Dh-Contemporary I: Wilkins Ch 55 Physical Impairment (Workbook))

Front 1

Describe the sensorimotor effects of the following lesions.
Complete spinal cord injury lesion
Incomplete spinal cord injury lesion

Back 1

Complete spinal cord injury lesion results in complete paralysis with no recovery of sensation

Incomplete spinal cord injury lesion results in partial paralysis with the ability to regain sensation within in 6 months

Front 2

What causes a decubitus ulcer and how can you help prevent this condition during dental hygiene treatment of a patient with paralysis?

Back 2

Decubitus ulcer (aka "Bed Sores")

CAUSE- by excessive pressure on bony prominences (common amongst patients with paralysis)

TREATMENT- Use of padding/cushions to relieve pressure is indicated, as well as frequent turning of patient

Front 3

Mouth-held appliances can aid your patient with a spinal cord injury in performing a variety of basic procedures that contribute to independence. List the criteria for an adequate oral orthosis.

Back 3

An adequate oral orthosis appliance
(1) should not cause harm to the teeth or periodontium
(2) stabilizes occlusion
(3) do not prevent the eruption of teeth
(4)does not cause fatigue or pain (5)Can be easily placed and removed by the quadriplegic patient
(6) pt can still swallow, speak, and moisten lips
(7) Is easy to fabricate
(8) Inexpensive

Front 4

What is a TIA?

Back 4

TIA (transient ischemic attacks)

A condition where blood supply to a localized area of the brain is interrupted, which produces "mini strokes" and TRANSIENT signs and symptoms. MAY not leave permanent damage

Front 5

What causes a stroke to happen?

Back 5

STROKE-sudden loss of brain function when blood does not reach the brain

CAUSE:
1. Thrombosis
2. Intracerebral Embolism
3. Ischemia
4. Cerebral hemorrhage

Front 6

What patient assessment technique, commonly used by dental hygienists, can provide information that may indicate your patient’s increased risk for CVA.

Back 6

PATIENT ASSESSMENT TECHNIQUE= panoramic x-ray

SIGN:
Calcifications of the carotid artery can be seen on a panoramic x-ray which indicates an increased risk for CVA

Front 7

What conditions increase an individual’s risk for CVA?

Back 7

CVA (cerebralvascular attack) aka " Stroke"

PREDISPOSING FACTORS:
1. Artherosclerosis
2. Hypercholesterolemia
3. Hypertriglyceridemia
4. Hypertension
5. Cardiovascular Disease
6. Smoking
7. Oral Contraceptives
8. Drug Use

Front 8

What is aphasia?

Back 8

APHASIA

a=without
Phasia= to speak


Loss of ability to speak, write or to understand spoken or written language due to brain damage.

Front 9

If your patient has a history of CVA damage to the right side of the brain, that patient would exhibit _________ hemiplegia, have difficulty with __________________, and would likely behave in an _______________________ manner.

Back 9

CVA DAMAGE - occurs on the opposite side of the body where the brain was damaged

Right side of the brain = left hemiplegia
SIGNS:
1. difficulty with physical coordination
2. are cautious and anxious

Front 10

If your patient has a history of CVA damage to the left side of the brain, that patient would exhibit_________hemiplegia, have difficulty with ___________, and would likely behave in ____________________________________ manner.

Back 10

Left side of the brain = right hemiplegia
SIGNS:
1. difficulty with speech
2. Act with overconfidence

Front 11

Describe the location and progression of osteoarthritis symptoms.

Back 11

OSTEOARTHRITIS

LOCATION-
Hips, knees, fingers, and vertebrae

Front 12

Describe osteoarthritis symptoms that can occur in the temporomandibular joint.

Back 12

OSTEOARTHRITIS (aka "DJD-Degenerative Joint Disease")

SYMPTOMS-TMJ
1. Crepitus
2. Clicking
3. Popping
4. Usually no pain is present

Front 13

Describe the symptoms of rheumatoid arthritis.

Back 13

RHEUMATOID ARTHRITIS

SYMPTOMS:
1. Migratory pain, swelling, tenderness
2. Morning stiffness
3. Weakness, fatigue, loss of appetite, anemia, low-grade fever
4. Subcutaneous nodules (elbows, wrists, fingers)
5. Pain with Jaw movements/difficulty chewing
6. Progressive deformity (ankylosis)

Front 14

What is juvenile rheumatoid arthritis?

Back 14

JUVENILE RHEUMATOID ARTHRITIS

1. Inflammation of the joints that occurs in children under age 16
a. Onset is acute with prolonged fever
b. Enlargement of the spleen and lymph nodes

Front 15

How does rheumatoid arthritis affect the temporomandibular joint?

Back 15

RHEUMATOID ARTHRITIS on TMJ

AFFECTS:
1. Fatigue in the joint
2. Difficulty opening

Front 16

What modifications to standard treatment techniques can you use to increase the comfort of your patient who has arthritic involvement of the temporomandibular joint while you are providing dental hygiene treatment?

Back 16

RHEUMATOID ARTHRITIS (TMJ)

TREATMENT:
1. Accommodate minimal opening
2. Allow frequent rests
3. Minimize pressure on mandible
4. Shorter appointments/Frequent Appointments

Front 17

What is the relationship between rheumatoid arthritis and periodontal disease?

Back 17

RHEUMATOID ARTHRITIS & PERIO

Are BOTH chronic inflammatory diseases. The pathogenesis of both are similar (but the etiology differs)

Front 18

If your patient has severe arthritis, what additional important question will you be sure to incorporate when you are updating his or her health history?

Back 18

SEVERE ARTHRITIS

ASK if patient has had a joint replacement. (This will help determine if the patient requires premedication).

Front 19

What oral findings are associated with impaired kidney function?

Back 19

IMPAIRED KIDNEY FUNCTION

ORAL FINDINGS
1. petechiae.
2. Ammonia in saliva with urine-like smell and taste changes.
3. Stomatitis, erythema, edema, candidiasis.
4. Demineralization of bone in radiograph.

Front 20

List the drugs, some commonly used or recommended during dental care, that use the kidney as a major pathway of elimination.

Back 20

IMPAIRED KIDNEY FUNCTION

DRUGS CONTRAINDICATED
1. lidocaine/Xylocaine local anesthetic.
2. Aspirin and NSAIDs.
Acetaminophen.
3. Penicillin. Clarithromycin.

Front 21

When is antibiotic premedication needed before dental treatment for your patient who has kidney dysfunction?

Back 21

KIDNEY DYSFUNCTION & PREMED

1. When a patient has a hemodialysis shunt
2. Recommended by physician
3. Other conditions in medical history require it

Front 22

What oral characteristics are associated with cerebral palsy?

Back 22

CEREBRAL PALSY

ORAL CHARACTERISTICS:
1. Muscular disturbances
2. Malocclusion
3. Attrition
4. Fractured Teeth
5. Dental Caries
6. Periodontal Infections (heavy calculus deposits)

Front 23

What symptoms of muscular dystrophy can directly affect your patient’s oral health status?

Back 23

MUSCULAR DYSTROPHY

SYMPTOM-Progressive Muscular Wasting causes problems with oral cleanliness
1. Inability to close lips (mouthbreathing)
2. Inability to hold a toothbrush
3. Weak facial muscles -trouble rinsing

Front 24

What oral factor places a patient with multiple sclerosis at risk for relapse or an increase of symptoms?

Back 24

MULTIPLE SCLEROSIS

INCREASE OF SYMPTOMS can include ORAL INFECTIONS

Front 25

Myasthenia gravis and scleroderma are both disabling conditions that have special significance for dental professionals. Why?

Back 25

MYASTHENIA GRAVIS & SCLERODERMA

SIGNIFICANCE
1. Myasthenia Gravis-Muscles of the eyes, facial expression, mastication, and swallowing are affected

2. Scleroderma (tightening of the skin and lips) makes is difficult to treat