Week 10 Terms: Orthopedics; Spine and LEs, Cancer, and Lymphedema Flashcards
Treatment for Ankylosing Spondylitis
Anti-inflammatory treatment
Pain relief measures
Maintaining mobility
Strengthening/exercise
Promote muscle support of posture
True/False
Ankylosing Spondylitis can be an autoimmune disorder.
True
Can also be a chronic progressive inflammatory condition
Form of reumatoid arthritis
What parts of the spine are affected in ankylosing spondylitis?
Sacroiliac joints
Intervertebral spaces
Costovertebral joints
Often a tear in the capsule (or disk) in the spine will cause…?
A. protrusion of nucleus pulposus
B. sensory, motor, or autonomic disfunction
C. Kyphosis
D. Both A and/or B
E. Both A and/or C
D. Both A and B
Often a tear in the capsule (or disk) in the spine will cause protrusion of nucleus pulposus and/or sensory, motor, or autonomic disfunction.
Herniated Intervertebral Disk
How do you diagnose a herniated intervertebral disk?
Myelography w/contrast dye
CT
MRI
Treatments for Herniated Intervertebral Disk
- Reduced weight-bearing
- Rest as needed
- Application of heat or ice
- Traction
- Medication
muscle spasm and pain - PT/OT
- Surgery in severe cases
Laminectomy or discectomy
Spinal fusion
What are some ways to protect your joints?
Joint Protection and Ergonomics
- Back safety and injury prevention
1. Avoid unnecessary bending & twisting
2. Hold items close to body
3. Lift with legs vs. back
4. Ergonomic assessment of workspaces
5. Maintain good strength in surrounding musculature
Most common types of hip fractures
Femoral Neck
Intertrochanteric
Subtrochanteric
Common Causes of Hip Fractures
Falls
Osteoporosis
Trauma - less common
Open Reduction Internal Fixation (ORIF)
Most common fracture repair surgery
Pins, screws or a rod placed to hold bone in place
Often result in limited weight bearing
What are some weight-bearing precautions after ORIF surgery?
Parameters set by MD
*Determined by *
surgical procedure
severity & location
type of prosthesis
bone integrity
patient weight
cognitive status
What are movement approach precautions for an Anterolateral (anterior) approach?
Hip Replacement
No extension
No external rotation
No adduction
Toes knees and hips need to be in the same direction
What are movement approach precautions for an Posterolateral (posterior) approach?
No flexion <90
No internal rotation
No adduction
Signs that a hip replacement is needed
Arthritis pain: Non-surgical treatments ineffective
“elective”
Hip Fracture
When would a client usually have a total knee replacement (TKR or TKA)?
Severe arthritis pain
Symptoms of Ankylosing Spondylitis
Reduced Lung Capacity
Compression Fracture
Osteoporosis
Kyphosis
Calcification or fusion
Inflammation of SI joints
Risk factors for Herniated Intervertebral Disk
Age
Metabolic Changes
Obesity
Trauma
Poor Body Mechanics
79 yo with a left total hip replacement (anterior approach) after failed conservative treatment for osteoarthritis
What type of weight bearing and/or movement restrictions would this client have?
Weight Bearing As Tolerated (WBAT) or
Partial Weight Bearing (PWB)
No extension/external rotation/adduction
Cancer
- Genetic Mutation; Mutant cells can change function, cell growth can get out of control
- Abnormal Cellular Behavior
True/False
Incidence for cancer is 10 times greater in those over 65y.
True
The mortality rate for cancer is higher among…
A. Women
B. Men
B. Men
The mortality rate for cancer is higer among men than women.
Highest in African American men
What are some risk factors for cancer?
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Age
Alcohol/Tobacco Use
Diet
Obesity
Radiation
Sunlight
Hormones
Chronic Inflammation
Cancer-Causing Substances
Immunosuppression
Infections
Tumor
Abnormal Growth of Cells
Characteristics of a Benign Tumor
No Cancerous Cells Present
Don’t Invade Nearby Tissue
Tumor Doesn’t Normally Return After Removal
Usually Has a Smooth, Regular Shape
Often Move Around if You Push on Them
Typically not Life-Threatening
May or May not need treatment
What types of malignant tumor cells are there?
Carcinoma
Sarcoma
Blastomas
Characteristics of Malignant Tumors
Contains Cancerous Cells
Able to Invade Nearby Tissue
Can shed cells that travel through the blood or lymphatic system to other parts of the body to form new tumors
Can Return After Being Removed
May have an Uneven Shape
Don’t Move Around When you Push on Them
Can be Life-Threatening
Require Treatment
Tumor Effects
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Pain
Obstruction
Weight loss
Fatigue
Necrosis and ulceration
Infection
Bleeding
Diagnostic Tests for Cancer
Routine Screening- for early detection
Self-Examination- early detection if done consistently
Blood Tests- measure blood cell levels during treatment, may detect tumor markers (PSA test)
Radiographs, Ultrasound, MRI, CT
Cytological Tests- Require biopsy or cell sample
Metastasis
Spread to distant sites
Spreads via blood or lymph or other body fluids
Ex. Carcinoma of the colon spreads to the liver
Stages of Cancer
Stage 0: Abnormal Cells are present but have not spread to nearby tissuse (also called carcinoma in situ CIS. CIS is not cancer, but may become cancer)
Stage I, II, and III: Cancer is present. The higher the number, the larger the cancer tumor and the more it has spread into nearby tissues.
Stage IV: The cancer has spread to distant parts of the body
Palliative Care
Full Definition
an approach that aims to improve quality of life for families and patients facing life-threatening illness. It provides relief from pain and other distressing symptoms, support to help patients live as actively as possible, and coping and bereavement assistance
Pre-Cancerous Tumor
Abnormal cells with potential to become cancerous
Invasion
In relation to the spread of malignant tumors
Local Spread
Tumor cells grow into adjacent tissues
What is TNM Staging?
Degree of Progression
Tumor Size
Number of lymph noed to which it has spread
Metastasis Present
How is surgery used in relation to cancer?
Used to diagnose, treat, and prevent cancer
What are secondary side effects from surgery?
Complications
Pain
Infection from wound site
Lymphedema
Chemotherapy
Medicines or drugs that are used to treat cancer
Kill cancer cells and eradicate altogether OR
Contain or slow down tumor growth
Secondary Side Effects of Chemotherapy
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Fever and chills
Nausea and vomiting
Hair loss
Fatigue
Sores in mouth or throat
Constipation or diarrhea
Itching/rash
Muscle or joint pain
Memory changes
Peripheral neuropathy
Radiation Therapy
Cancer
The use of high-energy particles or wavelengths to kill the cancerous cells and shrink tumors
Seconary Side Effects of Radiation Therapy
Cancer
Fatigue
Skin Irritation at Site
Fever and Chills
Immunotherapy
Cancer
A type of biological therapy that uses substances made from living organisms to treat cancer
Secondary Side Effects of Immunotherapy
Cancer
Skin Irritation at Needle SIte
Flu-like Symptoms
Swelling
Weight-Gain
Lung Cancer
Deadliest Type
More treatable than in past
Small cell or non-small cell
Leading cause: smoking, environmental factors
Often diagnosed (Dx) in late stages
Primary or secondary site
Colorectal Cancer
Is one of the more deadly cancers
Increased risk over age 50
Early detection and possible prevention by colonoscopy
Change in bowel habits or bowel obstruction at later stages
Can cause life-altering surgeries and treatments such as colostomy
In some cases colostomies are reversed if treatment goes well
Ovarian Cancer
Poor prognosis because of hidden nature of cancer
High mortality rates
May not be known until there is change in bowel or bladder function or unexpected increase in abdominal girth
All the other abdominal organs are vulnerable to spread due
Breast Cancer
Most common cancer among women
2nd leading cause of death for women
Risk Factors of Breast Cancer
Age
Heredity
Physical inactivity
Weight gain
Use of hormone replacement therapy
African American women most likely to die from breast CA, which may be due to more aggressive form
Brain Cancer
- Life-threatening because of compression of brain tissue
- Primary tumor usually fatal; thus, no metastasis (Gould)
- Common deficits for which rehabilitation services are needed include the following:
* Impaired cognition
* Weakness
* Visual-perceptual deficits
* Sensory loss
* Bowel–bladder dysfunction
May present as if they’ve had a stroke due to pressure on brain
Head and Neck Cancers
Throat, larynx, nose, sinus or mouth
More common in males
Older adults
Caused by tobacco, excessive alcohol use, Human Papaloma Virus (HPV)
May experience anxiety & guilt over cause of cancer & implications for loved ones
Lymphedema
Inadequate drainage of lymphatic fluid
Caused by blockage of lymphatic flow due to:
* tumor or scar tissue
* inflammation of lymph nodes and vessels related
to radiation
* surgical resection of lymph nodes
Most commonly associated with breast cancer
can occur with other forms of cancer
Typically occurs in the arms or legs
Increased edema in area impacted
affects ROM and function
