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Pt.2 PHRM/PHYS/NS > week 6 : mobility > Flashcards

week 6 : mobility Flashcards

1
Q

adequate mobility requires what ? and what is the importance of this ?

A

adequate energy, muscle strength, strength stability, joint function, and neuromuscular coordination in order to carry out desire function

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2
Q

structure dictates what ?

A

dictates function

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3
Q

what does musculoskeletal system relies heavily on ?

A

neuromuscular system

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4
Q

Pathophysiology review - the musculoskeletal system ( what undergoes this category ) - recall from anatomy ( suck a nut like i already forgot 😁 )

A

bones
cartilage
ligaments
tendons
muscles

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5
Q

name the following description :
make up the skeletons that supports our body

A

bone

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6
Q

what is bone essential for ?

A

weight bearing

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7
Q

name the functions of a bone

A

creates a supporting structure
protect underlying organs and tissues
muscles can attach to bone because of tendons

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8
Q

Finish the sentence :

bones are levers for ______
bones contain ____ to produce ____ and ___ blood cells
storage of _____ and phosphate

A

movement
marrow, red, white
calcium

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9
Q

when structure changes so does it function, name an example of this description and briefly explain it ( include the brain and the lungs, and the heart in your example )

A

fracture of a bone
it impacts your overall function as our bone connects to muscle by tendons and they act for movement essential for protecting internal structures such as the skull ( protecting the brain ) or bony ribcage to protect vital organs such as lungs or heart

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10
Q

Recall : Bones contain marrow to produce red and white blood cells , go more in depth of this means

A

bones are responsible for the function of hematopoiesis which is the production of red and white blood cells that are created in bone marrow

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11
Q

functions of joints : name the characteristics that undergoes this category

A

joints are where two bones meet and move in relation to each other

joints are enclosed in a capsule of fibrous tissue and joints two bones together, forming a cavity

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12
Q

what does synovial membrane contributes in terms of the functioning of joints and cartilage

A

synovial membrane lines the cavity and secretes synovial fluid

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13
Q

what is synarthorothic joint? what abt alpha arthrodial joints ? and diathrodial or synovial joints ?

A

synarthorothic joint which are totally IMMOVABLE ( skull )

alpha arthrodial joints which are slightly movable such as what connects the bones of the pelvis together

diarthrodial or synovial joints which are freely movable joints such as elbow and the knee (most common joint in the body)

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14
Q

what is a cartilage ?

A

rigid connective tissue that supports soft tissue

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15
Q

true or false. Joints are present whenever the bones are meeting in the body, and they have different ranges type of mobility.

A

this is true

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16
Q

recall that : synovial membrane lines the cavity and secretes synovial fluid, now dig more in depth of what this contributes to mobility
describe joint cavity ( filled with synovial fluid )

A

lines the cavity or what we also refer to as that intra articular space and the parts that is contained within this space is now filled with a fluid that’s called synovial fluid and this acts as a space lubricant - it helps reduce the friction between the two bones during movement

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17
Q

Recall the diagram of lewis fig 64-2 slide 5
describe the bone and the layer cartilage between them

A

two bone meeting is not directly bone on bone but there is a layer of cartilage between them
and cartilage is a rigid connective tissue that provides the smooth lubricated surface for articulation for the meeting of two bones and it has a protective factor for bones and help absorb shock

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18
Q

describe how cartilage help protect you from shock ( from walking or running )

A

the cartilage help protect those two bones that are connecting in your knee from that shock impact while you’re walking or running

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19
Q

what are the 3 types of muscles

A
  1. cardiac muscle - myocardium
  2. smooth muscle - airways, arteries, GI, bladder, uterus
    3.skeletal muscle- all other muscles of the body
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20
Q

name the 2 type of muscles that are involuntary

A

cardiac muscle ( myocardium ), and smooth muscle ( airways, arteries, GI, bladder, and uterus )

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21
Q

what is cardiac muscle : myocardium responsible for

A

this is the muscle of the heart, responding for contracting and pumping blood into our blood vessels : these muscles are involuntary

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22
Q

recall that smooth muscle : airways, arteries, GI, bladder, uterus , give an example of what this might look like

A

this is involuntary , for example : bronchioles that can dilate and constrict

within our arteries casing vasoconstrictor or vasodilation

along the gi tract causing peristalsis to occur along the bladder or uterus

they play a normal movement in the air, secretions or bodily fluids throughout the body

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23
Q

true or false. Smooth muscle play a normal movement in the air, secretions or bodily fluids throughout the body, what are the examples

A

true airways, arteries, GI tract, bladder and uterus are some examples

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24
Q

what is one voluntary act of the muscle

A

skeletal muscle

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25
Q

( voluntary ) name examples of skeletal muscles

A

biceps, abs, quadricepts ( all directed connected to skeletal system ) voluntary muscle

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26
Q

what is the skeletal muscles responsible for ?

A

responsible for overall body movement and mobility

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27
Q

true or false. skeletal muscles has to be a unconscious effort directed towards that muscle impulses in our nervous system in order for the skeletal to contract

A

false, CONCIOUS since it is voluntary U SUCTION CUP

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28
Q

in order for any muscle to contract, what type of impulse must there be ?

A

nerve impulse

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29
Q

motor nerve fiber stimulating a skeletal muscle fiber is what we refer to as what ?

A

motor end plate

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30
Q

what is the junction between the axon of the nervce cell adn the adjacent muscle cell ?

A

neuromuscular junction

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31
Q

neurotransmitter molecules, acetylcholine specifically are released from the ____

describe what this mean

A

neuron synaptic vessels and it diffuses across the synaptic cleft - they stimulate receptors in the motor end plate region of the sarcolemma

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32
Q

muscle skeletal system is closely connected to where ?

A

neurological system

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33
Q

give an example given in the neuromuscular junction

A

organs containing smooth muscles : GI tract this can be affected by a poor signal that automatic signal, ( those signals are involuntary )

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34
Q

recall that: organs containing smooth muscles : GI tract this can be affected by a poor signal that automatic signal, ( those signals are involuntary ) how is it going to impact the muscle ?

A

the ability of those smooth muscles in the GI tract to contract and cause peristalsis, if we have poor automatic signal or disruption in that impulse, it’s going to impact how well that muscle is able to contract and perform that function of peristalsis

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35
Q

what is ligaments and tendons composed of ?

A

dense, fibrous connective tissue

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36
Q

true or false. tendons attach muscle to bone

A

true

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37
Q

recall that tendons attatch a muscle to a bone. Name an example: and what can we do with this ? and define the description

A

for example : achilles tendons
tendons we can assess for reflexes, if they are struck with a mallet, they will trigger movement of the muscle they are attached to and move that bone

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38
Q

What does ligaments connect? and what does it do ?

A

ligaments connect bones to bones, provide stability but also enable movement at the joint

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39
Q

how are ligaments and tendons different ? and how are they similar?

A

these are similar and that they both support bones , different in the fact that they have different insertion and joints

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40
Q

name an example of ligament supporting healthy joint

A

the knee joints has numerous ligaments attaching in multiple different ways in order to create every strong support network to weight bear an individual’s weight when they’re walking

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41
Q

ligaments and tendons have low blood supply?

A

yes this is true

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42
Q

recall that ligaments and tendons have low blood supply, now what could happen if you have an injury ?

A

Low blood supply, which means it takes longer for healing when there is an injury

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43
Q

true or false. tendons and ligaments is composed of dense fibrous connective tissue which is great for supporting our muscles and bone and holding everything in place.

A

true

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44
Q

is fracture considered as a medical condition ?

A

yes it is

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45
Q

what is this description describing : break in the structure of the bone

A

fractures

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46
Q

fracture has classification : what is fractures classified as ? (hint there is a couple of them)

A

open or closed
complete or incomplete
direction of fracture line

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47
Q

if the skin has a broken and it has a bone sticking out what type of fracture is this considered as ?

A

open fracture

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48
Q

true or false. The skin is a tiny bit open, however it is still considered as an open fracture

A

this is true, once its open ( ITS OPEN )

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49
Q

most fractures are closed or open ?

A

closed

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50
Q

where could we see open fractures ?

A

high impact traumas such as car accidents or falls from significant heights

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51
Q

opening in the skin creates what type of opportunity (recall what she said in the lecture )

A

creates an opportunity for blood loss and there is a big enough vessel –> this could be a significant amount of blood loss that happens during this open fracture

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52
Q

how do you really identify an open fracture ?

A

the increased risk of infection that exists once the skin is exposed

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53
Q

what is the biggest risk for an open fracture ? explain

A

infection
skin is protective barrier against infection, once that barrier is open, allowing that external bacteria can penetrate into the wound and into the bone leading to infection

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54
Q

what is a complete fracture and what is an incomplete ?

A

complete fracture- if the break is completely though the bone

incomplete fracture- if the fracture occurs partially and the bone somewhat still remains in one piece

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55
Q

recall that the direction of the fracture can also be another way to classify a fracture : name an example

A

transverse across the bone of if it spirals along it

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56
Q

true or false. fractures can be surgical or non surgical

A

well no shaaaat the fack, it can be both

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57
Q

recall that fractures can be surgical or non surgical: some fractures can be displaced means the bone when it’s broken is misaligned for healing require intervention to realign referred to as

A

reeduction

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58
Q

when fixing a misalignment: name some intervention

A

can be sedation by pulling on that broken bone and manually realigning those bones during the casting process potentially require surgery with the insertion of surgical pins and rods to properly realign that bone.

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59
Q

Fractures can also occur without trauma or with very minimal impact in patients who have heart disease. would this be a true or false statement ?

A

bruh hell naw , its osteoporosis

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60
Q

Fractures can also occur without trauma or with very minimal impact in patients who have osteoporosis which we talk about further on and these are called

other than osteoporosis, these type of fracture is also common in what type of pts?

A

pathological fractures
cancer pts

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61
Q

what are the clinical manifestations of fractures

A

localized pain or bony tenderness
decreased function of the bone - think abt weight bearing
edema/swelling
- crepitus
- bruising

62
Q

decreased function of the bone in terms of fractures clinical manifestations also means ….

A

decreased range of motion and decrease mobility to weight bear

63
Q

this is a sound crucnhing noise meaning that the bone is not lined correctly, and two bones are grinding together

A

crepitus

64
Q

why does bruising occur during a fracture ?

A

there’s blood vessels within the bone, so when there is a trauma to the inside of the bone this will show up

65
Q

name the fractures complications

A

infection
compartment syndrome
venous thromboembolism
fat embolism

66
Q

true or false. once you have that open fracture, the bacteria cannot penetrate through the sterile environment.

A

UH U GOTTA BE THE MOST SUCKED IN of course its compromised now since its open ( infection has entered the chat )

67
Q

name what undergo infection in terms of fracture complications

A

open fracture high risk
open wound
surgery opens the wound to potential contaminants

68
Q

what are the signs of inflammation when the pt is experiencing an infection due to fracture complication

A

warmth, redness, swelling, increased pain, and fever

69
Q

true or false. even if there is an establishment of rules during surgery, there is no risk at all since it is a professional environment and precautions are made.

A

false, even if there is a precaution there is still a risk because AGAIN again I WANNA EMPHI that its still open

70
Q

People who are immunocompromised are more susceptible to infection for fracture complications. Name examples

A

diabetes, HIV< or on meds that can cause immunocompromised ( steroids –> prednisone ) pts are at high risk

71
Q

what are the specific neurovascular findings of comparment syndrome

A

The 6 P’s
1) Pain *out of portion, passive stretching
2) Pressure
3) Paresthesia
4) Pallor
5) Pulselessness
6) Paralysis * latest finding, loss of muscle function

72
Q

true or false. ashen and pale or an not consistent with their individual is an clinical manifestation of compartment syndrome.

A

true

73
Q

Compartment syndrome is only limited to leg and the forearm. true or false?

A

false, can happen in any part of the body, but is most common in leg and forearm

74
Q

what is occurring during a comapartment syndrome?

A

As muscle are losing that circulation and becoming ischemic with that compartment syndrome this can be a very painful process

75
Q

describe what pressure is under compartment syndrome

A

feel that space filling up and have that loss of mobility and range of motion due to that feeling of having in that area

76
Q

what clinical manifestation is this describing: if there’s compression on the nerves, this will change their function, and pts can have decreased sensation, sometimes describing it as that feeling of pins and needles

A

paresthesia

77
Q

this is bad sign, loss entire circulation to an area completely : what type of clini mani is this describing in terms of compartment syndrome

A

pulselessness

78
Q

When compartment syndrome occurs, does this happen rapidly or progression?

A

when compartment syndrome occurs it can happen very quickly and can progress very rapidly

79
Q

compartment syndrome :
muscle and nerve cells are damaged due to what ?

A

due to ischemia within 4 to 8 hrs ( HUGE RED FLAG ) for msk injuries and should be reported right way ( MAJOR PART OF ASSESMENT in surgery as well)!!!

80
Q

true or false. Muscle group is divided into compartment.

A

true

81
Q

with compartment syndrome there is an increase in pressure of that compartment and this can be due to multiple different factors: name those factors , what is the end result

A

It can be internal factors such as an increase in bleeding or swelling

it can be related to external factors such as a cast that’s inappropriately placed or way too tight.

Either way the end results in obstruction in blood flow and ischemia will result.

82
Q

venous thromboembolism

A

this is life threatening an immediate intervention is needed
major associated with clot formation

83
Q

venous thromboembolism : name characteristics

A

hip fractures, hip and knee surgery

after it forms it can travel
- unilateral leg pain, unilateral leg swelling
- pts are often anti coagulated to prevent the formation of a clot

84
Q

what does prophylaxis mean ?

A

means we’re trying to prevent something

85
Q

lying horizontally in a hospital bed ( allows pulling of blood ) this is one aspect of what we refer to as virchow’s triad , define how it correlates to DVT

A

outlines the three biggest riks factors for development of DVT

86
Q

What are the 2 outlines of virchow’s triad that outlines DVT

A

1) immobility and venous stasis
2) endothelial damage ( refers to the lining of the inside of the blood vessels ) can become damaged with trauma that caused the fracture –> activates clotting factors and platelets which start that clotting process

87
Q

what is the last of virchow’s triad that outline DVT

A

if a patient has blood
hyper coagulability = state where there is that imbalance of clotting mechanisms which could be due to medical conditions or potentially drugs that the patient is taking.

88
Q

a serious condition when the DVT clot breaks off and travels into vital organs such as the lungs, the heart, or the brain. A clot there could become life-threatening very quickly. is this true or false.

A

WEELLLL NO F ING SHAAT it is

89
Q

We always want to prevent virchow’s triad , for ex: someone who just finished surgery ( we must prevent blood clot forming )

A

yes true

90
Q

fat embolism : SATA
a. early recognition is important for preventing death
b. usually develop symptoms within 24-48 hrs
c. symptoms usually include bradycardia, bradypnea, and dyspnea
d. neurological changes may also occur which include confusion, irritability, and restlessness

A

a b and d is correct

c is incorrect : it’s tachycardia, tachypnea and dyspnea that occurs ( remember SNS )

91
Q

how can fat embolism occurs ?

A

can occur when a bone breaks and it’s often if it’s a long bone
fracture such as in the ribs or the pelvis

92
Q

true or false. 90% of people with the fracture that experience a fat emboli are often going to
have minimal symptoms. It’s fairly insignificant on their health.

A

true

93
Q

fat embolism - potential for these emboli to become serious because they could still potentially travel to areas of vital organs such as the lung, the heart, or the
brain.

A

true

94
Q

name other clini mani of fat embolism that can occur

A

respiratory distress ( if we havean impact in pulm. circulation ) chest pain, cyanosis, and decreased oxygen sat

95
Q

what is an arthritis, and what is the three type of it in terms of mobility ? also be referred as rheumatoid disease

A

refers to inflammation of the joint or many joint
1) osteoarthritis
2) rheumatoid arthritis
3) gout

96
Q

this is the most common arthritis , and define what it is

A

osteoarthritis, degenerative disease which mean that this occurs in the general onset and typically get worse overtime

97
Q

what are the risk factors for OA

A

obesity ( increase in pressure )
trauma
repetitive use
post menopausal ( as natural estrogen increase )
family hcx

98
Q

with time there is a sig. thickening of the articular bone of that fricture no longer smooth cartilage ( bone on bone ) - is this the possibility for osteoarthritis?

A

true

99
Q

osteoarthritis clinical manifestations : name them

A

not systemic
joint pain
stiffness in the AM
Joint deformity
- heberden nodes
- bouchard nodes
crepitus
asymmetrical

100
Q

what is this describing : this is localize to the area of the damage and therefore do not see systemic change

A

osteoarthritis

101
Q

osteoarthrithis clini mani: explain why joint pain and stiffness in the am occur

A

joint pain - repetive or continous use of that joint

stiffness in the AM - as a decrease in their range of motion , worse with use and better in rest

102
Q

true or false. Osteoarthritis-> Better in the morning - rest and worse throughout the day ( with use )

A

true

103
Q

Explain heberden nodes

A

these occur at the distal interphalangeal joint which is the joint just below the fingernail. this is very common site for osteoarthritis

104
Q

explain what bouchard nodes

A

occurs right under that within middle interphalangeal joint

105
Q

True or false. Both of nodes ( heberden and bouchard ) ,can be red swollen and painful. Crepitus might also be present when that joint is moved

A

true

106
Q

Crepitus - this is an assessment finding that’s that
crunching sound of bone-on-bone caused by an osteoarthritis, that small joint space, presence of osteophytes, and absence of cartilage with that more bone-on bone contact.

true or false.

A

true

107
Q

what type of arthritis is this describing : chronic and autoimmune disease

A

RA ( rheumatoid arthritis )

108
Q

what causes RA?

A

environmental triggers
genetics

109
Q

essentially with RA the body’s immune system is attacking the joints, is that true ?

A

true

110
Q

RA : this is a system remission ( decrease or absense of symptoms ) and exacerbations, is this true or false.

A

true

111
Q

describe RA as a first progression to it’s final stage

A

1) lymphocyte which has been activated by the immune system, infiltrating the joint space

2) we start to see formation of granulation tissue and destruction of that important cartilage

3) thickening of the joint capsules, and the edges of the actual bone can erode, and
there is a loss of bone density. so the bones can become more porous and more
therefore susceptible to injury.

112
Q

rheumatoid arthritis are believed to be genetic. true or false.

A

true

113
Q

RA clinical manifestations: what are the general manifestations

A

fatigue
fever
anorexia
weight loss
generalized stiffness

114
Q

unlike osteoarthrithis define the pain level in RA

A

pts with RA will have pain first thing in the morning, when they wake up along with stiffness ( it will improve throughout the day with use)

115
Q

RA clini mani : localized

A
  • Pain is worse in the AM
  • Multiple joints Bilaterally, usually in the smaller joints (hands and feet)
  • Flares (swelling, heat)
  • Stiffness in the morning
  • Limitation of movement
  • Heat
  • Swelling
116
Q

heat and swelling is a part of localized clini mani of RA, define why

A

due to those autoimmune inflammatory process

117
Q

figure 67.4 on slide 23 must be studied but i cant add on photos so just study it, and DONT BE UGH.

A

MWAHH thank yew

118
Q

the onset of this is very quick : what is this describing

A

gout

119
Q

gout define the characteristics

A

accumulation of uric acid crystals in one or more joints

purines can be exogenous or endogenous

120
Q

what are the risk factors of gout

A

male, obesity, HTN , diuretic use, excessive alcohol , kidney disease, diet in high purine rich foods

121
Q

how are uric acid created

A

purines are broken down in the body and a purine is a chem compound

122
Q

gout : kidneys excrete uric acid. is this true or false

A

true

123
Q

Would ingested such as food we eat be considered as exogenous or endogenous?

A

exo DUHHHHHHH

124
Q

the pathophysiology behind gout can be explained by three major concepts, what are they?

A

1) hyperuricemia
2) underexcretion of uric acid
3) diet in high in purines

125
Q

what is this describing : essentially refers to an increase in uric acid production. How can this accumulate ?

A

hyperuricemia
brough on by alcohol use, particularly beer.
dehydration can also be a culprit of this and also a very protein rich meal

126
Q

how quickly the body is essentially able to eliminate that uric acid and prevent it from building up crystallizing and getting stuck in those small joint spaces. This is thought to be
the most common contributing factor affecting about 90% of those who experience
gout: what is this describing

A

under excretion of uric acid

127
Q

diet high in purines : define the description

A

purines are broken down unto uric acid and they are found in many foods. Examples : are organ meats, alcohol, and seafood

128
Q

how can under excretion also occur ?

A

can be a result of decreased kidney function

it can also occur from fasting or excessive alcohol use both of which can create keto acids which actually inhibit the elimination of uric acid from the body.

129
Q

Gout : clini mani

acute gout : what is it triggered by ?

A

Acute gouty arthritis is triggered by trauma, surgery, stress, infection, alcohol ingestion

130
Q

acute gout clini mani

A

Inflammation of the big toe (Podagra)

Symptoms begin at night swelling + pain + low grade fever

Symptoms peak within several hours and the exacerbation subsides within 2-10 days

131
Q

True or false. So many frequent repeated acute gout attack flares over time can eventually lead to
chronic gout if these acute attacks happen frequently and often enough and lead to
those structural changes associated with chronic gout

A

true

132
Q

Gout : clini mani
Chronic

A

Multiple joint involvement

Visible deposits called tophi (develop years after onset of disease)

Tophi occur in the synovium, along tendons, and in the skin and cartilage
1) Typically painless
2) Decreased mobility
3) Can become infected

133
Q

Chronic Gout : Structural changes including cartilage destruction can lead to secondary OA

is this a true statement

A

true

134
Q

what does osteoporosis mean

A

osteo- bone
porosis - pores

135
Q

what is this describing : bones are going to be more porous and therefore more fragile and more susceptible to fractures

A

osteoporosis

136
Q

true or false. bones as a living and changing tissue and is constantly changing

A

true

137
Q

this is a disease of cellular regulation

A

osteoporosis

138
Q

define the characteristics of osteoporosis

A
  • Low bone mass – disease of cellular regular
  • Peak Bone Mass occurs at age 30, stable till
    age 50 then declines at a rate of 1%/year
  • Women, after menopause, have an accelerated rate of decline at about 2-3% lost per year
139
Q

what is osteoclast and osteoblast

A

osteoclasts responsible for bone reabsorption and
osteoblasts are responsible for new bone formation

140
Q

osteoporosis, the breakdown of bone by osteoclasts is faster than the new
formation by osteoblasts and the result is lower bone density or porous bones.

Bone mineral density is the amount of strength and it usually peaks between age 25 and 30. After that peak age range, the osteoclastic activity exceed osteoblastic activity and bone mineral density starts to decline.

define if these statements are true

A

both true

141
Q

Risk Factors for ↑ loss of bone
mass

A

(low calcium/vitamin D, low estrogen, smoking, etoh, drugs, physical inactivity

  • Primary (natural ageing, environment) vs secondary (drugs and medical conditions)
  • Secondary - Diseases (turners, Cushings, diabetes, RA)
142
Q

true or false. osteoporosis can be classified as being primary or secondary when it comes to risk factors

A

yes, that is true

143
Q

attributed to that onset of osteoporosis being triggered by a drug or a disease
process and it can occur at any age and again ultimately whatever is triggering
this secondary osteoporosis is causing what ?

A

the quicker reabsorption of bone than the bone production and this can sometimes be seen with chronic diseases such as
diabetes and rheumatoid arthritis.

144
Q

factors that can affect and help protect peak bone mass include

A

nutrition, strength change, training, and some hormones such as estrogens and androgens.

145
Q

clinical manifestations of osteoporosis

A
  • Pathological fractures (vertebral/compression)
  • Pain
  • Loss of vertebral height & changes to the spinal column: Kyphosis
146
Q

what is usually the placement for pathological fractures ( vertebral/compression ) when it comes to osteoporosis

A

wrist, hip, and spinal cord

147
Q

pain is usually associated with what in osteoporosis?

A

fragility of bone, the pain associated with activity

148
Q

what is this describing : forward bending of that thoracic spine

A

kyphosis

149
Q

what is the impact of chronic pain

A

Quality of life
* ADLs
* Anxiety, depression
* Fatigue, insomnia
* Fear, anger
* Affects social relationships

Financial
* Unable to work
* Medications
* OT/PT
* Supportive devices

150
Q

true or false impact of chronic pain : They can experience fatigue and insomnia as pain may keep them up at night and prevent them from sleeping and have impacts on their mental health including fear and anger.

A

true

Pt.2 PHRM/PHYS/NS (14 decks)

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