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Ortho Eval > Week 6 - Osteoarthritis > Flashcards

Week 6 - Osteoarthritis Flashcards

1
Q

a disorder of joints characterized by deterioration of the articular cartilage and secondary bone formation. onset is non-inflammatory but secondary inflammation is common

A

OA

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2
Q

describe the gender prevalence of OA.

A

2/3 female

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3
Q

name 4 etiologies of OA.

A
  • genetic
  • metabolic
  • systemic
  • traumatic
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4
Q

___ ___ is a risk factor for OA.

A

excess weight

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5
Q

what is the main cause of OA?

A

injury (to joints, fractures, ligament tears) and overuse (long periods of standing, heavy lifting, typing)

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6
Q

OA has the highest ___ of ALL illnesses.

A

morbidity

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7
Q

name 3 general symptoms of OA.

A
  • joint stiffness (limited ROM or stiffness, clicking/cracking when joint moves)
  • swelling
  • pain
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8
Q

name 2 situations when OA pain improves.

A
  • after gentle exercise and/or light activity

- after rest

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9
Q

when does OA pain worsen?

A

after forceful gripping or pinching

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10
Q

ppl with OA can have increased pain in what type of weather?

A

cold weather

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11
Q

ppl with OA experience stiffness after how many mins of static position?

A

15-30 mins

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12
Q

ppl with OA experience limited joint ROM and deformity due to what 2 things?

A

osteophyte formation or cartilage loss

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13
Q

ppl with OA can have ___ ___ from disuse.

A

muscle weakness/atrophy

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14
Q

name 6 most commonly involved joints.

A
  • knees
  • hips
  • PIP and DIP joints of hand
  • CMC joint of thumb
  • spine
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14
Q

name 6 most commonly involved joints.

A
  • knees
  • hips
  • PIP and DIP joints of hand
  • CMC joint of thumb
  • spine
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15
Q

what is the key to self management?

A

patient education

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16
Q

what is the general purpose of OT in OA?

A

evaluate functional performance and teach pt. how to self-manage OA

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17
Q

name 5 aspects of OA self management.

A
  • eliminate aggravating factors
  • reducing stiffness, pain and inflammation
  • maintain ROM and muscle strength
  • reducing joint stress
  • increase functional independence
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18
Q

name a symptom of OA of the hand.

A

pain with functional activities - exacerbated with activities requiring sustained or repetitive grip and pinch

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19
Q

how is OA of the hand managed?

A
  • pain management
  • rest via joint immobilization (orthotics) - to stabilize CMC joint
  • activity modification - adaptive equipment
  • joint protection techniques
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20
Q

which joint of the hand is very commonly involved?

A

CMC joint

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21
Q

osteophytes at DIP joints

A

Heberdon’s nodes

22
Q

osteophytes at PIP joints

A

Bouchard’s nodes

23
Q

what is STT arthritis?

A

CMC joint (scaphoid, trapezium, trapezoid)

24
Q

name 3 symptoms of CMC joint OA.

A
  • pain
  • stiffness
  • tenderness
25
Q

name 3 signs of CMC joint OA.

A
  • bony enlargement
  • limited ROM
  • deformity
26
Q

describe a CMC orthosis for OA.

A
  • hand based with C bar
  • allows IP movement
  • wrist free
27
Q

name 3 PAMs for acute inflammation OA.

A
  • cold
  • electrical stimulation
  • superficial heat
28
Q

name 1 PAM for chronic inflammation for OA.

A

conversion heat (ultrasound)

29
Q

pts. with OA of CMC joint may need to learn what during activities?

A

lighter touch

30
Q

name 3 orthoses to reduce OA stiffness.

A
  • soft splints
  • tubigrip
  • isotoner gloves
  • coban wrap
31
Q

what is 1 way to reduce OA stiffness?

A

exercise in warm water in morning

32
Q

name 2 ways to increase OA joint ROM.

A
  • heat and GENTLE stretch

- home exercise program (HEP)

33
Q

name 2 ways to increase strength in pts. with OA.

A
  • strengthening around specific joints
  • moderate load for strengthening
  • walking to improve cardio and general fitness
34
Q

describe an orthosis for STT arthritis.

A
  • splint wrist AND CMC joints

- forearm based splint

35
Q

name 2 treatments for STT arthritis.

A
  • splinting

- corticosteroid injections

36
Q

in which type of arthritis do you see a lot of swelling and which do you see bony nodes?

A

RA - swelling

OA - bony nodes

37
Q

describe ROM interventions for OA.

A

starts with AROM

38
Q

should you use the dynamometer or pinch gauge for pts. with OA who are acutely inflamed?

A

no

39
Q

determines whether or not there is pain at CMC joint (compressing MC at trapezium)

A

grind test*

40
Q

have pt. grab the tip of their thumb and go into ulnar deviation; if tendons on that side (APL and EPB) are inflamed they’ll scream in pain; used in CMC joint arthritis

A

finkelstein test*

41
Q

short thumb spica

A

splint that supports CMC joint

42
Q

supports CMC joint right at the base

A

Metagrip splint

43
Q

thin fragile, weaker, prevents palmar subluxation - key role in pronation/opposition

A

anterior oblique “beak” ligament (AOL)

44
Q

strongest toughest ligament - key ligament in stabilizing CMC joint during powerful subluxing forces in power pinch/grip

A

dorsal ligament complex

45
Q

essential in stabilizing thumb MC to index in absence of other ligaments or excision of trapezium

A

intermetacarpal ligament

46
Q

name 3 dynamic stability exercises for OA.

A
  • restoration of thumb web space
  • joint mobilization for pain control
  • orthotic fabrication to stabilize the CMC joint - as appropriate
47
Q

pressure to adductor by pinching with opposite thumb or clip, contract-release with stretch, or manual release

A

adductor muscle release

48
Q

grasp thumb with opposite hand behind back - let weight of arms distract joint

A

mobilization: distraction

49
Q

rest involved CMC joint atop skull, insert opposite thumb in webspace or gently on thumb column - hold hand gently rock forward and back 1-3 or more minutes

A

mobilization: reduce dorsal subluxing

50
Q

reach across dorsum of involved hand, wrap fingers around the length of the 1st MC, press hand to chest and gently loosen CMC joint by rolling the involved thumb away from chest, hold for 1-3 or more mins.

A

mobilization: retro-position

51
Q

-move through full abduction/adduction, then progress: first AROM - light resistance (rubberband), 10-15x 3x a day to max. resistance 10-12x/once per day

A

strengthening: first dorsal interosseous

52
Q

strengthen in a C position for which 3 muscles?

A
  • extensor pollicis brevis
  • abductor pollicis brevis
  • opponens pollicis
53
Q

place thumb in opposition to fingertips: begin to pinch, if MP starts to collapse STOP

A

place and hold

Ortho Eval (24 decks)

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