Procedures 2

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Author:
kellymillerSPTA
ID:
175634
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Procedures 2
Updated:
2012-10-05 14:24:43
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THR
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  1. RA
    chronic and progressive inflammatory systemic disease affecting connective tissue
  2. what 4 criteria has to be present for 6 wks?
    • 1.morning sitffness > 1hr
    • 2. arthritis of 3 or more joints (at the same time) soft tissue swelling
    • 3. Arthritis of the hands in at least 1 area
    • 4. symmetric arthritis
  3. 3 other criteria for RA
    • Rheumatod nodules over boney prominences
    • serum rheumatoid factor
    • radiological changes
  4. 4 different prognostic groupings of RA
    • 1/3 pts have 1 acute attack, then get better in a few wks
    • 2-3 bad yrs, develop residual joint changes, then into remission
    • most common cripples-onset of months or years with progressive deterioration of articular cartilage
    • manifested primarily by extra-articular symptoms. Typically a shorter life span d/t systemic failure
  5. Possible causes of RA
    • infection
    • auto immune disorder
    • hereditary component
    • endocrine disorder
    • psychological factors
    • dietary considerations
  6. Pathology of RA
    • chronic inflammation of synovial membrane-abnormal cellular products
    • fluid pressure phenomena
    • tendon sheaths show inflammatory changes
    • slender projections into joint causing pain
    • develop adhesions
    • instability
  7. RA treatment during acute
    • rest
    • resting splints to help prevent deformity
    • medication to control pain and decrease synovial irritation
  8. RA Tx Active Inflam
    • Pt ed
    • minimize joint stiffness & maintain ROM
    • -gentle P/AROM
    • minimize muscle atrophy
    • -gentle pain free isometrics
    • prevent joint deformity
    • -biomechanical rest
  9. Tx Contras and Pres for Active Inflam of RA
    • Do not stretch swollen joints or apply heavy resistance exercise that causes joint stress
    • Precaustions-respect fatigue and increased pain, do not overstress osteoporotic bone or lax ligament
  10. Tx sub acute-chronic RA
    • Maintance of ROM
    • pool therapy
    • heat (moist)
    • isometrics
    • corrective splinting
    • joint protection
    • AD
  11. Acute Hematogeneous Osteomyelitis
    • rapid developing blood-borne bacterial infection of bone and marrow in children
    • one of the most serious inflammatory disorders of the musculoskeletal systme
  12. Acute Hematogeneous Osteomyelitis
    Incidence
    • Bone disease of growing bones
    • boys 3x more likely
    • LE more commonly affected
    • occurs frequently of metaphyseal regions of long bones
  13. Acute Hematogeneous Osteomyelitis
    Etiology
    • staphylococcus aureus most common
    • portal of entry is through skin
    • 2nd to infected wounds
    • (celllulitis)
  14. OA
    • progressive destruction of articular cartilage
    • Non inflammatory
    • non systemic
  15. Types of OA
    • primary-cause unknown
    • secondary-trauma, congential, or other musculoskeletal disease
  16. OA Etiology
    • obesity
    • smoking
    • deviated arthorkinematics
    • immoblization
    • trauma
    • microtrauma
    • excessive work outs
  17. Chondromalacia
    • disease process where articular cartilage becomes yellow, opaque and softens
    • typically wiht the patella
  18. OA vs. RA
    • OA is articular cartilage, RA is synovium
    • OA not inflammatory
    • RA systemic
    • OA initially proteoglycan and collagen synthesis-RA later
  19. OA Signs & Symptoms
    • Pain w activity (no/decreased pain at rest)
    • some joint swelling
    • loss of ROM-painful,dont use, weak, adaptive shortening
    • bone deformity
    • joint popping
  20. OA pain caused by
    • incongruent joint surfaces
    • abnormal pressure
    • trabecular micro fx
  21. arthrodesis
    surgical procedure too fuse a joint
  22. Rehab managment OA
    • pt education
    • -deforming forces and prevention HEP
    • decrease effects of stiffness-AROM
    • decrease pain
    • -splinting, ADs
    • improve conditioning
    • improve balance
    • increase ROM-stretching
  23. Precautions w OA
    • Increased pain w resistive exercises
    • -too much WB or load on joint
    • wrong ROM
  24. Cardiac Output
    • stroke volume -amount of blood ejected each contrtaction
    • X HR
  25. Hip Fx Classified by
    • Location
    • extra capsular or intertrochanteric
    • femoral neck or subcapital
    • proximal femoral shaft or subtrochanteric
  26. Complications with Fx
    • AVN
    • DVT 40-90%
    • 3 main complications
    • -malunion, delayed union, non union

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