Quiz 3 Flashcards
What is rotator cuff tear
When the tendons of the rotator cuff separate from the bone
What is Bursa
A cushion between bones to prevent bone on bone grind
What is frozen shoulder
Adhesive capsulitis is another name for this And it leads to stiffness of the joint
What is calcific tendonitis
A condition of calcium deposits within a tndon, most commonly within the rotator cuff tendons
What are some effects of shoulder pain
Inability to carry objects
Injury that causes deformity of the joint
Inability to raise the arm
Pain that occurs at night or while resting
Swelling or significant bruising around the joint or arm
What are some treatments for shoulder pain
Rest Ice and heat application Stretching Occupational therapy Anti-inflammatory medications Cortizone injections
Do you use ice or heat when there is swelling
Ice
What is the condition when the space that holds the tendons and bursa become too narrow to accommodate them
Impingement syndrome
What are some symptoms of Shoulder bursitis
Pain with overhead activities
Pain while sleeping at night
Pain over the outside of the shoulder/upper arm
What type of test is usually used to diagnose the rotator cuff tear
MRI
When the rotator cuff is injured, it’s the what of the rotator cuff that is injured?
Tendons
What are some symptoms of rotator cuff tears
Most common symptoms is pain Over the top of the shoulder and arm
The pain can decend down the outside of the arm and all the way to the elbow
Weakness causes difficulty lifting arm up over head or difficulty with activities such as reaching, getting dressed, or carrying objects
What are the primary goals during the acute phase of hand injuries
Pain relief, maintaining joint and limb alignment, and restoring function of the primary goals
When prolonged immobilization is Necessary, it is usually best to place the patients hand in what position
Intrinsic plus position
In acute hand injuries, is the no pain no gain true
No
No pain better gain is more accurate
Should PROM be used in acute hand injuries
PROM can be injurious. You can disturb healing tissues, cause further inflammation, and damage structures
What should you not use on patients who have edema or swelling
Heat
What is a better activity for patients to do with an acute hand injury
Perform activity like turning a lid rather than squeezing a ball
What should A therapist do during an assessment of an acute hand injury after surgery
Observe the appearance of the upper extremity, position of hand/arm at rest, and the position the patient carries it in.
Look for lacerations, sutures, evidence of recent surgery, skin integrity
Always follow universal precautions for all wounds.
Observe scar location, length width, and height
Any scar crossing a joint may form a contracture
The affected part should be compared to the unaffected part
When is hand strength usually assessed
After the healing phase of trauma
What is measured to assess the presence of edema
Hand volume using things such as a volumeter
When assessing nerve damage, test can be divided into four categories. What are those categories
Test for pain, heat, cold, touch pressure
Functional tests to assess the quality sensation
Objective tests that do not require the participation of the patient
Provocative tests that reproduce symptoms
What are some good tests used for carpal Tunnel diagnosis
Tinel's sign Phalen's test Carpal compression Elbow flexion for a period of 3 to 5 minutes Vibration
What is Tinel’s sign
Gently tapping along the course of the nerve, starting distally and moving proximately to elicit a tingling sensation in the fingertips
What is Phalen’s test
It’s when you flex the wrist dorsum of hands pressing them together. Hold for one minute. Test is positive if tingling in the medial nerve distribution
What are some assessment tests for dexterity
Minnesota rate of manipulation test Box and block Perdue pegboard 9 hole peg test Jebson test of hand function TEMPA
What are some basic interventions for edema
Elevation, massage, compression, and AROM
Contrast bath
What are some basic interventions for wound healing and scar remodeling
Compression and desensitization are used to promote Scar softening and maturation.
Silicone gel pads can help promote scar maturation
More than half of occupational illnesses and disorders are due to what
Overuse
Treatment during the acute phase of a hand injury is R.I.C.E.
What does it stand for
Rest
Ice
Compression
Elevation
What are some ways to treat tendinitis
Pain must be avoided
Address reaching a gripping
Ergonomic adjustments can have dramatic effects
Exercise to increase proximal stability and scapular stabilization
Teach patience to avoid wrist deviation, especially in conjunction with pinching
Provide Built-handles
One of the four areas that are affected by tendinitis
Extensor carpi ulnaris
Flexor carpi radialis
Flexor carpi ulnaris
Flexor tenosynovitis (trigger finger)
How do you treat radial nerve injury
Innervates the extensor group of the forearm. Sensory loss of radial nerve does not usually result in dysfunction.
A dorsal splint that provides wrist extension, MCP extension, thumb extension to protect the extensor tendon from over stretching
What does the Medial nerve injury do and treated
Innervates the flexors of the forearm
Splints that position in Palmer abduction with slight opposition.
What does an ulnar nerve injury do and how is it treated
Innervates only the flexor carpi ulnaris, median half of the FTP, and intrinsics.
Results in hyperextension of MCPs at RF and small finger
Splints should block hyperextension of MCPs
What is the most common fracture
Distal radius which is typically a result from a fall on outstretched hand
What’s some general information about rheumatoid arthritis
Chronic, systematic, autoimmune disorder
Body attacks itself
Inflammation of joints will occur over long periods of time
Damage done during the active stage remains
Usually occurs between the ages 30 and 40
Women are three times more commonly affected than men
What are some common symptoms of RA
Fatigue Loss of appetite Fever Weight-loss Overall achiness or stiffness synovitis
In RA, joint swelling results from what
Abundance of synovial fluid
Enlargement of the synovium
What will inflamed joints look and feel like
Warm, swollen, tender, often red
Difficult or painful to move
Typically accompanied by a loss of range of motion, strength, endurance
In RA, what are the most common sites of thumb inflammation
MCP joints
CMC joints
In RA, As inflammation continues what happens
It’s invades Cartlidge, bone, tendons and secretes enzymes that damaged them
What are the joints most affected by RA
Wrist Thumb Hand PIP MCP
What are some common deformities of RA
Swan neck deformity
Boutonnière deformity
Trigger finger
What is osteoarthritis
Disease that causes breakdown of cartilage in joints leading to joint pain and stiffness
Not inflammatory
Referred to as the wear and tear disease
More common in men at the age of 45, beyond 54 years, more common in women
Osteoarthritis can affect any joint, but most frequently seen where
Weight-bearing joints such as the hips, knees, spine
Metatarsal phalangeal joints of the big toe
DIP, PIP joints of the hands and carpometacarpal joint at the base of the thumb
What are some symptoms of osteoarthritis
Appears as minor aches or soreness with movement.
Pain most frequently felt after long periods of inactivity.
Become stiff, although movement is possible
If not moved, surrounding musculature becomes weak
What is Osteophytes
Bone spurs may form in fingers or base of the thumb.
Hard to the touch
If seen at the DIP joint = Heberden’s nodes
If seen at the PIP joint = Bouchard’s nodes
Most common symptom is pain with motion
What is Gout
Metabolic disease marked by urate deposits that cause recurrent acute episodes of arthritis
Occurs in the middle aged men who are 40 to 50 years old, rarely occurs in women until after menopause
What is Crepitation
Seen in both RA and OA and occurs as the joints degenerate.
Characterized by a grating, crunching, or popping sensation and/or sound.
What is joint laxity
Describes ligamentous instability and major cause for loss of hand function
What is the medical management for Arthritis
No known cure, treatment geared towards reducing inflammation, pain, and joint damage
Drug therapy such as aspirin, NSAIDS, steroids
Surgical intervention
What is some occupational therapy intervention for osteoarthritis
Evaluation should consider factors such as: Morning stiffness, medication schedule, activity tolerance, proper positioning
Energy conservation joint protection techniques are essential in all areas of ADL
What’s OTs major treatment objectives for RA or OA
Maintain or increase joint mobility and strength
Increased physical endurance
Prevent, correct, or minimize the effect of deformities
Maintain or increase ability to perform ADL
Increased knowledge
Psychological
