PT 854 Exam 1 Questions With Complete Solutions.

PT 854 Exam 1 Tenosynovitis treatment - ANS 1. usually the result of an abusive weekend 2. Rest - sometimes requires a splint, or to leave alone 3. NSAIDs from MD 3-5 days 4. PRICE - splint at night if needed 5. iontophoresis if really uncomfortable Force-velocity relationship - ANS 1. increase speed, decrease force 2. concentric: as you increase speed, you decrease force/torque output 3. eccentric: as you increase speed, you increase or keep fairly constant force/torque output Length tension relationship - ANS Optimal LT ration is typically where cross-bridge formation occurs; peak strength measures are done secondarily and thus mid-range is the rule, muscle needs to be very strong (can handle large amounts conc and ecc weighted motion) and must be very long which helps in injury prevention and muscle protection (muscle is "turned on" before activation) Degenerative process - ANS 1. typically due to microtrauma: part of repetitive cycle - submax 2. tendinitis occurs due to a macrotrauma and is inflammatory, but if it persists for >6 weeks, tendinopathy likely occurs and leads to tendinosis which refers to microtrauma and degeneration Degenerative process example - ANS Jumper's knee: hypertrophy fibers around injury, but don't get rid of "plug of tissue" (tendinopathy) Contusions - ANS disruption of tissue-bleeding, regeneration is usually not a factor, benign neglect, donut pad if area that may get impact, load around area of injury Sprains - ANS Deal with ligamentous injury, whereas strains deal with muscle/tendon injuries Types of pain - ANS Cutaneous, somatic, visceral, neuropathic, referred Cutaneous pain - ANS Location: skin and subcutaneous tissues (can put your finger on it) Chemical nociception: actual tissue damage occurs Mechanical nociception: occurs in the absence of actual tissue damage, but when tissue is excessively strained or overused Somatic pain - ANS Location: muscles, bones, tendons, ligaments facia (musculoskeletal or neuromuscluar) Chemical nociception: when actual tissue damage occurs Mechanical nociception: occurs in the absence of actual tissue damage, but when tissue is excessively strained or overused Visceral pain location - ANS internal organs and the heart; pain is poorly localized and diffuse; is well known for its ability to produce referred pain, the neurology of visceral pain is still poorly understood Neuropathic pain - ANS Location: Initiated or caused by primary lesion or dysfunction of the PNS/CNS PNS origins: nerve compression, diabetes, cancer, crush injury, Guillain-Barre syndrome CNS origins: multiple sclerosis, spinal cord injury, stroke, traumatic brain injury Referred pain - ANS Loaction: often produced from visceral pain; the reflection of the lack of localizing info accompanying deep nociception The deeper the source, the more widespread the complaint of pain Treatment of Chronic Pain - ANS * requires a focus toward maximizing functional abilities rather than treatment of pain * therapy approach is to assess how the pain has affected the person * interventions may be aimed at: managing stress and decreasing emotional response to pain * a biopsychosocial approach is essential to understanding the patient with chronic pain * movement is the key to success Rheumatoid Arthritis signs and symptoms - ANS Inflammatory of synovitis, symptoms lasting >6 wks, AM stiffness >1 hr, symmetrical, polyarticular (MCPs, PIPs, wrists, ankles MTPs), nodules possible, synovial swelling, accompanying fatigue and weight loss, Rheumatoid arthritis Clinical Features - ANS RF and ACCP present, marginal erosions, periarticular osteopenia and joint space narrowing. Spondyloarthritis Signs and Symptoms - ANS Inflammatory, primarily axial skeletal pain, more common in males than females, onset is late adolescence-early adult hood, strong prevelance of HLA-B27 Spondyloarthritis Clinical Features - ANS Inflammatory back pain, bony tenderness, asymmetric peripheral arthritis, loss of spinal mobility, limited chest expansion, SI joint tenderness, modified Schober's test, Modified Schober's test - ANS Measures lumbar spine flexion, identify lumbo-sacral junction --> horizontal line across PSIS, mark spot 10 cm above and 5 cm below line, patient forward flexes maximally, re-measure distance b/t marked spots, increase > or = 5 cm is normal Spondyloarthritis if untreated - ANS loss of lumbar spine lordosis, accentuated thoracic spine kyphosis, gluteal muscle atrophy, fprward stoop of neck, flexion contractures of hips with compensated flexion at knees.