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Upper Extremity Orthotics > Week 5 > Flashcards

Week 5 Flashcards

1
Q

Orthoses for arthritis are used to do what?

A

Reduce inflammation
Support and stabilize joints during function to reduce pain
Protect joints from increased stress/demand
Prevent joint contractures
Immobilize unstable joints
Increase ROM
Increase Function
Position joints for occupational performance

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2
Q

What is the presentation for Rheumatoid arthritis?

A

Boutonniere deformity of thumb
Ulnar deviation of metacarpophalangeal joints
Swan neck deformity of fingers

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3
Q

What is the presentation for Osteoarthritis?

A

Fusiform swelling of joints
Heberden’s nodes
White in joint spaces in X-ray demonstrating bone overgrowth

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4
Q

What is Wolff’s law?

A

If you don’t use it, you lose it.

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5
Q

What joints does OA often affect?

A

DIP, PIP and CMC joints

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6
Q

What are the common symptoms of OA?

A

Joint tenderness

Crepitus pain-creaking joints

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7
Q

What often occurs to the wrist joint for RA patients?

A

95% develop bilateral wrist joint involvement

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8
Q

What are the four types of orthoses used for RA?

A

Resting orthosis
Static orthosis
Static progressive orthosis
Dynamic splints

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9
Q

What are the aspects of the resting orthosis?

A

Provides passive immobilization during acute stage of inflammation
Alleviate pain
Facilitate the use of uninvolved joints

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10
Q

What are the aspects of the static orthosis?

A

Provides support, stabilization, protection, and immobilization
No moving components

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11
Q

What do finger orthoses do?

A

Prevent swan neck deformity

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12
Q

What does a thumb post do?

A

Prevent swan neck deformity of thumb

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13
Q

What does a HO do?

A

Stabilizes CMC joint and MP joint

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14
Q

What should be used with more wrist involvement?

A

A WHO

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15
Q

What are the aspects of the static progressive orthosis?

A

Used to regain joint motion
Joint motion is achieved by the hook and loop closures, hinges, screw, and turnbuckles
Reduces ulnar deviation

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16
Q

What are the aspects of the Dynamic orthosis?

A

Used to apply force to lengthen tissue in order to restore motion
Counteract the deforming forces of RA with constant gentle traction
Essential for post-op rehabilitation to maintain the surgically achieved mobility

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17
Q

How many people in the US suffer from traumatic brain injury each year/

A

1.5 million

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18
Q

How many people die from TBI each year?

A

50,000

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19
Q

How many people suffer long term disabilities?

A

85,000

20
Q

How many people in the US live with disabilities cause by TBI?

A

5.3 million

21
Q

What are the top three causes of TBI injury?

A

MVA
Firearms
Falls

22
Q

Who are involved in the highest incident rates?

A

Males, 15-24

Geriatrics, 75+

23
Q

What are the two classifications of TBI?

A

Open head injury

Closed head injury

24
Q

What is open head injury?

A

Involved acceleration/deceleration with penetration

25
Q

What is closed head injury?

A

Rapid acceleration/deceleration without apparent visible damage.

26
Q

How do open head injuries occur?

A

Bullet wounds
Penetration of the skull
Largely focal damage

27
Q

How do closed head injuries occur?

A

Slip and fall, MVA
Focal damage and diffuse damage to axons
Effects tend to be broad
NO penetration of skull

28
Q

What are the immediate damages of closed head injuries?

A 
scalp laceration
skull fracture
cerebral contusions
cerebral lacerations
intracranial hemorrhage
diffuse axonial injury
29
Q

What are the secondary damages of closed head injuries?

A

Ischemia
hypoxia
cerebral swelling
infection

30
Q

What is another name for deceleration injuries?

A

Diffuse axonal injuries

31
Q

What is diffuse axonal shearing?

A

When the brain is slammed back and forth inside the skull it is alternately compressed and stretched because of the gelatinous consistency till they are torn

32
Q

What are deceleration injuries?

A

The long, fragile axons of the neurons are also compressed and stretched

33
Q

What occurs when axonal shearing happens?

A

The neuron dies

34
Q

What is Coup Contra-coup injury?

A

Instance where the brain bounces back and forth inside of the head, causing damage to the brain where it hit the skull

35
Q

What determines how a patient will present?

A

The extent of brain injury

36
Q

What are the different types of TBI presentations?

A

Hemiplegia
Diplegia
Quadraplegia

37
Q

What should be checked on TBI patients?

A

Each affected limb for flexor or extensor synergy patterns

38
Q

What is synergy?

A

Synergy occurs when muscles are firmly linked together and the patient is unable to master individual joint movements

39
Q

What can the static tests show?

A

The affected limb may manifest as dystonic with dominant synergy pattern slowly taking precidence

40
Q

What are the different limb synergies?

A

Reflexive
Voluntary
A combination of reflexive and voluntary

41
Q

What is a reflexive synergy pattern?

A

Involuntary evoked response to a physical agent (touch, stretching, vibration)

42
Q

What is a voluntary synergy pattern?

A

Produced through volitional movement, such as active knee or elbow extension

43
Q

Why are orthotic subscribed to TBI patients?

A 
Prevent contractures
Maintain mobility (for hygiene)
44
Q

What orthosis can be used for TBI patients?

A

A WHO to maintain wrist alignment and prevent finger flexor deformities
Finger separators are preferred to prevent friction between fingers

45
Q

What device should be used if spasticity occurs in the finger flexors and full extension can’t be reached?

A

A sphere-shaped palmer device

46
Q

What can be used if the patient has hypersensitivity to palmar contact?

A

A dorsal splint because palmar contact can elicit a grasp response

47
Q

What additional resources might benefit OA, RA and TBI populations?

A

Assistive devices

Knowledge-pamphlets, support groups, 360 care

Upper Extremity Orthotics (8 decks)

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