disease musculo

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joyjohnson
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145652
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disease musculo
Updated:
2012-04-09 16:48:26
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disease musculo
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disease musculo
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  1. MRI
    • soft tissue injuries
    • ligament tears
    • meniscal tears
  2. tenodesis
    • reciprocal motion of :
    • wrist
    • fingers

    occurs during active/passive wrist flexion/extension
  3. UE
    27 bones=hand & wrist
  4. arthroscopy
    • interior ofr joint
    • using fiber-optic endoscope
  5. CT
    • injury to:
    • bones
    • soft tissue
    • ligaments
    • tendons
    • muscles
  6. x-ray
    • assess for deformities
    • calcification
    • bone density
    • fractures
  7. irregular bones
    • vertebrae
    • sacrum
    • coccyx
    • sphenoid
    • mandible
  8. short bones
    • tarsal
    • carpal
  9. flat bones
    • frontal/parietal
    • sternum
    • ribs
    • scapula
  10. long bones
    • humerus
    • radius
    • ulna
    • femur
    • tibia
    • fibula
  11. bones
    • inorganic salts
    • calcium
    • phosphaate
  12. musculoskeletal-ortho
    • bones
    • muscles
    • ligaments
    • tendons
    • connective tissue

    • purpose:
    • gives shape to body
    • protects vital organs
    • movement
    • stores clacium/minerals
    • Hematopieses(how we look)
  13. boutonniere deformity
    PIP flexion/DIP hypertension
  14. swan neck
    • PIP -hyperextension/DIP flexion
    • possible MP-flexion
  15. mallet finger
    • DIP-flexion
    • finger loses the ability to extend the distal phalanx
  16. nerve supply
    Ulnar
    • innervates:
    • flexor carpi ulnaris &
    • median half of the flexor digitorum profundus

    • sensory:
    • dorsal & volar surfaces of
    • small & ring finger
  17. ulnar nerve injury
    • MP-hyperextension small & ring finger
    • clawhand

    • low(more severe)
    • deinnervation of most of the intrinsic muscles of the hand

    • 1.loss of transverse arch of hand
    • 2.inability to abduct and adduct fingers
    • 3.loss of fine motor/manipulation skills
    • 4.clawing of ring & little finger
    • 5.pinch compromised

    • high:
    • includes all low impairments
    • decreased claw deformity due to little finger and ring non-involvement
  18. Radial
    • innervates:
    • extensor-supinator muscles forearm

    • Sensory:
    • 1.strip of posterior upper arm/forearm
    • 2.dorsum thumb
    • 3.index & little fingers
    • 4.radial half ring finger to PIP

    sensory loss of radial nerve does not result in dysfunction
  19. radial nerve injury includes:
    • 1. pronation of forearm
    • 2. wrist flexion
    • 3. thumb in palmar abduction
  20. Rheumatic disease
    • chronic pain
    • progressive physical impairment of joints
    • soft tissues

    • osteoarthritis
    • rheumatoid arthritis
    • systemic lupus erythematosus
    • ankylosing spondylitis
    • scleroderma
    • gout
    • fibromyalgia
  21. nodes
    bony enlargements-cartilage damage caused by OA

    • hard to the touch
    • visual changes of joint
    • not painful
    • common to DIP jts(Heberden's)
    • PIP jts(Bouchard's)
  22. nodules
    granulomatous & fibrous soft tissue masses

    sometimes painful

    • at weight bearing surfaces:
    • ulnar/olecranon
  23. deviation
    change in normal jt position

    radial/ulnar
  24. ankylosis
    lack of jt mobility

    spontaneous jt fusion by bony ossification/fibrous tissue

    • treatment:
    • rest
    • physical agent modalities
    • ROMstrengthening
    • splinting
    • environmental modification
    • assistive devices
    • ADL
    • sexual activity
    • client/casregiver education
    • therapeutic exercises
    • symptom management
    • jt protection/fatigue management
    • community resources

    • Problems:
    • self-care
    • productivity
    • leisure
    • sensorimotor
    • cognitive
    • psychosocial

    • due to:
    • pain
    • loss ROM
    • loss of grip/pinch strength
    • muscle atrophy
    • depression/visual changes in apprerance
  25. peripheral nerve injuries
    • axillary
    • brachial plexus
    • thoracic

    • signs:
    • deep tendon reflexes-depressed
    • cutaneous distribution of nerve lost
    • dry skin
    • hair loss
    • cyanosis
    • brittle fingernails
    • painless skin ulcerations
    • slow wound healing

    • if severe:
    • deformities
    • contractures
    • stiffness
    • poor positioning
    • osteoporosis
    • epidermal fibrosis of jts

    • life changing
    • affect client,family,friends psychologically/emotionally

    educate/discuss adaptations to social/leisure activities to decrease depression

    modify to alter physical appearance

    • problems:
    • self-care
    • productivity
    • leisure
    • sensorimotor/psychosocial

    • pain
    • loss of hand function
    • loss of sensation
    • spasms
    • tenderness at jt
    • muscle fatigue
    • burning/tingling sensation
    • depression
    • reduced effectiveness of judgement
    • guarding injury
  26. Axillary nerve injury
    (peripheral)
    • C5-C6
    • upper trunk of brachial plexus

    common

    • 1.injured nerve in shoulder
    • 2.cause of injury in anterior dislocation of the shoulder

    • signs:
    • weakness/paralysis of deltoid
    • limitation of shoulder flexion/abd/ext
    • weakness lateral rotation of arm

    treatment:

    • shoulder dislocation reduction
    • sling
    • therapy that ranges from ROM-functional movements
    • 3.fracture of neck of humerous
  27. Brachial Plexus injury
    (peripheral)
    • C5-T1
    • motor & sensory fibers-intertwine close to vetebral column

    • unilater
    • occur during birth(forceps)

    • Erb-Duchenne (waiters hand)
    • lesions of upper trunk of brachial plexus
    • C5-C6
    • most common in newborns
    • shoulder & elbow affected
    • hand movements intact
    • functional movements afftected
    • UE extremely limited

    • Klumpke:
    • compression/traction lower trunk of brachial plexus
    • C8-T1
    • seen less often
    • nerves that innervate wrist & finger flexion,add, abd causing paralysis distal of injury causing claw-hand deformity

    • treatment:
    • partial immpbilization
    • positioning
    • passive/active ROM
    • tactile/proprioceptive sensory input
    • surgery to improve neve growth

    • problems:
    • self-care
    • productivity
    • leisure
    • sensorimotor
    • cognitive
    • psychosocial

    • due to:
    • loss of ROM
    • weakness
    • edema
    • pain
    • loss of motor control
    • decreased sensation
    • difficulty w/ coping
  28. Long Thoracic Nerve injury
    C5-C7

    • innervates:
    • anteratus anterior muscle
    • (anchors apex of scapula to posterior rib cage)

    not common

    • injuryed by:
    • carrying heavy weight on shoulders
    • blows to neck
    • compression
    • wounds

    • signs:
    • winging of scapula
    • difficulty w/ shoulder flexion > 90
    • difficulty w/ shoulder protraction
  29. club foot
    congential

    • deformed talus
    • shortened achilles tendon

    AKA/Talipes

    cause:

    • genetic
    • environmental factors in utero
    • heredity

    stopped/slowed growth at 9-10 week

    • signs:
    • mild-severe
    • talus deformed
    • achilles shortened
    • calcaneus shortened/flattened
    • calf muscles shortened/underdeveloped
    • resists efforts to manipulate
    • painless unless in adulthood due to arthritis

    treatment 3 stages:

    • 1.correction of deformity
    • 2.maintaining correction until foot regains normal muscle balance
    • 3.observation of foot for several years

    • mainpulation
    • casting
    • serial casting
    • exercises
    • night splints
    • orthopedic shoes
    • surgery
  30. Hip Dysplasia
    • present at birth
    • unilateral or bilateral
    • forms:
    • 1. unstable
    • 2. subluxed
    • 3. complete dislocation

    • Cause:
    • unknown
    • prevalent in breech births and positioning in utero
    • large children
    • twins
    • first births
    • more females than males
    • native Americans/Caucasian children

    • signs:
    • uneven knees
    • side to side sway
    • lordosis
    • jt malformation
    • soft-tissue damage

    • Treatment:
    • earlier the better
    • stretches
    • bracing/splints
    • traction
    • open & closed reduction hip
  31. muscular dystrophy
    congenital disorder

    symmetrical wasting of skeletal muscles w/o sensory deficits

    muscle mass enlarges due to connective tissue/fat deposits

    impression of muscle strength

    • treatment-no cure
    • assistive devices
    • environmental modifications
    • strength
    • work simplfy
    • energy cons.
    • ASL's
    • IASL's
  32. Duchenne dystrophy
    develop ages 3-5

    starts w/ legs, pelvis then involuntary muscles

    oscillation of irises to light(gower)

    x-linked

    progressive proximal muscle weakness

    muscles replaced by connective tissue

    • symptoms:
    • waddling gait
    • toe walking
    • lordosis
    • frequent falls

    • cause:
    • mutation Xp21
    • absence of dystrophin
  33. Becker MS
    progress slower

    start 15 yrs old

    x-link

    proximal muscle weakness

    mutation Xp21
  34. Fascio/scapulo/humeral MS
    • slow progression
    • inability to raise hands above head
    • near normal life span
    • X-linked
    • autosomial dominant/recessive

    weak facial muscles/shoulder girdle

    begin 7-20 yrs old

    4q35 gene

    decreased ability to raise arms
  35. limb-girdle MS
    weak limb girdle & proximal limb distribution

    teens-early childhood

    2q, 4q, 5q, 13q, 17q inherited

    • loss of hand function
    • loss independence
    • unable finishschool
    • loss fine/gross motor
    • waddling gait
    • weakness
  36. Arthritis=joint inflammation
    Osteoarthritis
    • most common
    • chronic

    • deterioration of joint cartilage
    • formation of new bone at margins & subchondral areas of joint

    • most common:
    • DIP
    • PIP
    • hips
    • knee

    3rd world health problem

    • risks:
    • age
    • gender
    • heredity
    • obesity
    • joint abnormalities
    • injury
    • overuse of joints
  37. OA:
    • Primary:
    • no known cause
    • localized to 1-2 joints
    • generalized 3+joints

    • secondary:
    • trauma
    • anatomical abnormalities
    • infections
    • necrosis
  38. OA=DJD(degenerative jt disease)
    • cause:
    • acquired
    • metabolic,genetic, chemical & mechanical factors

    can be 2nd diagnosis to rauma,congenital disorders, obesity

    • signs:
    • joint pain w/ exercise, wt bearing, weather change

    • treatment:
    • wt loss
    • relieving pain
    • stabiliz joint
  39. osteomyelitis
    chronic/acute bone infection from trauma where hematoma develops w/ infection in body.

    • can spread to:
    • marrow
    • cortex
    • periostuem

    • seen lower end of femur
    • upper end of tibia
    • humerus
    • radius

    • cause:
    • bacteria invasion to trauma bone site that has a hematoma that spreads to bone. as hematoma invaded, infection grows eventually forming abscess that cuts off blood supply to the bone causing necrosis.

    signs:

    sudden pain
  40. osteoporosis
    metabolic

    bone reabsorbed faster than it's formed/bone mass loss

    calcium/phosphate salts causing bone to become brittle, porus, vulnerability

    • primary or
    • secondary

    • 1.involutional
    • 2.idiopathic
    • 3.juvenile

    • cause:
    • calcium imbalance
    • estrogen def.
    • sedentary

    prolonged steroid use
  41. paget's disease
    • metablolic
    • excessive bone resorption-excessive abnormal bone formation
  42. kyphosis
    roundback/hunchback

    anteroposterior curve
  43. Scoliosis
    lateral curve

    • cause:
    • functional: leg length discrepancy
    • fused ribs

    • Musculoskeletal:
    • paralysis of trunk due to polio
    • CP
    • MS

    • idiopathis:
    • most common

    • signs:
    • noticable curve

    • treatment:
    • brace
    • strengthen trunk muscles
    • surgery-metal rod

    • special consideration:
    • teenagers shy, detected later
    • uneven legs, hip
  44. tendinitis/bursitis
    inflammation of tendons

    • cause:
    • overuse or injury
    • aging
    • often older adults
    • rheumatoid arthritis
    • gout

    • signs:
    • restricted jt movement
    • pain
    • swelling

    • treatment:
    • immobilization of jt
    • anti-inflammatory drugs
    • cold/heat
  45. epicondylitis
    • lateral:
    • inflammation extensor tendons forearm/tennis elbow

    • medial:
    • inflammation flexor muscles wrist golfer's elbow

    • cause:
    • partial tear in patients who engage in sports that require forceful grasp, wrist extension against resistance or frequent motion

    • signs:
    • gradual increase in pain that radiates over the forearm and back to the hand when they grasp an object or twists their elbow, tenderness opver the involved muscle group, weak grasp, swelling or restricted range of motion

    • treatment:
    • rrelieve pain withuse of medications and injections, immobilization, therapy, and only when necessary or non-compliant surgery

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