Physical Conditions Flashcards
Arthrodesis
Surgical procedure used to fuse a joint
Compression fx
Vertebral collapse typically associated with:
- decreased bone density
- trauma from vertical force
- spinal tumors
- infection
Lordosis
Excessive anterior curvature of the spine
Kyphosis
Excessive posterior curvature of the spine
Spondylosis
Degenerative process in the spine and typically associated with OA
Symptoms may include:
- pain
- neurological changes
- motor impairment
Spinal stenosis
Narrowing of intervertebral foramen often compressing the nerve as it exits the spinal column
Symptoms may include:
- pain
- parethesia
- muscle weakness
- sensory changes
Claw-hand deformity
Hand deformity secondary to an ulnar nerve injury
Presents with atrophy of the hypothenar eminence and hyperextension of the MCP joints and flexion of the IP joints of the 4th and 5th digits
Intervention includes orthotic positioning to prevent overstretching of the intrinsic muscles by restricting MCP joint hyperextension
Torticollis
Dystonic disorder that can be congenital or acquired
Defined by abnormal, asymmetrical head or neck position
Intervention includes: ROM, positioning, environmental adaptations
Macular degeneration
Progressive age-related visual condition characterized by:
- atrophy of the macula (posterior retina)
- decrease in central visual acuity
- blurry, distorted, or low vision
Intervention may include:
- magnification devices
- lighting recommendations
- color and contrast enhancements
- visual skills training
Myasthenia gravis
Autoimmune motor unit disorder characterized by:
- ptosis and double vision
- possible difficulty with chewing, swallowing, and speech
- weakness and fatigue that increases throughout the day
Intervention may include:
- energy conservation and work simplification education
- sleep hygiene strategies
- recommendation of adapted and assistive devices
- activity modification
Chronic obstructive pulmonary disease (COPD)
Pulmonary condition associated with limited airflow from the lungs, characterized by:
- difficulty breathing
- shortness of breath during activities
- dyspnea and fatigue that influence occupational performance
- persistent cough
- includes emphysema and chronic bronchitits
Dyspnea
Shortness of breath due to impaired breathing in response to activity or at rest, may require:
- medical attention
- modification to activity demands
- instruction in breathing techniques
- dyspnea control postures
Orthopnea
SOB due to impaired breathing when lying supine
Cerebral palsy (CP)
Neurological condition caused by a brain injury or malformation that occurs while the brain is developing.
Characterized by:
- body movements and GM skills
- muscle control and tone
- muscle coordination and FM skills
- reflexes, posture, and balance
- oral motor functioning
Myocardial infarction
Emergency medical condition characterized by blocked flow of blood to the heart
Expected functional outcome of SCI level C1-C3
Ventilator dependent
Total physical assistance for BADL and ADL
Able to direct care needs
Expected functional outcome of SCI level C4
Initially vent dependent; progress to breathing independently with reduced vital capacity
Total physical assistance for BADL and ADL
Able to direct care needs
Power chair with adaptations for independence in mobility
Total assistance for bed mobility and tranfers
Expected functional outcome of SCI level C5
Independent respiratory function with reduced vital capacity; may need assistance for a productive cough
Total assistance for bowel and bladder management
Independent self-feeding with adaptive devices
Assistance for grooming with adaptive devices
Total assistance for bathing
Expected functional outcome of SCI level C6
Independent respiratory function with reduced vital capacity; may need assistance for a productive cough
Minimal to total assistance for bowel and bladder management with adaptive devices
Some assistance for BADLs
May need some assistance for outdoor w/c propulsion in manual w/c
May need assistance with t/f and bed mobility with adaptive devices
Total assistance for standing
Expected functional outcome of SCI level C7-T1
Independent respiratory function
Assistance for bowel management
Modified independence for BADLs
Some assistance for standing
Modified independence for bed mobility and t/f
Independent driving with modifications
Expected functional outcome of SCI level T2-T12
Ind - mod I for BADLs
Mod I for bowel/bladder management
Mod I for bed mobility, t/f, and standing
Ind w/c mobility
Pulmonary embolism
Potentially fatal condition resulting when a blood clot travels to the lungs and blocks arterial circulations
May be asymptomatic or experience:
- sudden dyspnea
- sharp chest pain
- tachycardia
- tachypnea
- profuse sweating
- anxiety
Expected functional outcome of SCI level L1-L5
Ind ADLs and bed mobility
Ambulate with assistive devices
May use w/c for distance; Ind with loading/unloading from vehicle
Ind driving with hand controls
Stage 2 pressure ulcer
Characterized by:
- partial thickness skin loss
- exposed dermis
- open wound that looks like a scrape, blister, or tear
- client reports pain and tenderness
- warm to touch
- localized edema
Stage 3 pressure ulcer
Characterized by:
- full thickness skin loss
- open wound that looks like a crater
- wound extends into the fat layer but not to the tendon, muscle, or bone
Stage 4 pressure ulcer
Characterized by:
- full thickness tissue and skin loss
- open wound with visible muscle, tendon, or bone
- tunneling or undermining may both be present
Unstageable pressure ulcer
Characterized by:
- full thickness skin and tissue loss
- wound is completely covered by eschar or slough
Stage 1 pressure ulcer
Characterized by:
- no wound or tears in the skin
- skin reddens but does not blanch
- warm to the touch
- surrounding area may feel firmer or osofter
- client may report pain
Deep vein thrombosis (DVT)
Potentially fatal formation of a blood clot most often occurring in the calf area with high risk for pulmonary embolism, symptoms include:
- pain with dorsiflexion of the foot
- tenderness of the calf
- swelling of the leg
- warmth to touch
Gravitational insecurity
Inability of CNS to regulate vestibular input resulting in overreation to changes in head position and movement during ordinary activities
Ape hand deformity
Hand deformity secondary to a median nerve injury in the proximal forearm or at the wrist
Presents with atrophy of the thenar eminence and inability to abduct and oppose thumb
Intervention includes orthotic positioning to maintain palmar abduction and opposition
Duchenne muscular dystrophy
Inherited genetic disorder resulting in muscular weakness and atrophy of the proximal musculature of the pelvis and shoulder girdle
Symptoms more common in males and detected around 3 y/o
Results in gradual loss of independent ambulation and progressive deterioration of musculature of the trunk, neck, and distal extremities
Swan neck deformity
Joint deformity consisting of PIP hyperextension and DIP flexion commonly associated with RA and tendon trauma
Lateral bands of the extensor mechanism slip above the PIP, thereby hyperextending the PIP joint and flexing of the DIP
Intervention may include a tri-point ring orthosis to prevent PIP hyperextension
Boutonnière deformity
Joint deformity consisting of PIP flexion and DIP hyperextension, commonly associated with rheumatoid arthritis and PIP joint trauma
occurs when synovitis weakens, lengthens, or disrupts the dorsal capsule and central slip of the extensor mechanism; the lateral bands displace volarly below PIP
Intervention may include fabrication of orthosis to support the PIP in extension while allowing movement at the DIP
Rheumatoid arthritis (RA)
An autoimmune, chronic inflammatory disease associated with synovitis of the joints, characterized by:
- acute pain, erythema, and swelling during disease exacerbation
- symmetrical joint involvement
- chronic pain secondary to progressive joint damage
- prolonged morning stiffness lasting 1-2 hours
- swan neck and boutonnière deformity
- wrist radial deviation and MP ulnar deviation
Clonus
Reflexive abnormal motor movements in response to a tendon stretch, indicative or a cortical lesion
Characterized by a series of involuntary rhythmic contraction and relaxation of the muscle
Lead pipe rigidity
Motor dysfunction secondary to a lesion of the basal ganglia where during slow passive ROM, constant resistance is felt
Common symptom of Parkinson’s
Clasp-knife rigidity
Reflexive abnormal motor response due to a cortical lesion in which a spastic muscle suddenly releases tension and gives way in response to passive stretch
Mallet finger
Inability to extend DIP joint due to rupture of the distal end of the extensor tendon
Intervention may include static orthosis to maintain DIP in extension
Cog-wheel rigidity
Motor dysfunction secondary to a lesion of the basal ganglia in which the muscles respond in a jerky motion when force is applied during flexion of a joint
Common symptom of Parkinson’s
Decorticate rigidity
Characteristic of abnormal reflexive posturing secondary to severe brain injury, typically in patients with a score of 3 on motor section on GCS
Includes:
- flexion of the elbows across the chest
- adduction and flexion of wrists
- flexion of fingers
- extension and internal rotation of the legs
- plantarflexion of the feet
Web space contracture
Loss of tissue elasticity between fingers or toes impacting function, commonly associated with soft tissue trauma such as a burn
Decereberate rigidity
Characteristic of abnormal reflexive posturing secondary to severe brain injury, typically in patients with a score of 2 on motor section on GCS
Includes:
- adduction and extension of the arms next to the body
- pronation of the forearms
- flexion of wrists and fingers
- extension and internal rotation of the legs
- plantarflexion of the feet
Full thickness burn
Associated with:
- damage to nerve endings, dermis, and epidermis
- pale
- decreased sensation
- high risk of hypertrophic scar or contractures, may require surgery to promote wound healing
Ulnar drift
Hand deformity where MCP joints deviate to the ulnar side, commonly associated with RA
Intensified by functional activities requiring power grasp and lateral pinch
Carpal tunnel syndrome
Pain, numbness, and paresthesia in thumb, index, and middle fingers associated with median nerve compression
deQuervain’s tenosynovitis
Inflammation of the abductor pollicis longus and extensor pollicis brevis, resulting in pain, crepitation, and swelling over the radial styloid
Complex regional pain syndrome: stage III
Atrophic stage of CRPS that lasts sever years after injury or trauma, characterized by:
- decrease in pain intensity
- persistent edema
- irreversible changes in skin and joints
- bony demineralization
- severe muscle atrophy
- joint contractures
Complex regional pain syndrome: stage II
Dystrophic stage of CRPS that typically last from 6-9m after injury or trauma, characterized by:
- extreme pain
- hypersensitivity to light touch or deep pressure
- brawny edema
- skin redness and warmth to touch
- bony demineralization
- muscle atrophy
- joint contractures
Complex regional pain syndrome: stage I
Traumatic stage of CRPS that typically lasts up to 3m, characterized by:
- extreme pain
- decreased AROM
- hypersensitivity to light touch or deep pressure
- pitting edema
- blotchy looking skin discoloration
- hyperhidrosis
- skin temperature fluctuation
- changes in extremity hair and nail growth patterns
Complex regional pain syndrome (CRPS)
Disorder of the sympathetic nervous system typically triggered by sx or trauma, resulting in pseudomotor and vasomotor changes and disproportionate pain beyond the region of sx or injury
Divided into 3 stages: traumatic, dystrophic, atrophic
Neurotmesis
Seddon’s classification of a completely severed nerve where recovery will not occur unless sx repaired
Intervention may include:
- pain relief
- orthotic positioning
- controlled motion ex
- neural gliding ex
- scar and edema management
- compensatory techniques
- pt education
Trigger finger
Catching or locking of the digit due to inflammation or a thickening of the flexor tendon sheath during grasping activities
Axonotmesis
Seddon’s classification of a nerve compression that recovers spontaneously but is more severe compared to a neuropraxia
Characterized by:
- axon and myelin sheath disruption
- endoneurium remains intact
Classification of peripheral nerve injuries
Neurapraxia (1st degree)
Axonotmesis (2nd degree)
Neurotmesis (3rd degree)
Long thoracic nerve injury
Peripheral nerve injury characterized by weakness in the serratus anterior and winging of scapula
Axillary nerve injury
Peripheral nerve injury characterized by hyperesthesia on the lateral aspect of the shoulder and weakness of the deltoid and teres minor
Brachial plexus injury
UE nerve injury where the signs and symptoms may impact the arm, hand, or wrist depending on the severity, mechanism, and anatomical location of the injury and may include:
- loss of sensation or numbness
- decreased shoulder ROM
- weakness or paralysis
- pain
Lateral epicondylitis
Also called tennis elbow; term used to describe pain and tenderness at the supracondylar ridge of the elbow, most often associated with irritation at the origin of the extensor carpi radialis brevis tendon
Cubital tunnel syndrome
Pain, numbness, and paresthesia in the ring and small fingers due to ulnar nerve compression at the elbow
Symptoms are associated with direct compression of the nerve or repetitive or sustained flexing the elbow beyond 90º
Neurapraxia
Seddon’s classification of a nerve compression where there is disruption of the myelin and spontaneous recovery is expected
Deep partial thickness burn
Associated with:
- direct contact or lengthy exposure to a heat source
- complete destruction of epidermis and most of dermis
- redness and large blisters
- high risk or hypertrophic scar or contractures