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33 Cards in this Set
- Front
- Back
what is facet joint impingement/locking
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sudden locking of the posterior joint "theoretically" due to the capsule (or meniscoid) of the post. joint getting impinged between the facets
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what causes facet joint impingement/locking
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sudden movement inovloving backward bending, side bending, and/or rotation
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what position is the joint "locked in" in facet joint impingement
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(in lumbar spine) a protective position of SB and contralateral rotation
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what are the S and S for facet joint impingement
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1) protective position:SB and contralateral rotation
2) rest decreases pain 3) mov't restricted and painful in opposite direction of locked position 4) passive assessment of joint mobility (+) for locked segment 5) possible rotational positional fault 6) pain possibly in corresponding dermatomal distribution |
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if a patient with facet impingement is locked in L SB and R rotation, what movements will be restricted/painful
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pain and restrcition of movement with
- R SB - L rotation - flexion |
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what is the treatment for facet joint impingement
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*mobilization therapy and traction*
- preceded by modalities and soft tissue work to relieve soft tissue guarding and spasms - gentle rotation and SB in painfree direction 1st then toward restriction - ROM exercises if done progressively |
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what is the appropriate way to encorporate rotation and SB in the treatment of facet impingement
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gentle rotation and SB in PAINFREE direction 1st then toward the restriction
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what is a facet joint sprain
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sprain of the capsule of the posterior joint and surrounding ligaments
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what is the cause of facet joint sprain
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sudden movement/trauma
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what are the S and S for facet joint sprain
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*history of moderate to severe trauma*
- rest relieves pain - pain with movement, especially at end range - no firm restriction of mobility, movement PAIN limited - no positional fault - pain with testing of joint mobility |
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what is the treatment for facet joint sprain
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treat as an acute injury with relative rest, ice, pain modalities, and protection against further injury also, gentle progressive ROM
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is joint mobilization an appropriate tx for facet joint sprain
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NO- time to heal is needed
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what is the consequence of hypo or hyper mobility with a facet joint sprain
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if excessive mov't allowed, hypermobility may ensue.... if patient is treated conservgatively with rest/immobilization, hypomobility with subsequent dysfunctions occur!
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when would lumbar support be appropriate for a facet joint sprain
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only in the acute stage if needed
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what is joint inflammation
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irritation of the posterior articular structures
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what is the cause of joint inflammation
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- chronic loading of the joint ... secondary to poor posture and/or poor working habit (extension)
- insidious onset - can also be secondary to degenerative joint disease |
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what are the S and S for joint inflammation
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1) movement increases pain (especially movements loading posterior joints)
2) possibly some pain at rest (but reduced) due to chem. irritation 3) typically better in AM 4) (+) pain when joint stressed 5) slight/mod. restriction of motion due to pain |
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what movements would you expect to increase pain the most with joint inflammation
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those loading the post. joints .... extension and ipsilateral SB
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what is the treatment for joint inflammation
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1) ID causative factors and eliminate cause of injury
2) decrease pain and inflammation (treat as subacute) with modalities use of ice and gentle exercises 3) restore mobility 4) restore strength 5) return to normal posture |
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what disorders are included under the definition of chronic and progressive degeneration of the disc and facet joints
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- osteoarthritis
- spondylosis - DDD - DJD |
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what causes DJD
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1) wearing away of hyaline cartilage
2) thickening of the synovial lining and joint capsule 3) proliferation of calcific deposits in, and especially around the periphery of the joint (osteophytes) 4) thickening of the subchondral bone |
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what causes DDD
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1) dehydration of the nucleus pulposus
2) narrowing of the intervertebral space, leading to decrease foraminal opening 3) weakening and degeneration of the annular rings 4) approximatino of the facet joints 5) creation of osteophytes at the margin of the vertebral body |
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what is the common cause for OA/ Spondy/ DDD/ and DJD
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- develops secondary to the excessive wear and tear process
- segmental hypomobility or hypermobility may promote the process |
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joint hypomobility may lead to ...
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decreased nutrition of the structures
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joint hypermobility may lead to
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increased shear forces
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what are the S and S for OA/ Spondy/ DDD/ and DJD
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1) hx of jt. pain and/or stiffness
2) (+) radiographs 3) if irritation present, palpation or stress on spinal segment will cause pain 4) hyper or hypo mobiliry may be present 5) possible referred pain and/or neuro findings 6) pain may come from facet joints or the disc |
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what does it tell you if irritation is present for a patient suffering from OA/ Spondy/ DDD/ and DJD
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they are in the acute stage
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what is the belief about hypermobility and hypomobility regarding development in OA/ Spondy/ DDD/ and DJD
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hypermobility develops first due to the decreased height of the disc.... followed by hypomobility through decreased use due to pain
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what pain patterns are more indicative of a disc disorder
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increased pain with activities that inclued high loading on the spine (sitting, FB) and pain with FB
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what pain patterns are more indicative of a facet joint irritation
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increased pain with standing and BB of the spine
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what is the treatment for OA/ Spondy/ DDD/ and DJD
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*must be adapted to the signs and complaints*
- if hypermobility present provide stability (possibly with external support) - hypermobility present improve mobility (with caution and monitor tx results!) - correction of posture, working habits, etc - use of modalities to address pain |
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the treatment for OA/ Spondy/ DDD/ and DJD is concidered a process of ......
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long term management promoing healthy back habits and identifying and eliminating aggravating factors
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what approach is the method of choice when tx OA/ Spondy/ DDD/ and DJD
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problem-oriented approach
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