Pathology 11 - MSK Flashcards
spinal stenosis - what is it
the narrowing of the lumbar vert foremen or the intervertbral foremen
spinal stenosis - what are syms normally 2/2
compression on either the spinal cord or the nerve roots
spinal stenosis - primary
result of congenital malformatioj of the spinal structures
small precentages of cases
spinal stenosis - secondary
narrowing 2/2 acquired chnages in the foramina
spinal stenosis - structures normally involved
vert segment s
disk herniation
osteophytes formation
compression fx
systematic conditions - tumor, anklosing spondylitis
iatrogenic factors
what is anklosing spondylitis
a type of arthritis that causes inflammation in the spine and other joints
Stiffness: rigid and inflexible spine
In severe cases, this may cause the vertebrae (bones in the spine) to fuse (grow together)
spinal stenosis - risk factors
age - degentrative chnages of the spine that are part of the normal aging progress
what does iatrogenic factors mean
unintended negative consequences of medical treatment or advice
spinal stenosis - signs and symptoms
gradual onset
chronic pain at midline of lumbar region
unilateral nerve root involvement
parathesis
weakness
diminished reflexes
spinal stenosis - signs are increased with what activities
lumbar extension - standing upright, prone
spinal stenosis - sym are decreased with what activities
rest
lumbar flexion - leaning on grcery cart, sitting
spinal stenosis - posture
stooped to functionall reuve lumbar lordosis and min sypmtoms
spinal stenosis - imaging
MRI - most conclusive in diagnosing LSS due to its ability to differenciated soft tissue pathos
CT - look at the spinal cord , nerve roots and areas if conpression
spinal stenosis - first medication provide
NSIAD because fo the reduction of inflammation
spinal stenosis - surgery options
lumbar lamiectomy
what are the ottawa knee rules
Age: The patient is 55 years or older
Tenderness: The patient has tenderness at the head of the fibula or isolated tenderness of the patella
Range of motion: The patient is unable to flex the knee to 90°
Weight bearing: The patient is unable to bear weight, meaning they can’t take four steps immediately after the injury and in the emergency department
Talipes Equinovarus - is also known as
club foot
Talipes Equinovarus - characteristics
heel downwards and the forefoot point inwards
walking on lateral aspect of the foot
Talipes Equinovarus - cause
unknown
Talipes Equinovarus - is seen in what neuromuscular abnormalities
spina bifida
arthogryposis
what is arthogryposis
a rare condition that causes joint deformities and limited movement
Talipes Equinovarus - signs and sym
add of forefoot
varus positioing of the hindfoot
equinas at the ankle
Talipes Equinovarus - treatment
starts after birth
splinting and serial casting
surgical intervention of conservative fails
tarsal tunnel syndrome - where is the tarsal tunnel located
medial aspect of the ankle
between the medial mall and the superior calcaneus
roof flexor ret
medial distal tibia
tarsal tunnel syndrome - what runs through the here
post tib
flexor hallucis longus
flexor digitorum
tibial nerve
tarsal tunnel syndrome - what is it 2/2
compression of the tibial nerve
tarsal tunnel syndrome - motor or sensory dysfunction
both
tarsal tunnel syndrome - what causes the tibial nerve to compressed
intrinsic: tumors, scar tissues
extrinsic: crush injury, severe ankle sprains
tnesion factors: pes planus, hinfoot valgus
tarsal tunnel syndrome - signs and sym
numbess and parathesis in the bottom of the foot
antalgic gait with sym are exacerbated
muscle atrhophy
light touch and sensation may be dimished
tarsal tunnel syndrome - what is it often mistaken as
plantar fascia because fo location of the numbness
tarsal tunnel syndrome - what affected does rest have
alleviates the pain but does not completely relieve sym
tarsal tunnel syndrome - lab testing
EMG
nerve conduction velocity
MRI or US - used to assist in ID what compression is 2/2
what is an EMG
diagnostic test that measures the electrical activity in muscles and the nerves that control them
TMJ - what makes up this joint
TMJ - joint classification
hinge
synovial
condylar
intra-articular disk
TMJ - what is dys 2/2
occurs due to a changes in the joint structure that can cause multiple sym and limitation in function
muscle spasm and inflammation is the most common cuase fo dys
TMJ - a injury is most likey substain to what structure
intra-art disc
compressed and toes
TMJ - what does disc injury lead to
allows for bony portions of the joint to deteriorate 2/2 grinding of bone on bone
TMJ - risk factors
chewing on one side
eating tought food
clenching teeth
grinding of teeth
gum chewing and nail biting
TMJ - population
20-40
women > men (gender hormones thought to be reason)
TMJ - signs and sym
pain - persitant or recurring
muscle spasm
abnormal or limited jaw motion
headach
tinnitus
hearing clicking or popping with motion at the TMJ
TMJ - are signs and sym uni or bilateral
either
TMJ - imaging
MRI
mandibular kinesiography
CT scan
dental examination
TMJ - surgery
used if conservative treatment fail
condylectomy
osteotomy
arthrotomy
arthoscopy
reduction of sublexation
TMJ - avoid what behavior
all food and activities that aggravate symptoms
what is an occlusal splint
a custom-made mouth guard that fits over the upper or lower teeth.
It’s used to treat a variety of conditions, including teeth grinding, temporomandibular joint (TMJ) disorders, and sleep apnea
TMJ - what condition is a risk of getting TMJ again
perivous history of TMJ dysfunction
myofiscial pain dysfunction - what is it
nonarticulae disorder that affect the area around the TMJ
sym are produced 2ndary to muscle spasm
