Hi Everyone,
Hope you all are studying ,doing practice tests and some more…..
Similar to my previous post,I’m going to give you additional points/info for the various chapters.I’ve divided the chapter into four units as follows:
Unit 1-Arthritic Conditions:
Osteoarthritis(OA/DJD):Severe in older women,subchondral bone cysts are formed in this arthritis.There’s usually no ankylosis.Jt line tenderness and crepitus is +ve.The synovium is thickened and inflamed.Heberden’s nodes found.ESR is normal.
Ankylosing Spondylitis:occurs in males between ages 20-40 more often.HLA B-27 antigen found in many patients.Squaring of vertebral bodies and Ossification of ligaments gives the “bamboo” spine appearance.Bones become brittle and prone to #(Chalk stick fracture).Restrictive Lung Disease can occur in late stages due to costovertebral and costosternal joint involvement.
Chest expansion,Deep breathing,Posture correction,Spinal Extension exercises are taught.Activities like TaiChi,Yoga and Swimming are encouraged.
Gout:More common in males aged between40-60 .Tophi (collection of uric acid crystals) found in helix of ear,fingers,toes and olecranon bursa in untreated patients.Onset usually in big toe.
Dietary and Lifestyle modification very helpful.Limit consumption of alcohol,meat & seafood.Low fat diet helpful.
Unit 2-Upper Limb conditions:
SHOULDER:
Glenohumeral(GH) Dislocations:Antr-Infr type common.Axillary nerve may be injured.The dislocated humeral head lies below coracoid/below clavicle.Emphasis on Rotator cuff Strengthening.In Posterior dislocation head may be subacromial or subspinous.External rotation and supination may be restricted.
Acromio clavicular(AC) Joint Dislocation:
Grade 1-AC jt sprain without ligament (ligt) tear
Grade 2-AC ligt torn CC(coraco-clavicular) ligt intact
Grade 3-Both AC & CC ligts torn,>5mm AC jt elevation,clavicle elevated,deltoid & trapezius detached
Grade 4-Both AC & CC ligts torn,joint capsule torn,clavicle displaced into trapezius
Subcoracoid Bursitis:precedes rotator cuff tear usually.limits ext.rot.painful arc of abduction.seen in baseball pitchers.
Internal Impingement:Postr jt capsule tight.Pain in late cocking & early acceleration of baseball pitching.There’s also increased postr.deltoid activity to compensate for weak rotator cuff.
ELBOW:
In elbow dislocation relationship between the epicondyles & olecranon is maintained whereas in Supracondylar # it is not maintained.Ulna moves dorsally,distally in pronation and proximally,ventrally in supination.Inelastic Cuff worn around proximal forearm (counterforce bracing) helpful in TENNIS ELBOW
WRIST & HAND:
Colles’ #:Dinner fork deformity.wrist immobilized in palmar flexion,ulnar deviation & forearm pronation in Below-Elbow(BE) slab.
Smith’s #:Wrist immobilized in 30 degree dorsiflexion & forearm supination in Above-Elbow(AE)
Unit 3-Lower Limb Conditions:
Slipped Capital Femoral Epiphysis(SCFE):If SCFE is stable it would allow patient to ambulate with or without crutches.If it’s unstable,patient may not ambulate and will most often have complications such as OA and AVN(Avascular Necrosis) of the hip.Following surgical fixation of SCFE,patient is given crutches with protected weight bearing for 6-8 weeks.PT is given for strengthening,proprioception,balance & endurance.
Ortolani and Piston Tests used in CDH(Congen.Disloc.Hip)
Femoral Neck Anteversion & External tibial torsion >Q angle and Femoral Retroversion & Internal tibial torsion < Q angle.
Menisci transmit 50% compressive force during Knee Extension & 85% during 90 degree knee flexion.
Syndesmosis sprain have minimal swelling compared to common ankle sprains.They take longer to heal.There’s pain with passive dorsiflexion & external rotation.Tenderness over anterolateral tibiofibular joint is present.
Tarsal tunnel syndrome:Shoe with medial longitudinal posting on forefoot & hindfoot would help.
Flexor Hallucis tendinopathy: Pain behind medial malleolus,Dorsiflexion of toe <
Unit 4-Spine
SLR test(Lasegue’s test): 0-30* -Hip jt pathology
30-50*-sciatica
50-70*-hamstring
70-90*-SI jt
NOTE:All the info given above is from good sources,but I would recommend verifying it.As new studies come up with different treatment approaches everyday, the info above may also lose some relevance.So use your discretion everyone!!
REFERENCES:
WebMD Arthritis page
EMedicine-ACjt injury
High Ankle Sprain (Syndesmotic Sprain)
Orthopedic Physical Assessment by David J Magee
I found some interesting proverbs:
The more I want to get something done,the less I call it work-Richard Bach
A man is not finished when he is defeated.He is finished when he quits-Richard Nixon
See you all soon!
Please let me know if you found this post and my previous post helpful.Your feedback will help in making this blog more useful to all
physicaltherapyprep 