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27 Cards in this Set
- Front
- Back
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-Functional Position
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-Slight extension -Slight ulnar deviation -Fingers slight flexion at all joints -Thumb in midrange of opposition
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Distal Radioulnar Joint |
-Pivot joint -Radius is concave moving on convex ulna for pronation and supination -Articular disc and TFCC (Triangular Fibrocartilage Complex) -they are kinda the same thing -Positive/negative ulnar variance
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1. Distal Radioulnar Joint
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-Resting position – 10o supination -Close packed – 5o supination -Capsule pattern – pain at the end ROM
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Radiocarpal Joint |
-Biaxial Ellipsoid -Two concave facets on distal radius -Scaphoid -Lunate -Articular disc – TFCC -Attached to ulna -Adds stability to distal RU joint as well as securing ulna to proximal and distal carpal rows
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Radiocarpal Joint
rp,cpp,cp |
Resting position – Neutral with slight ulnar variance -CPP – Extension -Capsular pattern – Flexion and extension equally limited |
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Intercarpal Joints
rp,cpp,cp
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-Resting position – neutral or slight flexion -CPP – Extension -Capsular pattern – none
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Midcarpal Joint
rp,cpp,cp |
-Resting position – Neutral of slight flexion with ulnar deviation -CPP – Extension with ulnar deviation -Capsular pattern – Extension and flexion equally limited
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1st and 5th CMC |
First and fifth are sellar joints -Fifth has less mobility than true sellar joint
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2nd, 3rd, 4th CMC |
-Planar synovial joints -More stable
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1st and 5th CMC
rp,cpp,cp |
Resting position -Thumb – midway between flex, ext, add, abd -Flingers midway between flex and ext -CPP -Thumb – Full opp -Fingers – Full flexion -Capsular pattern -Thumb – abd then ext -Fingers – equal limitation in all directions
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2nd, 3rd, 4th, 5th Intermetacarpal joints
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-2nd -5th metacarpals -Planar joints -Allow gliding motion -With immobilization mobility is lost
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MCP
rp,cpp,cp
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Resting position – Slight flexion -CPP Thumb – Full opposition Fingers – Full flexion -Capsular pattern – Flexion, ext
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IP
rp,cpp,cp |
-Resting position – slight flexion -CPP – Full ext -Capsular pattern – Flexion, ext
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NV Exam
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Light Touch 1. Median N. – radial-volar tip of index 2. Ulnar N. – ulnar-volar tip of small finger 3. Radial N. – first dorsal interspace -Motor 1. Median N. – move thumb palmarly from frontal plane 2. Ulnar N. – finger adduction and abduction 3. Radial N. – move thumb into extension
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Is RA an inflammation of the cartilage? |
no, -Really an inflammatory synovitis rather than arthritis -Other involved systems include: CV, pulmonary, and GI
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-Age and gender are the two primary risk factors
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Peak onset in 3-4th decade of life -Women affected 2-3 more times than men
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Diagnostic Criteria for RA -Four or more of the following:
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-At least 1 hr of morning stiffness present for at least 6 weeks -Inflammatory arthritic manifestations in 3 or more joints for at least 6 weeks -Swelling of wrist, MCP, or PIP joints for 6 or more weeks -Symmetric joint swelling -Radiographic evidence of changes in hand or wrist joints that must include erosions or unequivocal bony decalcification
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Monocylic |
you may have an extended flare of symptoms lasting an average of two to five years, after which point symptoms abate and do not recur
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. Polycyclic |
pain and inflammation fluctuates over the course of your life
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Progressive: |
pain, swelling and limited function increases with time and does not recede
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What are the prodromal s/s that precede joint symptoms? |
-Fatigue -Weakness -Weight loss -Numbness and tingling
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3 clinical phases of RA? |
Inflammatory synovitis of joint and tendon mechanism leading to pain, swelling, and ↑ temperature 2) Joint deformity with subluxation &/or dislocation, & intrinsic fibrosis 3) Final Remission – The degree of deformity and functional limitation varies from person to person |
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When is DIP joint involved? |
-DIP joints not usually involved like in OA
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Progressive disease of MCPs lead to? |
to volar subluxation & ulnar deviation of phalanges
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ulnar drift results in? |
has the resultant effect of pulling the fingers into ulnar deviation, pronation, and palmar subluxation
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ligaments and tendon effected by ulnar drift? |
Deformity of ulnar drift & palmar subluxation are the result of complex interactions that cause damage to the collateral ligaments & extensor tendons
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RA subcutaneous nodules? |
Appear in about 20% and indicate a severe form of the disease -Usually in the subcutaneous tissue and located over bony prominences
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