Term
| rheumatoid arthritis is an autoimmune disease with inflammation of what (2) |
|
Definition
| synovial tissue of jts and tendons |
|
|
Term
| inflammation of the synovial fluid results in what |
|
Definition
|
|
Term
| systemic involvement of rheumatoid arthritis: s/s (5) |
|
Definition
fever
weight loss
fatigue
mm atrophy
prolonged morning stifness |
|
|
Term
|
Definition
(+) rheumatoid factor
inflammatory synovial fluid |
|
|
Term
|
Definition
|
|
Term
| RA and extremity involvement |
|
Definition
| most present with hand involvement (90%) |
|
|
Term
| RA is more likely to affect these (4) structures of the hand |
|
Definition
|
|
Term
| RA and the MCPJ results in what |
|
Definition
|
|
Term
| RA and the PIPJ results in what (2) |
|
Definition
swan neck deformity
boutonniere deformity |
|
|
Term
| RA and the degree of deformity |
|
Definition
| deformity does not indicate loss of function or pain |
|
|
Term
| RA INterventions: assess function of what (2) |
|
Definition
assess hand function
including strength of forearm mm |
|
|
Term
| RA INterventions: Easy step |
|
Definition
|
|
Term
| RA INterventions: exercise (2) |
|
Definition
combo of active ex and isometrics
ROM and tendon gliding ex |
|
|
Term
| RA INterventions: caution with introducing strength tranining |
|
Definition
| potential for instability |
|
|
Term
| RA INterventions: protection meaning what (2) |
|
Definition
jt protection techniques
decrease stress on tissues during funcitonal activity |
|
|
Term
| RA INterventions: splinting pros and cons |
|
Definition
may prevent further deformity
may decrease mobility |
|
|
Term
| RA INterventions: pain mgmt (5) |
|
Definition
relaxation techniques
yoga
encourage a positive outlook
use of thermal agents
medications |
|
|
Term
| RA Surgical Interventions (2) |
|
Definition
|
|
Term
| RA surgical intevention includes arthroplasty which includes what (2) |
|
Definition
soft tissue reconstruction
joint implant |
|
|
Term
|
Definition
| jt and procedure specific |
|
|
Term
| most common rheumatic disease |
|
Definition
|
|
Term
|
Definition
|
|
Term
| osteoarthritis results in progressive... |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| waxes and wanes with activity |
|
|
Term
|
Definition
|
|
Term
| OA: functional losses (2) |
|
Definition
limitation of motion
loss of strength |
|
|
Term
| OA: will affect what structures (2) |
|
Definition
|
|
Term
| OA conservative mgmt: rehab (6) |
|
Definition
patient education (jt protection techniques)
splinting
thermal modalities
exercise
manual therapy
adaptive equipment |
|
|
Term
|
Definition
educate pt
maintain/increse jt ROM and strength
prevention of deformity
decrease pain
improve function |
|
|
Term
| goals of therapeutic splinting (6) |
|
Definition
reduce inflammation
rest and support weakned jt structures
properly position jts
prevent or minimize deformity
help improve function
help reduce pain |
|
|
Term
| OA will affect what structures of the hand (3) |
|
Definition
|
|
Term
| If OA affects this jt it will affect function more than any other jt |
|
Definition
|
|
Term
| OA and DIP is called what |
|
Definition
|
|
Term
| OA and PIP results inw aht |
|
Definition
|
|
Term
| what is the most common site of symptomatic OA |
|
Definition
|
|
Term
| OA 1st CMC jt: exam findings: gender dominance |
|
Definition
|
|
Term
| OA 1st CMC jt: exam findings: age |
|
Definition
|
|
Term
| OA 1st CMC jt: exam findings: tenderness and swelling at base of 1st metacarpal or... |
|
Definition
|
|
Term
| OA 1st CMC jt: exam findings: if scaphoid is tender, evaluate for what |
|
Definition
|
|
Term
| OA 1st CMC jt: exam findings: jt sounds |
|
Definition
|
|
Term
| OA 1st CMC jt: exam findings: ROM |
|
Definition
| limited in a capsular pattern (abduction and extension limited with full flexion) |
|
|
Term
| OA 1st CMC jt: exam findings: end stage may see what findings |
|
Definition
| radial subluxation of base of MC |
|
|
Term
| OA 1st CMC jt: exam findings: (+) test |
|
Definition
| compression of CMC articulation |
|
|
Term
| bright white areas on an x-ray are indicative of what when looking at bone |
|
Definition
|
|
Term
|
Definition
splinting
grips modification
physical agents as needed
ROM exercises
mobilization
strengthening
home program
activity modificaiton |
|
|
Term
| TFCC Lesions: result of what (2) |
|
Definition
FOOSH with a supinated wrist
repetitive rotation forces |
|
|
Term
| TFCC Lesions: wrist pain on what side |
|
Definition
|
|
Term
| TFCC Lesions: ulnar sided wrist pain increase with what (2) |
|
Definition
end range pro/supination
forceful gripping |
|
|
Term
|
Definition
| pain in conjunction with audible or palpable click |
|
|
Term
| TFCC Lesions: tenderness is localized to what |
|
Definition
| posterolateral immediately distal to ulnar head |
|
|
Term
|
Definition
| initially negative but may ID a (+) ulnar variance |
|
|
Term
|
Definition
| Ulnomeniscotriquetra dorsal glide (Triquetrum-ulnar glide) |
|
|
Term
| TFCC Lesions: injury to center of disc vs peripheral disc |
|
Definition
| center of disc avascular, poor healing |
|
|
Term
| TFCC Lesions: conservative mgmt: casting |
|
Definition
| long arm cast with elbow in 90 flex, and forearm in ulnar deviation and extension for 6 weeks |
|
|
Term
| TFCC Lesions: why must the elbow be casted |
|
Definition
| elbow allows for supination/pronation |
|
|
Term
| TFCC Lesions: if no resolution in 3-6 months, what may be indicated |
|
Definition
|
|
Term
| dupuytren's contracture aka |
|
Definition
|
|
Term
| Dupuytren's Contracture: gender dominance |
|
Definition
| men 7-15x greater to require surgery |
|
|
Term
| Dupuytren's Contracture: race dominance |
|
Definition
| caucasician's of northern European descent |
|
|
Term
| Dupuytren's Contracture: higher incidence in what populations (4) |
|
Definition
alcoholic
diabetic
epileptic
possibly smokers |
|
|
Term
| Dupuytren's Contracture: onset |
|
Definition
|
|
Term
| Dupuytren's Contracture: involves contractures of the fascia with what (2) |
|
Definition
| nodules and tendon like cords |
|
|
Term
| Dupuytren's Contracture: most common jts involved |
|
Definition
| MCP, PIP, and sometimes DIP |
|
|
Term
| Dupuytren's Contracture: most common digit involved |
|
Definition
|
|
Term
| Dupuytren's Contracture: bilateral or unilateral involvement |
|
Definition
|
|
Term
| Dupuytren's Contracture: conservative mgmt |
|
Definition
| little evidence for, surgery usually the tx |
|
|
Term
| Dupuytren's Contracture: imperative postoperative tx for positive outcomes (2) |
|
Definition
|
|
Term
| Hyperextension/Foosh injuries to the wrist: tendons (2) |
|
Definition
flexor carpi radialis
flexor carpi ulnaris |
|
|
Term
| Hyperextension/Foosh injuries to the wrist: connective tissue sheets (2) |
|
Definition
TFCC
Interosseous membrane |
|
|
Term
| Hyperextension/Foosh injuries to the wrist: ligaments (2) |
|
Definition
lunate-capitate ligament dorsally
radiocarpal ligament volarly |
|
|
Term
| Hyperextension/Foosh injuries to the wrist: bone specific (2) |
|
Definition
scaphoid lunate articulation
lunate dislocation |
|
|
Term
| Hyperextension injuries to the wrist: most commonly dislocated/subluxated carpal bone |
|
Definition
|
|
Term
| Hyperextension injuries to the wrist: how does the lunate (perilunate) tend to dislocate |
|
Definition
| anteriorly and may spontaneously reduce |
|
|
Term
| Hyperextension injuries to the wrist: complication associated with lunate (perilunate) subluxation/dislocation (5) |
|
Definition
instability
median nn palsy
flexor tendon constriction
avasular necrosis of the lunate
scaphoid fx |
|
|
Term
| Hyperextension injuries to the wrist: what is keinbock's disease |
|
Definition
| avascular necrosis of the lunate |
|
|
Term
| Hyperextension injuries to the wrist: mgmt of lunate (perilunate) sublux/dislocation (6) |
|
Definition
reduce via mob/manip
rest
immob
use of a wrist support
symptomatic tx
progression into strengthening |
|
|
Term
| Keinbock's disease: may be associated with what |
|
Definition
| uneven articular surfaces of the radius and ulna (particularly the ulnar negative wrist) |
|
|
Term
| Keinbock's disease: during extension, what is the lunate compressed against |
|
Definition
| ulnar border of the radius and capitate |
|
|
Term
| Keinbock's disease: how is keinbock's ID'd (4) |
|
Definition
pt tenderness over the dorsal lunate
wrist pain
limited dorsiflexion of wrist
decreased grip strength |
|
|
Term
| Keinbock's disease: intervention |
|
Definition
| prolonged immob in cast 6-10 weeks and correction of ulnar deformity |
|
|
Term
| Keinbock's disease: intervention post casting |
|
Definition
| progressive ROM with splinting between ex sessions |
|
|
Term
| Keinbock's disease: surgical mgmt (3) |
|
Definition
excision arthroplasty
arthrodesis
revascularization procedures |
|
|
Term
| Carpal Instability Patterns are broken into what 2 categories |
|
Definition
dorsal intercalated instability pattern
volar intercalated instability pattern |
|
|
Term
| Carpal instability patterns: what is a dorsal intercalated instability pattern (3) |
|
Definition
scapholunate
>70 angle between lunate and scaphoid
result of a foosh |
|
|
Term
| Carpal instability patterns: what is a volar intercalated instability pattern |
|
Definition
|
|
Term
| Carpal instability patterns: intervention |
|
Definition
immobilizaiton in a cast and stabilizaiton ex
surgery indicated if chronic |
|
|
Term
|
Definition
gamekeeper's thumb
skier's thumb |
|
|
Term
|
Definition
| hyperextension of teh thumb |
|
|
Term
|
Definition
| rupture or avulsion of the UCL at teh MCP of the thumb d/t or repetitive stress |
|
|
Term
| most common ligament injury at the hand |
|
Definition
|
|
Term
| UCL sprain resluts in what instability |
|
Definition
|
|
Term
| UCL sprain: >35 degrees on valgus testing indicates what |
|
Definition
|
|
Term
|
Definition
| treat nonoperatively through immob for 6 weeks in a thumb spica cast |
|
|
Term
| UCL sprain: tx post immobilization |
|
Definition
| gentle AROM/PROM initiated at 6 weeks with strengthening initiated at 8w eeks |
|
|
Term
| Hyperextension injury to PIP/DIP: 4 potential tissues compromised |
|
Definition
jt capsule
transverse carpal ligament
collateral ligaments
volar plate |
|
|
Term
| Hyperextension injury to PIP/DIP: if there is an avulsion of the common extensor tendon, what is that called |
|
Definition
|
|
Term
| Hyperextension injury to PIP/DIP: tx (2) |
|
Definition
immobilize as needed
initiate ROM |
|
|
Term
|
Definition
| thin walled cysts containig mucoid hyaluronic acid |
|
|
Term
|
Definition
| over jt capsule or tendon sheaths |
|
|
Term
|
Definition
| on dorsum or volar aspect of fingers and wrist |
|
|
Term
|
Definition
typically benign
aspiration with needle or excision |
|
|
Term
| What is DeQuervain's disease |
|
Definition
| involvement of extensor pollic brevis and abductor pollicis longus with progressive stenosing tenosynovitis or tenovaginitis of compartment #1 |
|
|
Term
| what is Dequervain's disease MOI |
|
Definition
| related to excessive mechanical stress d/t work or recreational activities. Cumulative trauma disorder |
|
|
Term
| DeQuervain's Disease: symptoms (5) |
|
Definition
thumb and wrist pain
pain sometimes radiates into the forearm
weakness of grip and pinch
insidious onset
may note "creaking" in wrist with tendon movement |
|
|
Term
| DeQuervain's Disease: Signs (5) |
|
Definition
localized swelling at radial styloid process
severe pain with thumb flexion and adduction
crepitus
loss of CMC abduction of thumb
positive finklestein's test |
|
|
Term
| DeQuervain's Disease: interventions (5) |
|
Definition
immobilization of thumb and wrist
NSAIDS
Ionto/phonophoresis
Gentle stretching/joint mob
Activity modification
Friction massage |
|
|
Term
| DeQuervain's Disease: failure of conservative tx may require what |
|
Definition
|
|
Term
| DeQuervain's Disease: when is surgery indicated |
|
Definition
| if no relieft with 2-3 injections |
|
|
Term
| what is the most common wrist flexor tendon to become inflammed |
|
Definition
|
|
Term
|
Definition
| associated with repetitive trauma and racquet sports |
|
|
Term
| FCU tenodnitis: pain location |
|
Definition
| just proximal to pisiform |
|
|
Term
|
Definition
| forceful blow to the tip of an extended digit into flexion |
|
|
Term
| Mallet finger: MOI results in what |
|
Definition
| rupture or avulsion of terminal tendon |
|
|
Term
| Mallet finger: loss of what AROM |
|
Definition
| active terminal finger extension |
|
|
Term
| Mallet finger: intervention |
|
Definition
immediate immob in extension
xray to r/o bony injury
splinting of DIP for 6-8 weeks |
|
|
Term
| Mallet finger: if large bony injury what is the intervention |
|
Definition
| manage with ORIF followed by 6 weeks immobilization |
|
|
Term
|
Definition
referred pain
spinal disorders
peripheral nerve entrapment
myofascial pain syndrome
CRPS |
|
|
Term
| most common compression neuropathy |
|
Definition
|
|
Term
| Carpal Tunnel Syndrome: may occur secondary to what |
|
Definition
| swelling of nerve or flexor tendons d/t overuse |
|
|
Term
| Carpal Tunnel Syndrome: also associated with (5) |
|
Definition
RA
OA
Diabetes
Thyroid disorders
Hormonal changes (pregnancy, menopause) |
|
|
Term
| Carpal Tunnel Syndrome: sy,ptopms (5) |
|
Definition
numbness
tingling
night pain
clumsiness
weakness |
|
|
Term
| Carpal Tunnel Syndrome: may report symptoms (2) |
|
Definition
radiating pain to shoulder
dropping objects |
|
|
Term
| Carpal Tunnel Syndrome: signs (5) |
|
Definition
decreased sensation for median nerve distribution
atrophy of thenar mm
(+) phalen's
(+) tinnel's sign
May have significant EMG and NCV studies |
|
|
Term
| Carpal Tunnel Syndrome: differential Dx (2) |
|
Definition
| median nerve compression at pronator teres or anteiror interosseous syndrome |
|
|
Term
| Carpal Tunnel Syndrome: interventions (8) |
|
Definition
splinting for night in neutral
activity modification (limit periods of prolonged gripping and awkward positioning)
ergonomic mgmt/recommendations
tendon gliding/hook fist/blocking ex
nerve gliding
strengthing of FDS and FDP
modalities for pain relief
surgery may be indicated if conservative measures fail |
|
|
Term
|
Definition
Fx
Bony or Soft tissue surgical procedures |
|
|
Term
| Colle's/Smith's fx: which refers to dorsal displacement of the distal radius |
|
Definition
|
|
Term
| Colle's/Smith's fx: which is the silver fork deformity |
|
Definition
|
|
Term
| Colle's/Smith's fx: which refers to teh anterior deformity |
|
Definition
|
|
Term
| Colle's/Smith's fx: MOI for Colle's |
|
Definition
|
|
Term
| Colle's/Smith's fx: Smith's MOI |
|
Definition
|
|
Term
|
Definition
closed reduction/ORIF
immob 5-8 weeks |
|
|
Term
| Colle's/Smith's fx: potential for what secondary conditions is high (2) |
|
Definition
RSD/CRPS
median nerve damage |
|
|
Term
| Colle's/Smith's fx: post immobilizaiton intervention |
|
Definition
tx impairments
full recovery in 4 mos-1 year
Residual impairments common |
|
|
Term
| what accounts for 60% of all carpal fx |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
distal pole
midportion
proximal pole |
|
|
Term
| Scaphoid fx: which poles are at risk of avascular necrosis |
|
Definition
|
|
Term
|
Definition
MOI
tenderness over the floor of anatomical snuff box
radiographic exam |
|
|
Term
| Scaphoid fx: which pole is the most commonly fx |
|
Definition
|
|
Term
| Scaphoid fx: intervention proximal pole |
|
Definition
| immobilize for 16-24 weeks |
|
|
Term
| Scaphoid fx: intervention middle pole |
|
Definition
6 weks thumb spica
6 wks cast |
|
|
Term
| Scaphoid fx: intervention distal pole |
|
Definition
|
|
Term
| Scaphoid fx: intervention tuberosity |
|
Definition
|
|
Term
| Scaphoid fx: intervention non union occurs in how many cases |
|
Definition
|
|
Term
| Scaphoid fx: PT while casted |
|
Definition
| while casted make sure to initate ROM at adjacent jts proximal and distal |
|
|
Term
| Scaphoid fx: PT after cast removal (2) |
|
Definition
promote edema control
initate ROM of thumb and wrist and strengthening as toelrated |
|
|
