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84 Cards in this Set
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Signs and symptoms common to all types of arthritic conditions generally include: (4) |
Impaired mobility Impaired muscle performance Impaired balance Activity limitations |
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Characteristics: Age of onset for rheumatoid arthritis. |
15-50 years of age |
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Characteristics: Progression of rheumatoid arthritis. (3) |
Sudden development Within weeks Within months |
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Characteristics: Manifestations of rheumatoid arthritis. (2) |
Inflammatory synovitis Cartilage and bone damage |
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Characteristics: Joint involvement of rheumatoid arthritis. Few or many joints? Bilateral or unilateral? Which joints? (3) |
Many joints Bilateral MCP & PIP of hand, wrists, elbows, shoulders Cervical spine MTP, talonavicular & ankle |
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Characteristics: Joint signs and symptoms of rheumatoid arthritis. (5) |
Prolonged morning stiffness Redness Warmth Swelling Joint pain with activity |
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Characteristics: Systemic signs and symptoms of rheumatoid arthritis. (6) |
Feeling of sickness Fatigue Weight loss Fever Rheumatoid nodules Ocular, respiratory, hematologic, cardiac symptoms |
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Characteristics: Age of onset for osteoarthritis. |
After 40 years of age |
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Characteristics: Progression of osteoarthritis. |
Develops slowly over many years in response to mechanical stress |
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Characteristics: Manifestations of osteoarthritis. (3) |
Cartilage degradation Altered joint architecture Osteophyte formation |
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Characteristics: Joint involvement of osteoarthritis. Many or few joints? Symmetrical or asymmetrical? Which joints? (7) |
Few affected joints Usually asymmetrical DIP PIP 1st CMC of hands Cervical and lumbar spine Hips, knees, 1st MTP of feet |
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Characteristics: Joint signs and symptoms of osteoarthritis. (3) |
Morning stiffness < 30 minutes Joint pain weight bearing Crepitus and loss of ROM |
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Principles of management of rheumatoid arthritis. Subacute and chronic stages. (6) |
Treatment approach Joint protection Activity modification Flexibility Strength Cardiopulmonary endurance |
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Principles of management of rheumatoid arthritis. Active inflammatory period. (6) |
Patient education Joint protection Energy conservation Joint mobility (grade 1 or 2 distraction/oscillation) Exercise Functional training |
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Rheumatoid arthritis: How to education patient during active disease period. (2) |
Teach importance of rest, joint protection, energy conservation, and performance of ROM Teach HEP and activity modifications that conserve energy and minimize stress to joints |
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Rheumatoid arthritis: How to relieve pain and muscle guarding and promote relaxation during active disease period. (5) |
Modalities Gentle massage Immobilize in orthoses Relaxation techniques Medications as prescribed by physician |
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Rheumatoid arthritis: How to minimize joint stiffness and maintain available motion in active disease period. |
Passive or active-assistive ROM within pain limits Gentle grade I or II oscillations |
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Rheumatoid arthritis: How to minimize muscle atrophy during active disease period. |
Gentle isometrics in pain-free positions, progression to ROM when tolerated |
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Rheumatoid arthritis: How to prevent deformity and protect the joint structures during active disease period. (3) |
Use supportive and assistive equipment for all pathologically active joints Good bed positioning Avoid activities that stress joints |
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Osteoarthritis: How to educate patient. (2) |
Teach about deforming forces and prevention Teach HEP to reinforce interventions and minimize symptoms. |
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Osteoarthritis: How to decrease effects of stiffness. (2) |
Active ROM Joint-play mobilization techniques |
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Osteoarthritis: How to decrease pain from mechanical stress and prevent deforming forces. |
Orthoses and/or assistive equipment Alternate activity with rest |
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Osteoarthritis: How to increase ROM. |
Stretch muscle, joint, or soft tissue |
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Osteoarthritis: How to improve neuromuscular control, strength, and muscle endurance. |
Low-intensity resistance exercises and muscle repetitions |
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Osteoarthritis: How to improve balance. |
Balance training activities |
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Osteoarthritis: How to improve physical conditioning. |
Nonimpact or low-impact aerobic exercise |
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Principles of management of osteoarthritis. (8) |
Patient instruction Pain management (early) Pain management (late) Assistive and supportive device and activity Resistance exercise Stretching and joint mobilization Balance activities Aerobic conditioning |
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Criteria for diagnosis of rheumatoid arthritis. |
Presence of synovitis Total score of > 6 out of 10 |
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Rheumatoid arthritis: What are the extra-articular pathological changes? (4) |
Nodules Atrophy and fibrosis of muscles Fatigue Mild cardiac changes |
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Rheumatoid arthritis: Where do inflammatory changes occur and what happens to tendons if subjected to recurring friction? |
Tendon sheaths Tendons may fray or rupture |
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Rheumatoid arthritis: What leads to major economic loss and significant impact on families? (2) |
Progressive deterioration Decline in functional level |
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Widespread pain that affects multiple body regions plus axial skeleton and that has lasted for more than 3 months. |
Fibromyalgia |
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Similarities between FM and MPS. (3) |
Pain in muscles Decreased ROM Postural stresses |
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What is the prevalence of FM? (4) |
2% of population Women affected more than men Increases with age Men have longer duration of symptoms |
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What age can symptoms of FM occur? |
Any age (usually early to middle adulthood) |
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FM can develop after which events? (3) |
Physical trauma Motor vehicle accident Viral infection |
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People with FM have a higher incidence of certain problems such as: (9) |
Irritable bowel Tendonitis Headache Temporal mandibular joint (TMJ) dysfunction Restless leg syndrome Mitral valve prolapse Anxiety Depression Memory problems |
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What are some hallmark complaints of people with FM? |
Muscular pain in scapula, head, neck, chest, and low back |
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What are some factors that contribute to a flare of FM symptoms? (3) |
Environmental stresses Physical stresses Emotional stresses |
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Principles of management of fibromyalgia. (8) |
Exercise (aerobic) Additional: Medication Pacing activities to avoid symptom fluctuation Cognitive behavior therapy Avoid stress Decrease alcohol and caffeine Diet Manual therapy |
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What is myofascial pain syndrome? |
Chronic, regional pain |
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What is a trigger point? |
Hyperirritable area in a tight band of muscle |
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What are some possible causes of trigger points? (5) |
Chronic overload of muscle Acute overload of muscle Poorly conditioned muscle Postural stresses Poor body mechanics |
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Principles of managment: Myofascial pain syndrome. (3) |
Correct chronic overload Eliminate trigger point Strengthen muscle |
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What is osteoporosis? |
Bone disease that leads to decreased mineral content and weakening of bone |
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How is osteoporosis diagnosed? |
T-score of bone mineral density scan |
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What is a T-score? |
The number of standard deviations above or below a reference value |
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According to the World Health Organization, what is the established T-score criteria for osteoporosis? |
Normal: -1 or higher Osteopenia: -1 to -2.4 Osteoporosis: -2.5 or less |
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What are the risk factors in primary osteoporosis? (9) |
Postmenopausal Caucasion or asian descent Family history Low body weight Little or no physical activity Low calcium and vitamin D Smoking Prolonged bed rest Advanced age |
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What are the risk factors in secondary osteoporosis? (2) |
Due to other medical conditions Certain medications |
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Can therapeutic exercise positively alter the pathologoical process of rheumatoid arthritis? |
No |
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In individuals with RA, what is the main goal of therapeutic exercise? |
Maintain function |
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What does an osteoclast do? |
Breaks down bone |
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What does an osteoblast do? |
Builds bone |
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When is peak bone mass reached in a person? |
Third decade of life |
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Primary risk factors of osteoporosis. (4) |
Postmenopausal women Age Hormone replacement therapy Smoking |
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Secondary risk factors of osteoporosis. (5) |
Medication Fracture Sprain Sedentary Bed rest |
M F S S B |
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How to prevent osteoporosis? (4) |
Any physical activity Nutrition Vitamin D No smoking |
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Recommendations for exercise in individuals with osteoporosis. (4) |
Two to three days a week Rest in between each bout Use selecterized equipment/stationary bike Err on side of caution |
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What are some precautions and contra-indications regarding osteoporosis? (2) |
Avoid trunk flexion and rotation activities Increase exercise intensity progressively |
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How is a fracture identified? |
Site Extent Configuration Complications Relationship of fragments Relationship to environment |
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Risk factors of fractures. (5) |
Sudden impact Osteoporosis History of falls Repetitive stress Pathology |
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What are the phases of bone healing following a fracture? (3) |
Inflammatory phase Reparative phase Remodeling phase |
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How long does it take for a fracture to heal? |
About 8 weeks (faster in children, slower in geriatric) |
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Cortical bone healing: Inflammatory phase |
Internal bleeding followed by normal clotting |
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Cortical bone healing: Reparative phase (2) |
Hematoma Cells start to create callus (scab) |
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Cortical bone healing: Remodeling phase (2) |
Stage of clinical union Stage of radiological union |
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What is the stage of clinical union? (3) |
Bone is united by callus Fracture no longer moves Joint movement is allowed with caution |
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What is the stage of radiological union? (3) |
Callus replaced by lamellar bone Callus absorbed Bone returns to normal |
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What is rigid internal fixation? |
Surgically applied internal fixation device (rod or plate) |
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This type of bone healing occurs primarily through formation of an internal callus and is more susceptible to compressive fractures. |
Cancellous bone healing |
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There may be growth disturbances and bony deformity as the skeleton continues to mature in this type of bone healing. |
Epiphyseal plate healing |
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Principles of management of a bone fracture during period of immobilization. (3) |
Keep related structures as normal as possible by appropriate exercises If bed rest, physiological changes occur Alternative ambulation modes taught with lower extremety fracture |
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Principles of management of a bone fracture during post immobilization. |
ROM trumps strengthening Until radiologically healed, care should be used |
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Types of forces that cause fracture. (6) |
Bending (angulatory) Twisting (torsional) Straight pull (traction) Crushing (compression) Repetitive microtrauma Normal force on abnormal bone |
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What are the types of fractures? (6) |
Transverse or oblique (greenstick) Spirals Avulsion Compression (torus or buckle) Fatigue or stress Pathological |
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What force causes a transverse fracture? |
Bending (angulatory) |
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What force causes a spiral fracture? |
Twisting (torsional) |
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What forces cause a compression fracture? |
Crushing (compression) |
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What forces causes a fatigue or stress fracture? |
Repetitive microtrauma |
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What force causes a pathological fracture? |
Normal force on an abnormal bone |
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What is the end feel for arthrosis? |
Fused end feel |
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What helps protect an arthritic joint? |
Good muscle support |
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How long can arthrosis last? |
About 16 weeks |
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