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37 Cards in this Set
- Front
- Back
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What types of deformities are common with RA?
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-ulnar deviation and subluxation of wrsits and MCPS
Boutonnierre deformity (PIP flexion, DIP hyperextension) Swan neck deformity: PIP hyperextension, DIP flexion |
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Types of bone spurs
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Heberden's nodes - DIP joints
Bouchard's nodes at the PIP joints |
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Precautions when evaluating and treating arthritis
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avoid PROM (particularly at inflammatory stage)
avoid muscle testing unless ordered by MD Can use sphygmomanometer to assess grip strength avoid hot packs in inflammatory stage avoid strengthening during inflammatory stage (strength can prevent deformity otherwise) |
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splinting for arthritis
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acute stage: resting hand splints
unlar drift splint to prevent deformity silver ring splints for boutonniere and swank neck deformities Dynamic MCP felxion splint with radial pull s/p MCP arthroplasy hand based thumb splint for CMC arthritis |
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Following hip fracture, what determines type of device used?
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WB'ing status
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What is the most common approach for hip replacement?
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posterolateral
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Hip precautions
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-no flexion beyond 90*
-do not adduct/cross legs -do not internally rotate (if anerolateral, do not externally rotate) -do not pivot at hip -only sit on raised chair/toilet seat -transfer sit to stand: keep operated hip in slight abducation and extended in front |
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what is a forequarter amputation?
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loss of entire UE including clavicle and scapula
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What is a terminal device? What are the 2 main types?
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-helps an individual to grasp/hold and object s/p amputation
2 types: - hook (voluntary open and voluntary closing varieties) - hand -also cosmetic devices available w/ min. function |
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What is a neuroma?
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complication of amputations
growth occurring when nerve endings adhere to scar tissue can be very hypersensitive and painful |
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complications of amputations
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1. neuromas
2. skin breakdown 3. phantom limb syndrome 4. phantom limb pain 5. infection 6. knee flexion contracture (transtibial BKA) 7. psychological impairments 2/2 shock or grief |
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What is the appropriate way to wrap the residual limb s/p amputation?
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-distal to proximal
-decrease tension as you move proximally -figure 8 wrapping (circular wrapping is bad for circulation) |
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considerations for pre-prosthetic treatment
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1. change dominance PRN
2. ROM to uninvolved joints 3.desensitization 4. wrapping to shrink/shape 5. skin care and ADL training |
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Prosthetic treatment
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-functional training
-doff/donning prosthetic -increase wearing tolerance |
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Treatment for LE amputations
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-wrap/shape residual limb to limit swelling
-desensitize -UE strengthening (triceps for transfers) -transfers (stand pivot) -ADLs, LE dressing -standing tolerance -W/C mob |
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superficial burn
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1st degree
epidermis only no blisters, minimal pain heals 3-7 days |
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superficial partial thickness burn
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2nd degree
epidermis and upper porition of dermis red, blistering, wet heals in 7-21 days |
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deep partial thickness burn
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Deep 2nd degree burn
involves epidermis, dermis, hair follicles, and sweat glands red, white elastic possibly impaired sensation may become fullthickness if infected Heals 21 to 35 days |
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full thickness burn
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3rd degree
involves dermis, epidermis, hair follicles, sweat glands, and nerve endings white, waxy, leathery, non-elastic sensation absent needs skin graft; months to heal hypertrophic scar |
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4th degree burn
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inolves fat, muscle, bone
electrical burn - destruction of nerve along pathway |
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rule of 9's
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% total body surface area (TBSA) describes burn severity
9% = head, each arm 36% = midsection/torso 18% = each leg 1% = genitals |
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intervention for deep partial thickness burns
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-ROM 72 hrs post op
strength and sensation when wounds are healed -Wound care and debridement, sterile whirl pool, dressing changes gentle AROM/PROM as tolerated edema control splinting |
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Full thickness burn intervention
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requires graft
evaluate ROM 5-7 days post op First 72 hrs (emergent phase): dressing changes, splint at all times 5-7 days: AROM, light ADL, sterile whirlpool massage when wounds are healed order compression garment (scaring) otoform/elastomer to control scaring |
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Hand splints for burns
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wrist 20-30* extension
MCP 50-70* flexion IP full extension thumbs abducted and extended |
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Splinting if burns develop flexion contractures
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Palmar extension splint:
wrist = 0-30* extension MCPs neutral to slight extension and abducted IPs = full extension thumb abducted and extended |
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Anti-contracture position: anterior neck burn
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tendency: neck flexion
remove pillows. neck extension collar |
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Anti-contracture position: Axilla burn
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tendency: adduction
splint/position: 90-120* abduction axilla splint/positioning wedges (airplane splint) watch for brahial plexus strain |
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Anti-contracture position: anterior elbow burn
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tendency: flexion
extension splint5-10* flexion |
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Anti-contracture position: dorsal wrist burn
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tendency- wrist extension
support wrist in neutral |
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Anti-contracture position: volar wrist burn
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tendency: wrist flexion
wrist cock-up, 5-10* flexion |
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Anti-contracture position: dorsal hand burn
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tendency: claw hand deformity
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Anti-contracture position: dorsal hand burn
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tendency: claw hand deformity
functional hand splint 70-90* MPs IPs extended open webspace thumb opposition |
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Anti-contracture position: volar hand burn
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tendency: palmar contracture, cupping
palm extension splint MPs in slight hyperextension |
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Anti-contracture position: anterior hip burn
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tendency: hip flexion
position in prone weights on thighs in supine knee immobilizers |
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Anti-contracture position: knee burn
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tendency: knee flexion
knee extension w/positioning/splint prevent ER (may cause peroneal N. compression) |
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Anti-contracture position: foot burn
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tendency: foot drop
ankle at 90* with foot board or splint watch for signs of heel ulcer |
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splinting for web space burn
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C-splint
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