Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DPT 516 > Quiz #4 > Flashcards

Quiz #4 Flashcards

1
Q

what causes myofascial compartment syndrome?

A

increased institial pressure w/closed myofascial compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where is myofascial compartment syndrome likely to occur?

A

in the envelopes of the lower leg, forearm, thigh, and foot where the fascia can’t give or expand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why is myofascial compartment syndrome most likely to occur in the lower leg?

A

the tibia and fibular create harder barriers than fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what can the following conditions cause:
fractures
severe contusions
crush injuries
excessive skeletal traction
reperfusion injuries and trauma
shin splints?

A

myofascial compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are some other risk factors for myofascial compartment syndrome?

A

burns

circumferential wraps/restrictive dressings

cast/other unyielding immobilizer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the pain descriptors of myofascial compartment syndrome?

A

deeping, throbbing pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

t/f: compartment syndrome can cause sensory deficits/paresthesia distal to the area of involvement

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the objective signs of severe compartment syndrome?

A

swelling w/smooth shiny, red skin

extremity is tense on palpation

passive stretch increases pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the standard intervention for compartment syndrome?

A

prompt surgical decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is a subluxation?

A

partial disruption of anatomic relationship w/in a jt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what joints are at risk for subluxation?

A

mobile jts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is a dislocation?

A

complete movement of a bone out anatomical jt alignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the general guidelines for soft tissue injuries?

A

immediate immobilization but shouldn’t last too long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the treatment for soft tissue injury?

A

early movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why is early movement important in treatment of soft tissue injuries?

A

it allows induces rapid intensive capillary ingrowth into injured area

better repair of muscles fibers

more parallel orientation of regenerating myofibers compared w/immobilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what should be avoided in the first week post soft tissue injury?

A

stretching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the PT role in soft tissue injuries?

A

prevention of detrimental effects of immobilization

promote tissue flexibility

minimize inflammation

enhance tissue healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

in 7-10 days post soft tissue injury, what can be done?

A

gradual progression in using injured muscles more actively

pain and tolerance as guide in setting limits

isometric training should be started 1st then progressed to isotonic training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the damaging role of fluoroquinolone use in soft tissue injuries?

A

tendinopathy

jt tenderness

swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

when do the damaging effects of fluoroquinolone usually set in?

A

6 months post use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are possible side effects of creatine use?

A

muscles cramping

diarrhea and other GI symptoms

dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how are soft tissue injuries prevented?

A

early participation of young children in sports

PTs identify risk factors b4 injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is heterotopic ossification (HO)?

A

bone formation in non-osseous tissues

ectopic bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what often occurs following fractures, surgery, SCI, TBI, burns, and amputations?

A

heterotrophic ossification (HO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

who is more at risk for HO, men or women?

A

men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

t/f: there seems to be some kind of link b/w the severity of injury and formation of ectopic bone?

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

why is HO common in military personnel?

A

from blast injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the risk factors for HO?

A

serious traumatic injury

previous history of HO

ankylosing spondylitis (AS)-fused vertebrae

diffuse idiopathic skeletal hyperostosis-bone growth down the anterior vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the most common locations affected by HO?

A

hip, elbow, knee, shoulder, and TMJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what a common feature of both HO and myositis ossificans (MO)?

A

deposits of mature lamellar bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the location of HO?

A

non-osseous tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the location of MO?

A

bruised, damaged, or inflammed muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what most likely affects pluripotent mesenchymal (stem) cells that could differentiate intocartilage, bone, or tendon/ligament become osteoblasts instead?

A

HO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what phase of HO is being described: inflammatory process resulting in edema and degeneration of muscle tissue?

A

acute phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

in HO, after a few weeks, the inflammed tissue is replaced with ____ and ____

A

cartilage and bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the Hallmark sign of HO?

A

progressive loss of jt motion at a time when post traumatic inflammation should be resolving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

as ectopic ossification advances…

A

acute symptoms may subside

motion continues to decrease even with intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

t/f: ectopic ossification can result in abnormal hard end feels

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

how can HO be prevented?

A

radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the potential side effects of HO treatment with radiation?

A

GI disturbance and osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what is used to reduce frequency and magnitude of ectopic bone formation in some areas?

A

NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is contraindicated in rehab of HO?

A

forcible jt manipulation as this could create more inflammation and perpetuate the problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is rehab phase 1 of HO?

A

1-2 weeks post

minimize swelling and scar formation, pain management, PROM and AROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is rehab phase 2 of HO?

A

2-6 weeks post

some modalities, self-passive stretching, weighted stretches, static/dynamic progressive splinting, functional use of affected area, strengthen if appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

when are bone fractures usually healed, allowing more aggressive splinting?

A

week 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

when is scar tissue fully formed but still malleable?

A

6-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is the 3rd phase of rehab in HO?

A

6-12 weeks post

healed bone=more aggressive splinting

fully formed malleable scar tissue

splinting an resistive exercises can continue to maximize gains in motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what is the last phase of rehab in HO?

A

3-6 months post

organized fibrotic scar tissue

may get small gains, but often motion has reached plateau

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is polymyalgia rheumatica?

A

bilateral symmetrical diffuse pain and stiffness primarily in shoulder and pelvic girdle musculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what structures does polymyalgia rheumatica affect?

A

neck, SC, shoulders, hips, low back, and buttocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

t/f: polymyalgia rheumatica can start with upper or lower symtoms

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are the Hallmark features of polymyalgia rheumatica?

A

painful stiffness lasting greater than an hour in the morning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

why is diagnosis of polymyalgia rheumatica often delayed?

A

bc it can look like normal aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

polymyalgia rheumatica can indicate what endocrine disorder, malignancy, or infection?

A

giant cell arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is giant cell arteritis?

A

inflammation of arteries of the head and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what are the s/s of giant cell arteritis?

A

blurred or lost vision

headaches

jaw pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what % of ppl with polymyalgia rheumatica can develop giant cell arteritis?

A

15-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

t/f: polymyalgia rheumatica has a known etiology

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what muscle testing can be done for polymyalgia rheumatica?

A

serum creatinine-kinase levels

electromyograms

muscle biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what are the s/s of polymyalgia rheumatica?

A

aching and stiffness

flu-like symptoms

sometimes peripheral manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

how is polymyalgia rheumatica diagnosed?

A

rapid response to Prednisone

ESR > 30-40 mm/hr

diagnosis of exclusion

MRI/US when ESR is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

when would a PT do an immediate referral on a patient in regards to polymyalgia rheumatica?

A

when the patient develops a temporal headache, temporal tenderness, scalp sensitivity, or visual complaints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what are the side effects of Prednisone?

A

weight gain

mood swings

cataracts

glaucoma

diabetes

easy bruising

rounding of the face

difficulty sleeping

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what is rhabdomyolysis?

A

rapid breakdown of skeletal muscle tissue caused by a large release of creatine phosphokinase (CPK) enzymes and other cell byproducts into the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what can these all be a cause of:

accumulation of muscles proteins

high dose statins

herbal supplements

strenuous exercise

toxic effects (ethanol, methanol, heroine)

metabolic abnormalities

A

rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what is statin induced rhabdomyolysis?

A

mild myopathy following initiation of statin therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what are risk factors for rhabdomyolysis?

A

over 80 y/o

small, frail body structure

kidney or liver disease

drinking excessive grapefruit juice (over a quart a day)

use of other meds

alcohol abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

how is rhabdomyolysis diagnosed?

A

patient reported muscles pain and mild to severe weakness

urine color change to tea or cola color

urine dipstick (blood but no cells-myoglobinuria)

lab test confirmation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

how is rhabdomyolysis medically managed?

A

rehydration and correction of electrolyte imbalances

dialysis for renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

how does acute care PT treat rhabdomyolysis?

A

AROM and AAROM w/in limits of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

how is rhabdomyolysis treated in outpatient PT?

A

strength and functional limitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what does the prognosis for rhabdomyolysis depend on?

A

kidney damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

in mild cases of rhabdomyolysis, when can patients return to normal activities?

A

within a few weeks to a month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is a developmental disorder?

A

a collection of syndrome that are either present or in the process of developing at birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is the most common chromosomal disorder?

A

Down syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

with Down syndrome, maternal age of <30 y/o has an incidence of __ in __ births

A

1/2000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

with Down syndrome, maternal age of >40 y/o has an incidence of __ in __ births

A

1/20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what is the etiology of Down syndrome?

A

trisomy 21 (47 chromosomes instead of 46)

deterioration of oocyte, environmental factors, viruses

translocation of chromosome 15, 21, 22

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what are the clinical manifestations of Down syndrome?

A

flat nose and occiput

almond eyes

congenital heart disease

language, cognitive, and motor delays

short limbs and broad hands and feet

simian crease in the palm just below the metacarpals

otitis media (ear infections)

compromised respiratory system

decreased antibody response

decreased feeding ability

increased risk of Alzheimers at a younger age

increased risk for eye problems and cancer

heart septum defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

what are musculoskeletal manifestations of Down syndrome?

A

soft laxity and muscle hypotonia

patellar subluxations

risk of patella riding laterally with knee valgus

foot overpronation

knee valgus

trendelenburg sign

scoliosis

SCFE

hip dislocation

OA or AA instability

SC compression

decreased step length

decreased knee flexion at heel strike

knee hyperextension

decreased single limb support

decreased push off at terminal stance

slower rxns

delayed developments of midline UE movement

obesity and OA later in life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what is the Trendelenburg sign?

A

hip drop from weak gluteus medius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

what is the atlantooccipital joint?

A

joint between C0 and C1

“yes joint”-flexion and extension

50% total flex/ex ROM in cervical spine

occipital condyles and superior articular facet of the atlas

ellipsoid jt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what is the atlanto-axial jt?

A

jt b/w C1 and C2

“no jt”-rotation

50% total rotation of cervical spine

anterior arch of atlas, transverse ligament, and dense

pivot and plane jts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

t/f: a fractured dens is a contraindication for PT

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

due to AA instability in Down syndrome, what are some activity avoidances?

A

direct downward, traction, and translatory motions in the cervical spine

manual therapy, some surgeries, tumbling, diving, horseback riding, football, soccer, wrestling, and trampoline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

what are some precautions with Down syndrome?

A

carnival rides, roller coasters, and spinning rides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

cord compression can lead what UMN signs?

A

clonus

hyperreflexia

Babinski sign

b/b signs

weakness

altered sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

what is a PT role in Down syndrome activity limitations?

A

educating the family and public of risks and precautions

promoting active lifestyle early to decrease risk of obesity, DM, and CVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

how do cardiac defects in Down syndrome impact activity levels?

A

they have to work harder due to increased HR, O2 consumption, and minute ventilation

need to work closely with PTs to guide activity safely

need to keep peak HR and VO2 lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

what are the 2 upper cervical tests?

A

transverse ligament sharp purser test

alar ligament test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

what is the sharp purser test?

A

stabilize C2 and provide slight neck flexion and posteriorly directing force to feel for a clunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

what is a negative sharp purser test?

A

no movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

what is a positive sharp purser test?

A

clunk feel/production of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what is the alar ligament test?

A

stabilize C2 and provide SB force from the head and allow no rotation to feel for excessive motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what is a negative alar ligament test?

A

about 10 deg w/firm end feel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

what a positive alar ligament test?

A

excessive motion/reproduction of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

how is Down syndrome managed?

A

specific medical management
- antibiotics for infection
- cardiac surgery
- monitoring thyroid function
- address gross and fine motor development
- promote physical activity early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

what is scoliosis?

A

abnormal lateral curvature in the frontal place which includes abnormal rotation of the spine in the transverse plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

is an S curve or C curve more common in scoliosis?

A

S curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

what is the most common scoliosis?

A

idiopathic scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

what is idiopathic scoliosis?

A

unknown cause

most common scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

what is osteopathic scoliosis?

A

bone abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

what is myopathic scoliosis?

A

muscle imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

what is neuropathic scoliosis?

A

CNS disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

what is neuromuscular scoliosis?

A

a combo of myopathic and neuropathic scoliosis (muscle imbalance with CNS disorder)

CP, polio, muscular dystrophy, myelomeningocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

what % of scoliosis cases are infantile (0-3 yo)?

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

what is the most common curve in infantile scoliosis?

A

L thoracic curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

is infantile scoliosis more common in males or females?

A

males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

what is the most common curve in juvenile scoliosis (3-10 yo)?

A

R thoracic curve

110
Q

what is the most common age for scoliosis diagnosis?

A

adolescence (age 10-20)

111
Q

what is adult scoliosis?

A

over 20 yo

curve over 30 deg

112
Q

what % of cases of scoliosis are over 50 yo?

A

6-10%

113
Q

what % of children have scoliosis?

A

0.4-5.5%

114
Q

what proportion of those with scoliosis need intervention?

A

1/4

115
Q

what is the ratio of male to female scoliosis cases with a curve over 30 deg?

A

10:1

116
Q

what is functional scoliosis?

A

caused by factors outside the spine like pain, posture, leg length discrepancy, and muscle spasm

117
Q

what is structural scoliosis?

A

fixed curve w/vertebral body deformity

118
Q

what are the 4 types of structural scoliosis?

A

congenital

musculoskeletal

neuromuscular

idiopathic

119
Q

what is congenital scoliosis?

A

wedge vertebra, fuse rib/vertebra, hemi-vertebrae

120
Q

what is musculoskeletal scoliosis?

A

osteoporosis, spinal tuberculosis, RA

121
Q

the earliest changes in scoliosis are seen in ____ tissues

A

soft

122
Q

what is the pathogenesis of scoliosis?

A

abnormal forces w/muscles on convex side lengthened and muscles on concave side shortened

hypertrophy on the side of concavity

mechanical advantage on the side of concavity

bony deformity overtime due to assymetric forces resulting in assymetric bone density

123
Q

what is a primary curve in scoliosis?

A

where the problem starts

124
Q

what is a secondary curve in scoliosis?

A

the result of the primary curve

L lumbar curve is the most common

125
Q

what are some clinical manifestations of scoliosis?

A

rotational deformity on the convex side (rib hump)

assymetric shoulder and pelvic position may be the 1st indicator

back pain-primary presenting symptom

126
Q

<__deg rarely produces problems in scoliosis

A

20

127
Q

> __deg results in pulmonary insufficiency, back pain, disc disease, sciatica etc.

A

60

128
Q

what is usually the 1st indicator of scoliosis?

A

assymetric shoulder and pelvic positions

129
Q

what is the primary presenting symptoms in many patients with scoliosis?

A

back pain!

130
Q

how do you measure Cobb’s angle for measuring the curve in scoliosis?

A

on a radiograph of the spine, choose the most tilted vertebrae above and below the apex and draw a parallel line coming out of them

then draw perpendicular lines through those lines and measure the angle created

131
Q

____ and ____ _____ may prevent severe deformity in scoliosis

A

bracing, surgical intervention

132
Q

what is the management for scoliosis with a curve of <25 deg?

A

observation and monitoring every 6 months

133
Q

what is the management for scoliosis with a curve of 25-40 deg?

A

spinal orthoses

134
Q

what is the management for scoliosis with a curve >45 deg?

A

segmental stabilization or Herrington surgery (entire spine length)

135
Q

exercise may be effective in ____ scoliosis and for secondary effects in _____ scoliosis

A

functional, structural

136
Q

what does exercise for scoliosis focus on?

A

trunk extensors

abdominals

gluteals

137
Q

what is developmental dysplasia of the hip?

A

abnormally formed acetabulum and malpositioned femoral head

138
Q

what is the unstable form of developmental dysplasia of the hip?

A

positioned normally but may be displaced manually

139
Q

what is the subluxation form of developmental dysplasia of the hip?

A

the femoral head remains in contact with the acetabulum but is partially displaced

140
Q

what is the dislocation form of developmental dysplasia of the hip?

A

the femoral head isn’t in contact with the acetabulum but stays within the capsule

slopping roof of the acetabulum

141
Q

what is the treatment for hip dysplasia with dislocation?

A

splinting, surgery, rehab

142
Q

are females or males more likely to be affected by hip dysplasia?

A

females

143
Q

what is the etiology of hip dysplasia?

A

effects of relaxin on fetus

hereditary systemic laxity

infant positioning pre and postnatally

144
Q

what does FABER stand for?

A

flexion, abduction, and external rotation for slinging a baby for better contact and stability of the femoral head in the acetabulum

145
Q

what are risk factors for hip dysplasia?

A

twins

breech delivery

large birth size

CP

spina bifida

idiopathic scoliosis

arthrogryposis (congenital jt contraction where one/more jts are contracted at birth)

torticolis

feet adducted in

family history

gohydramnois (deficient amniotic fluid limiting fetal movement)

146
Q

what is arthrogryposis and what is it a risk factor for?

A

congenital jt contraction where one/more jts are contracted at birth

risk factor for hip dysplasia

147
Q

what is gohydramnois and what is it a risk factor for?

A

deficient amount of amniotic fluid limiting fetal movement

risk factor for hip dysplasia

148
Q

what is the pathogenesis of subluxation in hip dysplasia?

A

shallow acetabulum

acetabular roof slopping at increased angle

149
Q

what is the pathogenesis of dislocation in hip dysplasia?

A

femoral head is on iliac wing and ligamentum teres is elongated

150
Q

what can delayed correction of hip dysplasia lead to?

A

avascular necrosis

151
Q

what is the pathogenesis of hip dysplasia?

A

subluxation or dislocation

stretched hip capsule

contracted structures at the hip

change in blood supply to the hip

flattened femoral head

acetabulum dysplasia

false acetabulum

152
Q

what are clinical manifestations of hip dysplasia?

A

significant abduction

gluteal fold assymetry

leg length discrepancy

153
Q

how is hip dysplasia diagnosed?

A

Ortolani test (1st month of life)

Barlow test

Galeazzi sign

154
Q

what is the Ortolani test?

A

confirms DDH in first month of life

flex hips, abduct, traction, and anterior pressure

(+) if hip pops back in

(-) requires serial exams

155
Q

what is the Barlow test?

A

confirms DDH in first month of life

flex hips, adduct, and downward pressure

(+) pop out the hip

(-) requires serial exams

156
Q

what is the Galeazzi sign?

A

in older infants, the femur is off and makes the leg look shorter

157
Q

what is the primary goal in management of DDH?

A

ensure stability of the femoral head in the acetabulum through approximation of bony structures

158
Q

what is the pavlick harness?

A

used for infants with DDH

allows 100-110 deg flexion, 40-60 deg abduction to keep femoral head properly aligned

159
Q

what is management of DDH in 6 months to 2 years?

A

closed reduction with adductor release and psoas tenotomy

160
Q

what is management of DDH at >18 months?

A

open reduction w/derivational osteotomy

161
Q

what is PT management of DDH pre op?

A

LE and trunk strengthening

parent/caregiver education

proper positioning and handling

flexion no more than 120 deg, abduction no more than 70 deg, and relative ER

no force to reduce the risk of avascular necrosis

162
Q

what is the safe zone for harnessing with DDH?

A

100-110 deg flexion and 40-60 deg abduction

163
Q

what is PT management of DDH post op?

A

cast care

check capillary refill, dusky color, cool to touch, and numbness

education for patient and caregiver

164
Q

PT roles in DDH management

A

pain control

gait training

proximal hip PREs

165
Q

what is the prognosis for DDH dependent on?

A

age

166
Q

what are musculoskeletal neoplasms?

A

new/abnormal growth of cells

tumor

cancer

167
Q

what are the characteristics of a benign neoplasm?

A

no tendency to metastasize

non-invasive

slow-growing

168
Q

what are the characteristics of a malignant neoplasm?

A

invasive

cancer

metastasizes

169
Q

what are primary tumors?

A

tumors that develop within tissue in a localized area

benign or malignant

soft tissue or bone

170
Q

what is a benign neoplasm

A

well differentiated

rarely invade locally

low potential for autonomous growth

not innocuous

can cause pathologic fxs

rarely can become malignant

171
Q

what is a malignant neoplasm?

A

spreads to other sites

can be aggressive and destroy adjacent tissues

can metastasize to other sites

not as common

difficult to manage

cancer centers

172
Q

t/f: most cases of osteosarcoma are unknown

A

true

173
Q

what is Paget’s disease?

A

bone production disease

174
Q

what is Li-Fraument syndrome?

A

predisposed to cancers

175
Q

what are bone tumors?

A

malignant cells uncouple the balance b/w bone formation and resportion

176
Q

where are bone tumor often 1st noticed?

A

in cortical bone bc it has higher metabolic activity than cancellous bone

177
Q

osteoclastic resorption…

A

thins bones

178
Q

what is reactive bone?

A

osteoblastic deposition of normal bone growth

179
Q

what is an osteoid?

A

a young bone that’s not undergone calcification

180
Q

what are 4 genetic disorders that cause sarcomas?

A
  1. translocations
  2. gene amplifications
  3. mutations
  4. complex genetic imbalances
181
Q

are benign or malignant tumors more superficially located?

A

benign

182
Q

are benign or malignant tumors deeper?

A

malignant

183
Q

are abdominal or extremity tumors larger with poorer outcomes?

A

abdominal

184
Q

what is the Hallmark of tumor development?

A

pain

185
Q

what pain is associated with bone tumors?

A

intense pain w/rapidly growing lesions

pressure/tension on periosteum and endosteum

186
Q

what is constant tumor pain?

A

pain not dependent on position/activity

increased with weight bearing activities

187
Q

what is night pain with tumors?

A

pain that wakens the pt from sleep rather than difficulty falling asleep

188
Q

t/f: pain is always a sign of progression

A

false

189
Q

what is mechanical pain

A

pain that changes with changes in movement

190
Q

pain patterns can vary w cancer based on…

A

nature, change, site, and rate of tumor growth

191
Q

t/f: pts may not notice tumors in extremities as much

A

true

192
Q

t/f: pathologic fxs are rare in primary neoplasms

A

true

193
Q

there is an increased risk for fractures if the lytic lesion affects more than __% of cortex or occupies __% of bone diameter

A

50, 60

194
Q

t/f: the risk for fracture can depend on location

A

true

195
Q

what are miscellaneous manifestations of tumors?

A

swelling

fever

presence of a mass

unexplained weight loss

failure of rest to provide pain relief

age

history of cancer

196
Q

what are the clinical manifestations of tumors?

A

pain, fractures, miscellaneous, swelling, and mass

197
Q

what may be one of the first signs of ST tumors?

A

ST swelling

198
Q

how do sarcomas spread?

A

through hematogenous routes (through the bloodstream) rather than lymphatics

199
Q

what are the most common places for extremities to metastasize?

A

lungs, then liver, then other bone sites

200
Q

what should one be looking for in a physical exam for tumors?

A

cafe au lait sports (common in neofibromatosis)

skin ulceration

Neuro findings

lymph nodes with palpation

201
Q

what do sharp geographic margins on a radiograph indicate?

A

slow growing

202
Q

what does destruction of the cortex on a radiograph indicate?

A

fast growing

203
Q

what are some treatment options for tumors?

A

observation

radiation

chemotherapy

complete resection of the cancer

limb sparing

amputation

204
Q

what is osteochondroma?

A

the most common benign neoplasm

located at the metaphysis

typically stops growing when skeletal growth ceases

dx with radiographs

205
Q

what are bone islands?

A

small oval sclerotic lesions bone

206
Q

what are the primary benign bone tumors?

A

osteochondroma

bone islands

osteoid osteoma

207
Q

how are bony island managed?

A

assure pts that there is no significant health concern

208
Q

what is osteoid osteoma?

A

rare, benign vascular osteoblastic lesion

primarily in young men

immature bone surrounded by osteoblasts and cysts

reactive bone forming lesion

round small nidus (nest) of osteoid tissue surrounded by reactive bone sclerosis

209
Q

how does osteoid osteoma manifest?

A

local pain

symptomatic for 2-3 years w/recovery for 3-7 years as the osteoid nidus ossifies

jt pain and dysfunction

may appear like normal LBP

210
Q

what is the treatment of osteoid osteoma?

A

NSAIDS/ASA for symptom control

serial radiographs to track nidus progress
surgical excision of nidus

211
Q

do osteoid osteomas have the potential for malignant transformation?

A

no!

212
Q

what is an osteoblastoma?

A

reactive but benign bone leasion that is larger than osteoid osteoma

common in the spine, sacrum, and flat bones

more common in men

less painful than osteoid osteoma

poorly localized, dull, aching pain

213
Q

t/f: NSAIDS are ineffective in treating osteoblastoma

A

true

214
Q

how is osteoblastoma managed?

A

radiographs, CT, and MRI

long bones: curettage

cervical spine: complex

215
Q

what is the prognosis for osteoblastoma?

A

95% cured by initial Rx

10-20% recurrence rate

can become malignant

may need chemo/radiation

216
Q

t/f: primary malignant bone tumors are rare

A

true

217
Q

what are low grade primary malignant bone tumors?

A

chondroma and chondrosarcoma

218
Q

what are high grade primary malignant bone tumors

A

osteosarcoma and Ewing sarcoma

219
Q

what is the most frequent type of bone tumor?

A

osteosarcoma

220
Q

who is more prone to primary malignant bone tumors, males or females?

A

males

221
Q

what is osteosarcoma?

A

the 2nd most frequent malignant condition of bone behind myeloma

extremely malignant tumor

222
Q

what are the manifestations of osteosarcoma?

A

pain and swelling near metaphysis

early lung metastasis in 90% of cases

appears in bone undergoing active growth phase

223
Q

what bones are more vulnerable in osteosarcoma?

A

long bones of the LE

224
Q

osteosarcoma occurs primarily in males <__ years old

A

30

225
Q

what is the pathogenesis of osteosarcoma?

A

rapid growth and locally destructive

lifts periosteum as the tumor grows

226
Q

how is osteosarcoma diagnosed?

A

dull aching pain, nigh pain persistent over months

227
Q

why is osteosarcoma often delayed in diagnosis or misdiagnosed?

A

often though to be “growing pains”

228
Q

what are treatment options for osteosarcoma?

A

chemo

surgery

limb salvage

expandable prosthesis

rotationplasty

tibial turn up

229
Q

what is a rotationplasty?

A

using the foot backwards as a replacement for the knee jt

230
Q

what is a tibial turn up?

A

the residual tibia is fused to the femur to lengthen the femur for better prosthesis fit and therefore better functional outcomes

231
Q

what is Ewing sarcoma?

A

malignant, non-osteogenic primary tumor in bone or ST

3rd most common primary malignant bone tumor of children, adolescents, and young adults

232
Q

80% of Ewing sarcoma occurs in pts <__ years old

A

20

233
Q

what are the most common sites effected by Ewing sarcoma?

A

pelvis and LE

234
Q

what are the risk factors for Ewing sarcoma?

A

caucasian

parental occupations (exposure to pesticides, fertilizers)

parental smoking

extraosseous tumors of the trunk and extremities

235
Q

95% of Ewing sarcoma tumors are derived from translocation b/w what 2 chromosomes?

A

11 and 22

236
Q

what are the clinical manifestations of Ewing sarcoma?

A

local bone pain post injury

long tubular bone and pelvis

swelling in 70% of cases

progressive pain

young children with flu-like symptoms

237
Q

t/f: there is frequent later stage metastasis of Ewing sarcoma

A

true

238
Q

how is Ewing sarcoma diagnosed?

A

radiographs with possible “moth eaten” appearance affecting the cortical bone and medullary canal

reactive bone formation on the cortex-“onion skin” appearance

CT, MRI, bone scan to stage the tumor

239
Q

what are treatment options for Ewing sarcoma?

A

chemo, radiation, biotherapyh, embolization, surgery, limb sparing techniques

240
Q

what is the prognosis for Ewing sarcoma?

A

steadily improving

5 year survival rate in 70% if no metastasis

5 year survival rate is 25% if metastasized

better at distal sites like hands and feet vs central sites

241
Q

what is the initial Rx focus for Ewing sarcoma?

A

life-saving, extensive surgery, resection, limb salvage, amputation

242
Q

what is the rehab focus with Ewing sarcoma?

A

improvement of impairment, function, and social reintegration

243
Q

what are the bengign ST tumors?

A

lipoma

ganglia

popliteal cycst

nerve sheath tumor

neurofibromas

schwannomas

244
Q

what is a lipoma?

A

common superficial tumor of mature fat cells

unlikely to be malignant

maybe be tender

can be excised but had to get all of it or it can come back

245
Q

what is a ganglia tumor?

A

tumor arising from a jt capsule or tendon sheath

pain/tenderness may/may not be present

may not do anything if not interfering with function

246
Q

what is a popliteal cyst?

A

a subtypes of ganglion tumor that of often palpated behind the knee in older adults with OA

Baker cysts

a rupture or hemorrhage would cause pain

swelling distal to lesion may occur

associated with irritation of knee jt

247
Q

what is a nerve sheath tumor?

A

tumor that arises in peripheral nerve and grows concentrically form the center for the nerve

usually superficial, painless, and benign but can degenerate into cancer

248
Q

what is neurofibroma?

A

single lesion or greater #s as part of collection of symptoms in association Von Recklinghausen disease (neurofibromatosis) and schwannomas

contain cells and features of schwann cells

benign, grow slowly, and can be cured surgically

249
Q

what is a schwannoma?

A

tumor that arises from coverings of peripheral and cranial nerves

rare tumor of the sheath/lining around peripheral nerves

benign form: slow growth and tumor stays on outside of nerve

having multiple is common

harder to dx

cafe au lait spots

250
Q

cancer commonly metastasizes to _____

A

bones

251
Q

t/f metastatic tumors are more common than primary bone lesions

A

true

252
Q

about ____ of all people w/cancer develop bone metastasis at some point

A

1/2

253
Q

skeletal involvement is the ___ most common site for metastasis

A

3rd

254
Q

what are the top 3 most common sites for metastasis?

A

lung, liver, and bone

255
Q

t/f: all malignant tumors have the capacity to spread to bone

A

true

256
Q

primary cancers responsible for 75% of all bone metastases include:

A

prostate

breast

pelvis

proximal femur

ribs

vertebrae

lung

kidneys

thyroid

257
Q

what is the most common source of skeletal metastasis in men?

A

prostate

258
Q

what are the 4 most common sites for breast cancer to metastasize?

A

pelvis, ribs, proximal femur, and vertebrae

259
Q

t/f: the lung can metastasize to bone early in disease

A

true

260
Q

where do the kidneys metastasize to?

A

vertebrae, pelvis, and proximal femur

261
Q

what is the most common presenting symptoms in malignant tumors?

A

pain

262
Q

__% of ppl with breast or prostate metastasis have no pain

A

50

263
Q

how is the pain associated with malignant tumors described?

A

sharp, severe, worse at night

transient/intermittent in early course but eventually constant in more advanced cancer

mechanical

264
Q

what is the most commonly affected place in the body for malignant tumors?

A

the spine

265
Q

> __% of metastasis involving the spine

A

50

266
Q

how are malignant tumors prevented?

A

adequate exercise

proper diet and nutrition

avoidance of tobacco

267
Q

what are the 3 ways that cancer can spread?

A

hematogenous

lymphatic system

direct extension into adjacent tissue

268
Q

with spinal metastasis, tumor cells from above the areas traverse throughout _____ to the spine

A

circulation

269
Q

cells from primary tumor mass enter the circulation by traversing either the ____ of small blood vessels in _____ tissue, or ____ of vessels induced by the tumor itself

A

walls, normal, walls

270
Q

t/f: after gaining access to vertebral venous system, tumor cells can travel to distant organ sites

A

true

271
Q

what are the direct connections to the vertebrae that can be affected by metastasis via direct extension?

A

ribs

pelvis

skull

shoulder

DPT 516 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions