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52 Cards in this Set
- Front
- Back
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Potential drugs for ankylosing spondylitis
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NSAIDs
Corticosteroids Cytotoxic drugs (block cell growth) if don't respond well to steroids TNF inhibitors |
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What joints does psoriatic arthritis typically effect early on?
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Joints of the digits and axial skeleton
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most common joints that gout effects
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Knee
1st MTP |
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Most common joints affected by RA, and common deformities
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MCP and PIP
Ulnar drift and volar sublux of MCPs Swan-neck Boutonniere deformities Bouchard's nodes (excessive bone formation on dorsal aspect of PIP) |
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Pharm for RA
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NSAIDs
DMARDs (methotrexate) Immunosuppresive agents (cyclosporine) Corticosteroids |
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How to dx RA? Abnormal lab tests?
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Symmetrical involvement as seen on X-ray
Elevated WBC Elevated ESR Hgb and Htc show anemia Elevated Rhematoid factor |
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Diff dx of TOS vs. facet syndrome or cervical nerve root
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Will have pallor and coolness
Muscle fatigue and cramps No pain with hyperextension and rotation of spine |
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Common fx sites associated with osteoporosis
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T-sp and L-sp
Distal radius Proximal humerus Proximal tibia Pelvis femoral neck |
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Common meds prescribed for osteoporosis
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Calcitonin
Biophosphates Ca Vit D Estrogen |
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What is osteomalacia characterized by?
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Decalcification of bones due to Vit D deficiency
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Arthrogryposis multiplex congenita
PT interventions? |
Congenital disorder causing limitations of joint motion
Adaptive devices, ADs, orthotics Implemet flexibility ex to maintain/improve normal joint motion and length of mm |
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Osteogenesis imperfecta
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Genetic disorder causing abnormal collagen synthesis
Leads to very thin bone, deformities, and fractures |
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Osteochondritis dissecans
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Separation of articular cartilage or subchondral bone
Occurs most often in medial femoral condyle. Less often at femoral head, talar dome, humeral capitulum |
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What is myofascial pain syndrome
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TRigger points.
Active trigger points have a characteristic referral pattern when provoked |
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S/s of bursitis
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Pain at rest
PROM and AROM are limited, but not in a capsular pattern |
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Myositis Ossifans:
Cause How can it be induced? Surgery? Most common mm affected? |
Calcification of mm belly after trauma and hematoma
Can be induced with aggressive/early mobilization and stretching Surgery may be indicated after 6 months if interferes with joint movements or impinges on nerve Quads and biceps |
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What is CRPS and what are the two types?
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Dysfxt of SNS including pain, circulation, and vasomotor disturbances
CRPS I: no underlying nerve injury CRPS 2: nerve injury |
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Interventions for CRPS
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Desensitization activities
Flexibility ex TENs HANDS OFF |
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What is Paget's dx
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Metabolic bone disease possibly caused by virus
Abnormal osteoblastic and osteoclastic activity results in large, misshapen bones Leads to spinal stenosis, facet arthropathy, spinal fx |
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2 types of scoliosis
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Structural: irreversible with rotational component
Nonstructural: reversible lateral curve of spine, no rotational component. Curve straightens as individual flexes |
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Intervention for structural scoliosis based on cobb angle
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<25 deg = PT
25-45 = spinal orthoses >45 = surgery |
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TOS: what makes up the NV bundle
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BP
Subclavian artery and vein Vagus and phrenic nerves Sympathetic trunk |
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TOS: common areas of compression
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Superior thoracic outlet (T1 and 1st rib)
Scalene triangle (between 1 and 2) Btw clavicle and 1st rib Between pec minor and thoracic wall (Wright's hyperabd test) |
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Potential surgery for TOS
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Remove cervical rib
Release anterior or middle scalene |
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What is internal impingement and what are the characteristics?
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Irritation btw RC and greater tuberosity or posterior glenoid and labrum
Seen in overhead athletes Pain posterior shoulder Use posterior internal impingement test |
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2 common types of humeral fractures in elderly osteoporotic women. Intervnetion?
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Humeral neck fx (FOOSH)
Greater tuberosity fx (fall ono shoulder) Does not require immobilization b/c these are stable fractures |
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Mechanism of tennis elbow
Most common tendon affected |
Sports activities that require repetitive wrist ext or strong grip with wrist ext
ECRB |
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Golfer's elbow:
mechanism tendons primarily affected |
ACtivity that requires strong hand grip and excessive pronation of the forearm
FCR and pronator teres |
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Types of distal humeral fractures?
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Suprcondylar fx (examine quickly for NV status like radial nerve or volkmann's ischemia of flexor comparmtnet of forearm)
Lateral epi fx common in young ppl and usually require ORIF Higher incidence of malunion than proximal humeral fxs |
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Panner's disase
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Localized avascular necrosis of capitellum leading to loss of subchondral bone
Causes fissurin gand sotening of articular surfaces of radiocapitellar joint 10 yo or younger |
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Common impingment sites for the ulnar nerve
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Cubital tunnel
FCU |
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Muscles that can cause median nerve entrapment
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Pronator teres (pronator syndrome)
FDS Occurs with excessive gripping activities like electricians or tennis players |
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Radial tunnel syndrome
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Radial nerve becomes entrapped by mm in the forearm (supinator)
Often confused with latral epicondylitis Electrodiagnostic tests are helpful to diagnose this |
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Most common elbow dislocation and common complication
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Posterior dislocation
Avulson fx of medial epicondle secondary to traction pull of MCL |
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Tendon's affected by DeQuervain's tenosynovitis
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EPB
Abductor pollicis longus both radial nerve |
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Characteristic deformity of colles fx
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Dinner fork
Distal fragment of radius is posterior and radially deviated |
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Common deformity of Smith's fx
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Volar displacement of distal radius = Garden Spade Deformity
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Complications of scaphoid fx
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AVascular necrosis due to poor vascular supply
immobilized 4-8 weeks |
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What is Dupuytren's contracture
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Contracture of palmar fascia which adheres to skin
Causes flexion contracture of MCP and PIP of 4th and 5th digits |
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Boutonniere deformity
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Rupture of central tendinous slip of extensor hood
Causes flexion of PIP and hyperextension if DIP and MCP Trauama and RA common |
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Swan neck deformity
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Cuased by contracture of intrinsic mm
Hyperflexion of MCP and DIP Hyperext of PIP Dorsal subluxation of lateral extensor tendons |
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Ape hand deformity
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Thenar mm wasting, with first digit moving dorsally until in line with second digit
Median nerve dysfxt |
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Mallet finger
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Rupture of extensor tendon as it inserts into distal phalanx
Flexion of DIP joint |
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Gamekeeper's thumb
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Sprain/rupture of ulnar collateral ligament of first MCP joint
Immobilized 6 weeks |
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Boxer's fx
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Fracture of neck of 5th metacarpal
Casted 2-4 weeks |
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Line of gravity at hip, knee, and ankle
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Hip = posterior to joint center = makes it want to flex
Knee and ankle = anterior = force into EXT and DF (soleus and gastroc active) |
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Capsular pattern of TMJ
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Opening
Lateral protrusion greater to unaffected side Deviation upon opening to involved side |
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How can you tell there is weakness of pterygoids?
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Lateral deviation upon protrusion to non-weak side
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When to screen for scoliosis
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pre-puberty b/c can dramatically increase after puberty
9-11 girls 11-13 boys |
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Normal TMJ ROM
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40 mm opening
10-15 mm lateral deviation 5 protrusion/retrusion |
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Interventions for phantom limb pain
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Iceing and massage
Desensitization stuff |
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What are administrative controls?
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Controls that reduce the duration, frequency, and severity of exposures to ergonomic stressors.
ie. job rotation |
