttock
palpation of lymph nodes like cancer
fever
referral for chondrosarcoma
urgent
incidence/prevalence of appendicitis
most common in late adolescence
males > females
rare in older adults but half of all deaths due to rupture are those > 70
etiology 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
Hx for appendicitis
classic sequence:
-periumbilical to R lower quadrant pelvic pain
-may also have R hip or groin P!
-not eating
-possible infection or cancer S&S
worse with increased abdominal pressure:
-fwd bending or knees to chest
-valsalva maneuver (i.e. coughing, laughing)
observation with appendicitis
redness and swelling/hot with infection in R lower quad
ROM findings for appendicitis
pain and limitations with hip and trunk flexion at end ranges
palpation findings for appendicitis
> 2cm
firm
tender if infection is acute
non tender/immobile if cancer
appendicitis referral
urgent unless severe pain then emergent
overview/pathogenesis of inguinal hernia
congenital or aquired weakness/tearing int eh abdominal organ covering that allows portions of organs to move out of their boundary or herniate
etiology of inguinal hernia
age
obesity/pregnancy
abdominal muscular weakness
trauma like sx/heavy lifting
incidence/prevalence of inguinal hernia
most common type of hernia
75% of all hernias
can occur at any age
Hx for inguinal hernia
painless and small at first
progressively bulges and becomes painful in groin area
worse with increased abdominal pressure
burning/pinching
may radiate into thigh/pelvic midline
S&S for inguinal hernia
herniating organ may become resitricted and dysfunctional and may develop into systemic S&S of the respective organ that is herniated
ROM = pain with hip/trunk flexion at end range
pain with palpation and percussion in lower quads; palpable bulge especially with activity
referral for inguinal hernia
urgent
what is septic or infective arthritis
active local infection on a weakened or compromised joint at site of primary infection
risk factors/etiology of septic or infective arthritis
penetrating trauma
total joint replacement
chronic joint damage
diabetes
immunosuppression
infectious disease
substance abuse
sickle cell disease
renal failure affects immunity
incidence of septic or infective arthritis
most common in LE joints, particularly hip and knee
infants, children, and older adults at increased risk
pathogenesis of septic arthritis
microorganizsm invasion that could be bacterial. viral, or fungal
multiplies rapidly due to weakened/compromised joint health and moist nature of synovial fluid of joint
bacteria activates clotting factors that may lead to thrombosis
massive inflammation or pannus erods articular cartilage and subchondral bone in a few weeks
Hx and observation for septic arthritis
acute/sudden onset of infection and antalgic and asymmetrical gait
other infection S&S
scan findings for septic arthritis
refusal to move or allow affected joint to be moved so pain and limited ROM and weakness in multiple/all directions
possible sign of buttock
palpation for septic arthritis
severe TTP
abnormal lymph nodes (firm and tender)
heat
swelling
referral for septic arthritis
emergency
early dx is critical to avoid permanent joint and bone damage
treatment within 4 days of infection can prevent damage
