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CLIN MED - SPRING EXAM 2 > Pathologies Related to the Pelvis and Hip II > Flashcards

Pathologies Related to the Pelvis and Hip II Flashcards

1
Q

What does the colon do?

A
  • dehydrate food and form it into stool
  • bacteria feed on waste and break it down futher
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2
Q

What is the function of the rectum?

A

stool storage prior to bowel movement

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3
Q

What is the prevalence of colon cancer?

A
  • 3rd MOST common cancer
  • 2nd leading cause of cancer death
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4
Q

Where does colon cancer commonly metastasize?

A

to the thorax!

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5
Q

What is the etiology of colorectal cancer?

A

UNKNOWN

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6
Q

What are some risk factors for colorectal cancer?

A
  • > 50 yo
  • family hx
  • biological male
  • IBS
  • Obesity
  • smoking/alcohol use
  • diets low in veggies and high in sugar and animal fats (SAD)
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7
Q

What is the pathogenesis of colorectal cancer?

A

malignant neoplasm that develops in the large intestines

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7
Q

What will we observe with colorectal cancer?

A
  • wavelike motion in lower Left Quadrant if obstruction
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7
Q

What will we find in hx with colorectal cancer?

A
  • cancer S&S
  • possible referred pain that is dull and diffuses to lower left quadrant in T10-S2 distribution
  • change in bowel function, even obstruction
  • Bloody (black) stools (HALLMARK SIGN!)
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8
Q

What will we find with palpation with colorectal cancer?

A
  • abnormal
  • <2cm and immobile but NON-TENDER due to limited inflammation with typical slow growth of MOST cancer
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9
Q

What will be painful with palpation AND percussion with colorectal cancer?

A

the lower left quadrant with inflammation

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10
Q

What will we find with vital signs with colorectal cancer?

A

fever

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11
Q

What should we ensure a screening of BEFORE colorectal cancer? When?

A
  • routine screening (colonoscopy beginning at 45 years)
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12
Q

What helps bowel function and transit time?

A

EXERCISE

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13
Q

What kind of a referral is colorectal cancer?

A

Urgent referral to MD

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14
Q

What is the function of the cervix?

A
  • sex cell motility
  • protection from bacteria and foreign objects
  • path for birthing
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15
Q

Is cervical cancer largely preventable?

A

YES

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16
Q

What is the PRIMARY risk factor for cervical cancer?

A

Human papillomavirus (HPV)

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17
Q

What are other risk factors for cervical cancer?

A
  • drug and alcohol use that inhibits judgement
  • > 5 sexual partners
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18
Q

What is the prevalence of cervical cancer?

A

3rd MOST common biological female cancer behind breast and colorectum

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19
Q

What is the incidence of cervical cancer doing?

A

Increasing in younger females

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20
Q

What is the pathogenesis of cervical cancer?

A
  • HPV limits neoplasm suppressors in the cervix and allows malignant neoplasm to develop
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21
Q

What will we find in hx with cervical cancer?

A
  • cancer S&S
  • pelvic or LBP
  • excessive and untimely bleeding
  • bowel/bladder and/or sexual dysfunction due to pressure from enlarged cervix
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22
Q

What will we find with palpation with cervical cancer?

A
  • abnormal lymph nodes
  • > 2 cm, firm immobile but NON-tender due to limited inflammation with typical slow growth of MOST cancer
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23
Q

What will we find with vital signs with cervical cancer?

A

Fever

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24
Q

What should we ensure to PREVENT cervical cancer?

A
  • regular OB/GYN visits annually
  • HPV vaccine t 11-12 years of age (less effective after any sexual activity)
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25
Q

What effect does radiation have on bone density?

A
  • decreases estrogen so decreased bone density may be a side effect
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26
Q

What kind of referral is cervical cancer?

A

Urgent referral to MD

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27
Q

What is chondrosarcoma?

A

slow growing malignant neoplasm
- literally cartilage, cancer

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28
Q

What is the etiology of chondrosarcoma?

A

sporadic and unknown

29
Q

What body parts is chondrosarcoma more common in?

A

pelvis and femur

30
Q

What demographic does chondrosarcoma effect MOST?

A

middle aged biological males

31
Q

What is the pathogenesis of chondrosarcoma?

A
  • chromosomal abnormalities lead to malignant cartilage neoplam and possible bony changes
32
Q

What will we see on imaging (radiograph) with chondrosarcoma?

A
  • thickening of cortex
  • destruction of the medullary and cortical bone
  • soft tissue mass
33
Q

What are the ABCS of imaging?

A
  • alignment
  • bone density
  • cartilage space
  • soft tissues
34
Q

What will we find in hx with chondrosarcoma?

A
  • progressive and local swelling and pain
  • cancer S&S
  • possible fracture S&S if advanced
35
Q

What will we find in our exam with chondrosarcoma?

A
  • potential mechanical symptoms because of space occupying potential but wont match orthopedic conditions
  • possible sign of the buttock
36
Q

What will we find with palpation with chondrosarcoma?

A
  • abnormal lymph nodes
  • > 2cm, firm, immobile, NON-tender due to limited inflammation with typical slow growth of most cancer
37
Q

What will we find in vital signs with chondrosarcoma?

A

fever

38
Q

What kind of referral is chondrosarcoma?

A

urgent referral to MD

39
Q

What is the function of the appendix?

A

unknown function
- possibly a storehouse of good bacteria
- others say useless

40
Q

What is appendicitis?

A

inflammation of appendix

41
Q

What population is appendicitis MOST common in?

A

late adolescence
- males>females
- rare in older adults half of all deaths due to rupture are in those >70 yo

42
Q

What is the etiology of apendicitis?

A
  • unknown in 50% of cases
  • obstruction due to neoplasm, infection, foreign body preventing normal drainage
43
Q

What is the pathogenesis of appendicitis?

A
  • inflammation that can result in infection, necrosis and rupture
44
Q

What will we find in hx in those with appendicitis?

A
  • classic sequence
  • periumbilical to right lower quadrant pelvic pain
  • may also have right hip or groin pain
  • not eating
  • possible infection or cancer S&S
45
Q

What makes the pain worse with appendicitis?

A
  • increased abdominal pressure
  • forward bending or knees to chest
  • valsalva maneuver (coughing, laughing, straining, etc.)
46
Q

What would we observe with appendicitis?

A

redness and swelling with infection

47
Q

What would we find with ROM with appendicitis?

A

pain and limitation with hip and trunk flexion at end ranges

48
Q

What would we find with palpation with appendicitis?

A

Lymph nodes
- > 2 cm diameter firm and tender if infection due to acute onset
- >2 cm diameter, firm, immobile and nontender if cancer

49
Q

What will we find with our abdominal quadrant assessment with appendicitis?

A
  • tenderness or “pinch an inch” at McBurney point
  • rebound tenderness is the MOST accurate predictor of inflammation
  • hot and swollen in right lower quadrant
50
Q

What will we find with vital signs with appendicitis?

A

Fever

51
Q

What kind of referral is appendicitis?

A
  • urgent referral to MD unless severe pain then emergent referral
52
Q

What is an inguinal hernia?

A
  • congenital or acquired weakness/tearing in the abdominal organ covering that allows portions of organs to move out of the boundary or herniate
53
Q

What are the etiologies of inguinal hernias?

A
  • age
  • obesity/pregnancy
  • abdominal muscular weakness
  • trauma like surgery or heavy lifting
54
Q

What is the incidence/prevalence of inguinal hernias?

A
  • MOST common type of hernia (75% of all hernias)
  • occur at any age
55
Q

What will we find in history with an inguinal hernia?

A
  • painless and small at first
  • progressively bulges and becomes painful in groin area
  • more painful with increased abdominal pressure (forward bend, knees to chest, valsalva, coughing, laughing, straining, etc.)
  • burning or pinching sensation
  • may radiate to thigh or pelvic midline
56
Q

What are clinical manifestations of an inguinal hernia?

A
  • herniating organ may become constricted and dysfunctional and may develop systemic S&S of the respective organ that is herniated
57
Q

What will we find with ROM with an inguinal hernia?

A
  • Pain and limitation with abdominal or hip flexion activation
58
Q

What will we find with palpation of an inguinal hernia?

A
  • pain with palpation and percussion
  • palpable bulge, esp with trunk flexor activity like crunch, coughing, etc.
59
Q

What kind of referral is an inguinal hernia?

A

urgent referral to MD

60
Q

What is septic or infective arthritis?

A

an active local infection on a weakened or compromised joint at the site of the primary infection

61
Q

What are risk factors / etiologies for septic or infective arthritis?

A
  • penetrating trauma (stabbing)
  • total joint replacement
  • chronic joint damage (RA, age related joint changes)
  • diabetes (suppresses immune system, circulation)
  • immunosuppression
  • infectious disease
  • substance abuse
  • sickle cell disease
  • renal failure affects immunity
62
Q

Where is septic or infective arthritis MOST common in the body?

A
  • LE joints, particularly the hip and knee
63
Q

What populations are at an increased risk of septic or infective arthritis?

A

infants, children, and older adults

64
Q

What is the pathogenesis of septic or infective arthritis?

A
  • microorganism invasion that could be bacterial, viral or fungal
  • multiplies rapidly due to
    > weakened and compromised joint/health
    > moist nature of synovial fluid in the joint
  • bacteria activated clotting factors that may lead to thrombosis
65
Q

How soon can we see changes with septic or infective arthritis?

A
  • MASSIVE inflammation or pannus erodes articular cartilage and subchondral bone in a FEW WEEKS (FAST)
66
Q

What will we find in our hx with septic or infective arthritis?

A

acute and sudden onset of:
- infection S&S
- NWB

67
Q

What will we find in our observation with septic or infective arthritis?

A

acute and sudden onset of:
- antalgic and asymmetrical gait if they can bear weight at all

68
Q

What will we find in our scan with septic or infective arthritis?

A
  • refusal to move to allow affected joint to be moved- so pain, limited ROM and weaknesses in multiple if not all directions
  • possibly pain with compression and relief with distraction depending on whether bone is involved or not
  • possible sign of the buttock
69
Q

What will we find with palpation with septic or infective arthritis?

A
  • severe TTP
  • abnormal lymph nodes > 2cm diameter, firm, TENDER due to rapid onset of inflammation with infection
  • heat
  • swelling
70
Q

What kind of referral is septic or infective arthritis?

A

EMERGENCY referral

71
Q

Why is early dx of septic or infective arthritis critical?

A
  • to avoid permanent joint and bone damage
72
Q

How soon do we need to treat septic or infective arthritis to prevent damage?

A

4 days!

CLIN MED - SPRING EXAM 2 (4 decks)

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