PRELIMS: Deconditioning Syndromes

Question 1

What is Wolff’s Law?

Answer 1

Bone develops according to the stress applied.

Question 2

How does disuse affect muscle protein synthesis?

Answer 2

Disuse decreases muscle protein synthesis and increases protein breakdown.

Question 2

What are the common sites of muscle atrophy during bed rest?

Answer 2

Proximal muscles, lower extremities, and antigravity extensor groups.

Question 2

What is the impact of immobilization on ligaments and tendons?

Answer 2

Leads to haphazard collagen disposition, decreased collagen mass, and increased stiffness.

Question 3

How long does recovery take for ligaments and tendons after immobilization?

Answer 3

Recovery time is approximately twice the length of immobilization.

Question 3

What are the types of contractures and how can they be prevented?

Answer 3

Types include arthrogenic, myogenic, and periarticular. Prevention involves stretching, ROM exercises, and proper positioning.

Question 3

How does immobilization affect ligaments and tendons?

Answer 3

Leads to haphazard collagen disposition, increased stiffness, decreased collagen mass, and altered fibroblast function.

Question 3

What are key strategies for osteoporosis prevention and treatment?

Answer 3

Include isotonic exercises, weight training, functional training, calcium and vitamin D intake, and medications like bisphosphonates.

Question 3

What is heterotopic ossification and how is it managed?

Answer 3

Bone formation in joints, leading to loss of motion. Managed by gentle joint movement, monitoring for thrombophlebitis, and avoiding movement until coagulation is stable.

Question 3

What are the common cardiovascular changes due to deconditioning?

Answer 3

Resting tachycardia, increased heart rate post-exercise, orthostatic hypotension, changes in fluid balance, and increased risk of DVT.

Question 4

What are the management strategies for pressure ulcers? (PER GRADE)

Answer 4

Grade I: Regular repositioning.
Grade II: Wound care and possible myoplasty.
Grade III: Intensive care, possible myoplasty.
Grade IV: Aggressive treatment, frequent repositioning.

Question 4

What is olecranon bursitis and its common name?

Answer 4

: Inflammation of the bursa at the elbow, commonly known as “Thinker’s Elbow” or “Student’s Elbow.”

Question 4

What are the gastrointestinal changes due to deconditioning?

Answer 4

Increased risk of constipation, GER, decreased motility, reduced fluid intake, and potential nutritional impairment.

Question 4

How can neurovascular deconditioning be prevented?

Answer 4

Using tilt tables and embolic stockings to prevent blood pooling in the lower extremities.

Question 4

How can urinary tract infections (UTIs) be prevented in a deconditioned patient?

Answer 4

By standing up regularly and preventing urinary stasis.

Question 4

What endocrine changes occur due to deconditioning?

Answer 4

Decreased glucose tolerance, increased urinary hydrocortisone excretion, altered PTH and growth hormone levels, and increased plasma renin and aldosterone.

Question 4

What are the symptoms and consequences of pulmonary complications related to deconditioning?

Answer 4

Symptoms include dyspnea, cough, hemoptysis. Consequences can include pulmonary embolism, mucus plugs, pneumonia, and atelectasis.

Question 4

What are the psychological effects of prolonged immobility?

Answer 4

Social isolation, emotional lability, anxiety, hallucinations, restlessness, decreased pain tolerance, irritability, and changes in balance and coordination.

Question 4

What is Critical Illness Neuropathy (CIN) and how is it managed?

Answer 4

A condition linked to prolonged ventilation causing neuropathies. Managed with early physical and psychosocial stimulation, regular exercise, group therapy, and family interactions.

Question 5

What changes occur in body composition during prolonged immobility?

Answer 5

Decrease in lean body mass, increase in body fat, and loss of minerals such as calcium and phosphorus.