584 Rheumatology pt.1

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584 Rheumatology pt.1
2013-02-02 16:37:21
584 Rheumatology pt

584 Rheumatology pt.1
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  1. Function of ____ is to protect, support, provide mechanical basis for movement, and produce blood cells
  2. -Local tissue reaction to injury
    -Heat, Redness, Swelling, Pain, Loss of function
  3. -are important in intercellular interactions between WBCs
    -are molecules that are secreted from one cell to interact with another cell at receptor sites
  4. Prevalent chronic condition
     Leading cause of disability
     Encompasses > 100 diseases and conditions
    Rheumatic Diseases
  5. “when clinically evident…characterized by joint pain, tenderness, limitation of movement, crepitus, occasional effusion, variable degrees of inflammation without systemic effects.”
  6.  Gradual loss of articular cartilage
     thickening of subchondral bone
      _________at joint margins
     mild, chronic, nonspecific synovial inflammation
  7. -Structural and biochemical changes of the matrix occurduring aging.
    -Reduced capacity of molecules to retain water.
    -Biomechanical properties altered- fissures develop
    Aging cartilage
  8. what is phase 1 of OA joints?
  9. what is phase II of OA joints?
    fissuring and pitting of cartilage
  10. what is phase III of OA joints?
    fragments of cartilage detach and “fall” into the articular cartilage and uncover subchondral bone where osteophytes form.
  11. -osteophytes proximal interphalangeal joints
    -boney growth on sides
    Bouchard nodes
  12. -osteophytes distal interphalangealjoints
    -DIP thickening
    Heberden nodes
  13. -Chronic, systemic inflammatorydisease
    -Symmetric polyarticular pain, swelling,morning stiffness, malaise, and fatigue
    -Etiology unknown
    -Progressive joint damage resulting insignificant disability if not treated
    Rheumatoid Arthritis
  14. 3-1 female to male ratio with primary onset between ages of 35 and 50.
  15. How long for stiffness to improve for RA?
    greater than or equal to one hour
  16. Arthritis of PIP, MCP, and wrist joints
    Symmetry of presentation
  17. Most commonly joint affected for RA?
  18. Swelling, pain, and stiffness
    Small joints of hands, wrists, elbows, knees, andfeet
    Features of RA
  19. Articular or Periarticular Structures?
    synovium, synovialfluid, articular cartilage, joint capsule
  20. Articular or Periarticular Structures?
    tendon, bursa,ligament, muscle, bone, fascia,nerve, skin
  21. 5 signs of inflammation
    • Inflammation leads to increased blood flow that can be felt as HEAT.
    • Increased blood flow causes the skin to look RED.
    • The synovium produces extra fluid when inflamed which we see as SWELLING.
    • PAIN due to Swelling or due to joint cartilagedamage.
    • STIFFNESS or loss of funtion.
  22. True or false?
    Swelling may be in (articular) or around (perarticular) the joint
  23. The Joint lining or the Synovial Membrane is the structure that is inflamed.
  24. Increased fluid causes pressure on the surrounding joint structures which is experienced as ______. Damage is causedwhen the inflamedsynovium grows overthe cartilage
  25. -Swelling stretches the supporting ligaments.
    -Joint laxity is the result.
    -Joint laxity and instability causes deformity.
  26. Too much joint movement
  27. _____is secondary to joint inflammation and pain.
    -happens slowly and is reversible
    muscle weakness
  28. make it more difficult to move the joint.
    pain and swelling
  29. True or false?
    Joints will stiffen up and lose flexibility if they are not moved regularly through range of motion
  30. True or false?
    It is easier to prevent stiffness than to reverse it.
  31. The longer you have Rheumatoid Arthritis and the more aggressive the disease is, the more ______ ______ that will occur!
    cartilage damage 
  32. If the joint is swollen, tenderness is assessed or not assessed?
    NOT assessed
  33. If the joint is swollen or tender, stress pain is assessed or not assessed.
    NOT assessed
  34. The amount of pressure applied to the joint is equal to ... 
    the examiner’s fingernails blanching (4 kg/cm2)
  35. True or false?
    Assess most joints in neutral position
  36. How can you measure disease activity?
    Total number of swollen and tender joints
  37. How many joints are required for the disease to be considered active?
    3 joints - active disease
  38. Positions of deformity primarily refer to positions of...
    • flexion
    • ulnar deviation
    • poor biomechanics
  39. Hand deformity:
    bump on wrist due to raised, loose ligaments between ulna and radius
    Piano key
  40. Hand deformity:
    tendons shift off of MCP joint,causing fingers to shift towards the little finger
    Ulnar deviation
  41. Managing local inflammation (at rest)
    Offering joint stability
    Improving function
    Hand splints
  42. Will I lose motion and muscle strength if I use a splint?
    • Yes, if the splint is worn all of the time.
    • However, functional splints are meant to make you moreactive.

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