Arthritis Overview and Treatments
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Questions and Answers

What is a key characteristic of Rheumatoid Arthritis?

  • Results from physical injury
  • Wear and tear of joints
  • Local symptoms only
  • Systemic autoimmune response (correct)
  • Which treatment method is specifically used to reduce inflammation in arthritis?

  • Surgery
  • DMARD's (correct)
  • Physical therapy
  • Occupational therapy
  • What type of joint symptoms are commonly experienced with Osteoarthritis?

  • Widespread joint deformity
  • Localized pain and stiffness (correct)
  • Bilateral swelling
  • Systemic fatigue
  • Which type of splint is recommended for a client with ulnar drift?

    <p>Soft splint (A)</p> Signup and view all the answers

    What node is typically found at the PIP joint in Osteoarthritis?

    <p>Bouchard's Node (A)</p> Signup and view all the answers

    What is a primary goal of occupational therapy treatment with arthritis patients?

    <p>Joint protection and energy conservation (A)</p> Signup and view all the answers

    What is a common symptom associated with Rheumatoid Arthritis?

    <p>Fatigue and weight loss (A)</p> Signup and view all the answers

    Which technique is NOT part of energy conservation strategies for arthritis?

    <p>Ignoring pain signals (C)</p> Signup and view all the answers

    What is the primary function of a stump sock in upper extremity prosthesis?

    <p>Protects the residual limb from rubbing and irritation (A)</p> Signup and view all the answers

    What characterizes a phantom limb pain sensation?

    <p>Sensation of burning, shooting pain, and squeezing in the amputated part (A)</p> Signup and view all the answers

    Which of the following describes a hypertrophic scar?

    <p>A scar that is raised and remains within the borders (D)</p> Signup and view all the answers

    What is the primary goal during the rehabilitation phase for burn recovery?

    <p>Prevent deformities or contractures while achieving independence (C)</p> Signup and view all the answers

    What does the Lund and Browder chart do in burn assessment?

    <p>Divides total body surface area into percentages while accounting for pediatric ratios (B)</p> Signup and view all the answers

    What complication is associated with burn patients regarding body temperature?

    <p>Risk of hypothermia during recovery (D)</p> Signup and view all the answers

    Which positioning technique is recommended for a lower extremity amputee?

    <p>Maintaining proper cushion for neutral hip alignment (A)</p> Signup and view all the answers

    What defines a voluntary opening terminal device (TD)?

    <p>It opens with amputee's efforts and closes at rest (C)</p> Signup and view all the answers

    What is a common characteristic of eschar?

    <p>It is dead/necrotic tissue that adheres to the wound bed (C)</p> Signup and view all the answers

    What is the definition of contracture in a medical context?

    <p>Shortening of soft tissue around a joint leading to a loss of movement (A)</p> Signup and view all the answers

    What is the primary characteristic of a muscle strain?

    <p>Tearing of individual muscle fibers (C)</p> Signup and view all the answers

    Which movement should be avoided to prevent a facet joint sprain?

    <p>Twisting (D)</p> Signup and view all the answers

    What is a common sign of orthopedic spinal conditions?

    <p>Localized pain (A)</p> Signup and view all the answers

    What can lead to macrotrauma?

    <p>Sudden injury from a major force (B)</p> Signup and view all the answers

    Which term describes the sliding of a superior vertebra over an inferior one?

    <p>Spondylolisthesis (A)</p> Signup and view all the answers

    What is a key intervention for managing phantom limb pain?

    <p>Mirror therapy (B)</p> Signup and view all the answers

    What defines a congenital amputation?

    <p>Absence of a limb at birth (A)</p> Signup and view all the answers

    What is a characteristic of a myoelectric prosthesis?

    <p>Operated by muscle activity using electrodes (B)</p> Signup and view all the answers

    Which of the following interventions is appropriate for increasing muscle strength in amputees?

    <p>Cuff weights and exercise bands (B)</p> Signup and view all the answers

    What is a recommended intervention for promoting hygiene of the residual limb?

    <p>Adaptive techniques for self-care (B)</p> Signup and view all the answers

    Which body part is affected in a transhumeral amputation?

    <p>Humerus (C)</p> Signup and view all the answers

    What describes a body-powered prosthesis?

    <p>Dependent on shoulder movement (D)</p> Signup and view all the answers

    What approach is vital during preoperative care for an amputation?

    <p>Educating on prosthetic options (C)</p> Signup and view all the answers

    Which type of pain is characterized by lasting longer than 6 months?

    <p>Chronic pain (A)</p> Signup and view all the answers

    What is the primary goal of occupational therapy intervention for acute pain?

    <p>Establish trust and explain treatment process (C)</p> Signup and view all the answers

    Which modality is used to decrease stiffness and increase range of motion?

    <p>Heat therapy (A)</p> Signup and view all the answers

    What does ORIF stand for in the context of fracture treatment?

    <p>Open reduction internal fixation (D)</p> Signup and view all the answers

    Which of the following is a characteristic of chronic pain?

    <p>Pain persists after normal healing (B)</p> Signup and view all the answers

    What precaution should be taken with a client experiencing acute pain?

    <p>Calm down the pain using methods like hot or cold packs (B)</p> Signup and view all the answers

    Which of the following is considered a common type of fracture line?

    <p>Transverse (C)</p> Signup and view all the answers

    What is a key intervention for chronic pain patients in occupational therapy?

    <p>Focusing primarily on improving function despite pain (B)</p> Signup and view all the answers

    What is the pain cycle as defined in pain management?

    <p>Pain -&gt; Muscle Guarding -&gt; Inactivity (D)</p> Signup and view all the answers

    What defines a Colles fracture?

    <p>Fracture of the distal radius (C)</p> Signup and view all the answers

    Which of the following theories explains abnormal pain responses where nerve fibers interpret pain differently?

    <p>Misinterpretation theory (D)</p> Signup and view all the answers

    What does a Mallet finger refer to?

    <p>Avulsion fracture of the distal phalanx (A)</p> Signup and view all the answers

    What is the recommended duration for an upper extremity (UE) fracture to heal?

    <p>6-12 weeks (C)</p> Signup and view all the answers

    Which of the following best describes the characteristics of acute pain?

    <p>Signals tissue damage (A)</p> Signup and view all the answers

    Flashcards

    Rheumatoid Arthritis

    A chronic autoimmune condition causing inflammation of joints and surrounding tissue.

    Osteoarthritis

    A degenerative joint disease from wear and tear, leading to cartilage damage.

    Symptoms of Rheumatoid Arthritis

    Includes systemic symptoms, joint pain, swelling, weight loss, fatigue, and deformities.

    Bouchard's Node

    A node occurring at the PIP (middle) joint in osteoarthritis.

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    Heberden's Node

    A node occurring at the DIP (distal) joint in osteoarthritis.

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    Joint Protection

    Strategies to prevent joint damage, such as using larger joints and avoiding deformity positions.

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    Energy Conservation

    Methods to manage fatigue, such as planning, resting, and using good postures.

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    Silver Ring Splint

    Used for conditions like swan neck or boutonniere deformities to support fingers.

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    ROM

    Range of Motion; movement of a joint through its full extent.

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    Acute Pain

    Pain that lasts less than 6 months.

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    Chronic Pain

    Pain that lasts longer than 6 months.

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    Characteristics of Acute Pain

    Identifiable cause, signals tissue damage, well localized, includes objective signs.

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    Characteristics of Chronic Pain

    Lacks identifiable cause, poorly localized, fluctuating physical signs, continues after healing.

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    Pain Cycle

    Sequence of pain leading to muscle guarding and inactivity.

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    Complex Regional Pain Syndrome

    Pain condition due to miscommunication in the nervous system that can improve with early intervention.

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    Etiology of Pain

    The cause of pain involving nociceptors, thalamus, somatosensory cortex, frontal cortex, and analgesic pathways.

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    OT Intervention for Acute Pain

    Establish trust, early interventions, and focus on strengthening and ADL return.

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    OT Intervention for Chronic Pain

    Establish trust, avoid focusing on pain, and improve overall function.

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    Types of Fractures

    Closed (skin intact) and open (skin broken).

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    Colles Fracture

    Fracture of the distal radius, common when catching a fall.

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    Malett Finger

    Avulsion fracture of the distal phalanx, causing loss of straightening ability.

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    ORIF

    Open Reduction Internal Fixation; surgery to stabilize broken bones.

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    Precautions for Back Injury

    Types: NWB, PWB, TTWB, FWB for different weight support.

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    Voluntary Opening TD

    A terminal device that is closed at rest and opens with the amputee's efforts, such as shoulder flexion.

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    Voluntary Closing TD

    A terminal device that is open at rest but closes when the amputee exerts effort.

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    Components of UE Prosthesis

    Includes stump sock, harness, cable components, and socket for comfort and function.

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    Neuroma

    A benign tumor that may develop at the proximal end of a severed nerve after amputation.

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    Phantom Sensation

    Sensation felt in the amputated limb, despite its absence.

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    Phantom Limb Pain

    Pain sensations such as burning or shooting in the amputated limb area.

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    Proper Positioning for LE Amputee

    Includes daily ROM, avoiding pillows under the knee, and maintaining neutral hip alignment.

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    Types of Burns

    Superficial, partial thickness, and full thickness burn classifications.

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    Hypertrophic Scar

    A raised scar that remains within the borders of the original wound.

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    Contracture

    Shortening of soft tissue around a joint, causing permanent loss of movement.

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    Muscle Strain

    Tearing, bruising, or irritation of individual muscle fibers.

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    Facet Joint Sprain

    Tearing or inflammation of the ligament or joint capsule of a facet joint.

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    Slipped Disc

    Bulging or herniated disc compressing nerves and blood vessels.

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    Spinal Stenosis

    Narrowing of the spinal canal affecting nerve function.

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    Spondylolisthesis

    Superior vertebra slips over the inferior vertebra.

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    Macrotrauma

    Sudden injury from a significant force.

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    Microtrauma

    Injury occurring at a microscopic level, leading to significant issues over time.

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    Forequarter Amputation

    Removal of the humerus with part of the scapula and clavicle.

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    Transhumeral Amputation

    Amputation through the humerus leaving no elbow.

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    Transradial Amputation

    Below the elbow amputation, where the forearm is removed.

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    Congenital Amputation

    Absence of a limb at birth due to developmental defects.

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    Postoperative Care

    Focuses on emotional support and acceptance of amputation.

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    Body-Powered Prosthesis

    Prosthesis operated by shoulder movement.

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    Myoelectric Prosthesis

    Prosthesis operated via muscle activity detected by electrodes.

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    Study Notes

    Rheumatoid Arthritis

    • Chronic, systematic autoimmune disease
    • Characterized by synovitis (inflammation of joint lining)

    Osteoarthritis

    • Degenerative joint disease
    • Caused by cartilage breakdown and wear-and-tear

    Rheumatoid Arthritis Symptoms

    • Systemic symptoms (body-wide)
    • Joint pain, swelling, and deformity
    • Weight loss, fatigue

    Osteoarthritis Symptoms

    • Localized joint pain, swelling, and stiffness
    • Deformity, weakness (especially CMC joints)

    Rheumatoid Arthritis Course

    • Acute (flare-ups) and chronic (remissions) phases

    Osteoarthritis Course

    • Progressive disease

    Arthritis Medical Treatments

    • NSAIDs (non-steroidal anti-inflammatory drugs)
    • DMARDs (disease-modifying antirheumatic drugs)
    • BRMs (biologics response modifiers)
    • Analgesics (pain relievers)
    • Steroids
    • Surgical options (synovectomy, tenosynovectomy, tendon surgery, arthroplasty, arthrodesis)

    Joint Nodes

    • Bouchard's nodes: PIP (proximal interphalangeal) joints
    • Heberden's nodes: DIP (distal interphalangeal) joints

    De Quervain's Tenosynovitis

    • Inflammation of tendon sheath

    OT Treatment Goals for Arthritis

    • Joint protection
    • Energy conservation

    Joint Protection Aspects

    • Respect pain
    • Use larger joints
    • Avoid positions of deformity
    • Avoid unnecessary joint loading

    Energy Conservation/Work Simplification Aspects

    • Pre-planning
    • Rest
    • Good posture and mechanics
    • Avoid extremes, diaphragmatic breathing

    Adaptive Equipment for Arthritis

    • Button hooks, zipper pulls, jar openers, enlarged/lever handles, reachers, dressing sticks, tub seats, grab bars, raised toilet seats

    Splinting

    • Used for rest, hand function support, and deformity prevention

    Splint Types and Uses

    • Silver ring splint: swan neck or boutonniere deformities
    • Soft splint: ulnar drift
    • Wrist splint: De Quervain's

    OT Treatment Phases for Arthritis

    • Acute: ROM only, no resistance
    • Chronic: ROM, gentle stretching, isometric strengthening

    Modalities

    • Heat: decreases stiffness, increases ROM
    • Cold: decreases inflammation, swelling

    Pain Definitions

    • Acute pain: lasts less than 6 months
    • Chronic pain: lasts 6 months or longer

    Acute Pain Characteristics

    • Signals tissue damage
    • Identifiable cause, well localized, accompanies objective signs

    Chronic Pain Characteristics

    • Occurs after tissue heals
    • No identifiable cause, poorly localized, lacks/fluctuates objective signs

    Chronic Pain Additional Characteristics

    • Multiple failed interventions
    • Psychological effects (anxiety, anger)
    • Potential legal issues (lawsuits)

    Chronic Pain Conditions

    • Cancer, arthritis, fibromyalgia

    Complex Regional Pain Syndrome (CRPS)

    • Miscommunication with sympathetic nervous system causing increased pain response (potentially reversible with early intervention)

    Pain Etiology (No One Thinks So Funny Dad)

    • Nociceptors (pain receptors)
    • Thalamus (pain signal dispersal)
    • Somatosensory cortex (pain localization)
    • Frontal cortex (pain response coordination)
    • Descending analgesic pathways (pain suppression)

    Pain Cycle

    • Pain -> Muscle Guarding -> Inactivity

    Acute Pain Precautions

    • Calm pain (modalities, exercises, massages)

    Abnormal Pain Response Theories

    • Misinterpretation of pain signals
    • Centralized pain theory (brain "ownership")
    • Gate control theory (blocking signals)

    Chronic Pain Precautions

    • Break pain cycle in areas of inactivity
    • Avoid inactivity

    OT Intervention: Acute Pain

    • Establish trust
    • Early intervention (splinting, ADLs, joint protection, soft tissue techniques)
    • Strengthened return to ADLs

    OT Intervention: Chronic Pain

    • Establish trust
    • Avoid focusing on pain
    • Focus on function and activity (ADL modification, body mechanics, risk reduction techniques)

    Pain Documentation

    • Location, description, intensity, pain triggers, and relievers

    Fracture Definition

    • Break or crack in a bone

    Fracture Types

    • Closed (no skin break), open (skin break)

    Fracture Lines

    • Transverse, oblique, spiral, comminuted, segmental, avulsed, impacted, torus, greenstick

    Specific Fracture Types (Upper Extremity)

    • Colles: distal radius (falling)
    • Mallet: distal phalanx (avulsion)
    • Boxer's: 5th metacarpal (pinky)
    • Scaphoid: carpal bone

    Fracture Etiology

    • Trauma (falls, accidents) or disease (cancer, osteoporosis)

    ORIF Definition

    • Open reduction internal fixation (surgery to fix bone)

    Fracture Healing Times

    • Upper Extremity: 6-12 weeks
    • Lower Extremity: 12-30 weeks

    OT Intervention: Upper Extremity Fractures

    • Maintain integrity of unaffected joints
    • Splinting
    • Control pain, edema, scarring
    • ROM (once stable)
    • Strength and control
    • Psychosocial adjustment
    • ADL training, adaptive equipment

    Back Injury Precautions

    • NWB (non-weight bearing)
    • PWB (partial weight bearing)
    • TTWB (toe-touch weight bearing)
    • FWB (full weight bearing)

    Post-Surgery Movements to Avoid (Hip Posterior/Anterior Approaches)

    • Posterior: Flexion, internal rotation, adduction
    • Anterior: External rotation, adduction, extension

    OT Goals for Fracture Recovery

    • Maximize ADLs while maintaining safety,functional mobility, transfers, IADL’s

    Muscle Strain

    • Tearing, bruising, bleeding, or irritation of muscle fibers (tendon)

    Facet Joint Sprain

    • Tearing or inflammation of facet joint ligament/capsule (avoid twisting)

    Slipped Disc

    • Bulging or herniated disc compressing nerves, blood vessels, and ligaments (avoid forward bending)

    Spinal Stenosis

    • Narrowing of spinal canal

    Spondylolisthesis

    • Superior vertebra sliding over inferior vertebra (avoid spinal extension)

    Orthopedic Spinal Conditions Symptoms

    • Localized pain, radiating pain, muscle guarding, weakness, numbness, tingling, restricted mobility

    Macrotrauma

    • Sudden, major injury

    Microtrauma

    • Microscopic tissue injury (cumulative effects lead to major injury)

    Cumulative Back Injury Factors

    • Poor posture, poor mechanics, decreased flexibility, poor fitness

    Amputations (Upper Extremity)

    • Forequarter: humerus, scapula, clavicle removal
    • Shoulder disarticulation: humerus-glenoid fossa separation
    • Transhumeral: humerus amputation (loss of elbow)
    • Wrist disarticulation: forearm-hand separation
    • Transradial: below-elbow amputation
    • Elbow disarticulation: lower arm removed at elbow
    • Transcarpal: amputation through hand bones
    • Finger/phalangeal: finger amputation
    • Transmetatarsal: foot amputation at metatarsal bones
    • Hemipelvectory: through the pelvis

    Amputations (Lower Extremity)

    • Transfemoral: above-knee amputation
    • Knee disarticulation: lower leg separated from femur at knee
    • Transtibial: below-knee amputation
    • Symes: foot amputation at ankle joint

    Amputation Interventions

    • Muscle strength: cuff weights, bands
    • Residual limb hygiene: adaptive techniques
    • Phantom limb pain: mirror therapy
    • Prosthetic training: specific exercises
    • Edema control: wrapping, positioning
    • Change of dominance: hand coordination
    • Psychological support: active listening
    • ROM: prevent soft tissue contractors
    • Recreational activities: activity-specific adaptations

    Amputation Types

    • Congenital: present at birth
    • Acquired: due to trauma or surgery

    Upper Extremity Prostheses

    • Passive mitts
    • Body-powered
    • Myoelectric (muscle-powered)
    • Brain-powered

    Body-Powered Prosthesis

    • TD operation through shoulder flexion/protraction

    Myoelectric Prosthesis

    • TD controlled by electrodes on muscles

    Preoperative Amputation Care

    • Psychological support, prosthetic options, postoperative exercise programs, one-handed ADLs

    Postoperative Amputation Care

    • Emotional support, prosthesis benefits, active listening

    Lower Extremity Amputation Interventions

    • Positioning, transfers, strengthening, ADLs, IADLs, balance, driving, vocational activities, community reintegration

    Upper Extremity Amputation Interventions

    • Stump care, wrapping, ROM, desensitization, prosthesis schedule, skill training

    Types of TD (Terminal Device)

    • Voluntary opening: TD closes, amputee opens
    • Voluntary closing: TD opens, amputee closes

    UE Prosthesis Components

    • Stump sock, harness, cables/components, socket

    Neuroma

    • Benign tumor at the proximal end of a severed nerve

    Phantom sensations

    • Sensations felt in the missing limb

    Phantom limb pain

    • Pain felt in the missing limb

    Lower Extremities Amputee Positioning

    • Daily ROM, neutral hip alignment, reduced contractors, edema and ulcers

    Burn Definitions

    • Tissue damage (heat, radiation, electricity, chemicals)
    • Eschar (dead tissue)
    • Hypertrophic scar (raised, borders)
    • Keloid scar (raised, beyond borders)
    • Contracture (shortened tissue)
    • Debridement (removing tissue)

    Burn Types

    • Superficial (1st degree, epidermis)
    • Partial thickness (2nd degree, dermis)
    • Full thickness (3rd/4th degree, subcutaneous/bone)

    Burn Assessment

    • Rule of Nines
    • Lund and Browder chart

    Burn Complications

    • Infection, temperature regulation, shock, scarring, contractors, psychosocial issues (PTSD, depression, anxiety)

    Acute Phase Burn OT Interventions

    • Edema control, contracture prevention

    Rehabilitation Phase Burn OT Interventions

    • PROM/AROM, edema control, scar management, ADLs

    Scar Management Techniques

    • Wraps, compresses, silicone products, stretching, ultrasound, massages

    Post-grafting Burn OT Interventions

    • Positioning, immobilization depending on graft

    Acute Care Burn OT Interventions

    • Medical management, edema management, splints

    Rehabilitation Phase Burn OT Interventions (general)

    • Achieving independence while preventing deformities

    Wrist/Hand Burn Splint Positioning

    • Wrist extension 30 degrees
    • Thumb abduction/extension
    • MCP flexion (50-70 degrees)
    • IP extension

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    Description

    This quiz covers the essential aspects of rheumatoid arthritis and osteoarthritis, including their definitions, symptoms, disease courses, and medical treatments. Test your knowledge on the differences between these two types of arthritis and understand their management options.

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