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Questions and Answers
Which demographic is specifically indicated to have a higher risk for osteoporosis?
What are possible medical conditions associated with secondary osteoporosis?
Which of the following is NOT a recommended preventive measure for osteoporosis?
What is a common clinical manifestation of osteoporosis?
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Which medication is linked to an increased risk of osteoporosis?
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How can height loss indicate potential osteoporosis?
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Which of the following is a key difference between osteoporosis and osteoarthritis?
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What symptom is less likely associated with osteoporosis?
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What is the T-score range indicating low bone mass (osteopenia)?
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Which drug is classified as a bisphosphonate used in the treatment of osteoporosis?
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What assessment tool is used to evaluate fracture risk in osteoporosis patients?
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Which dietary component is crucial for osteoporosis treatment?
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What imaging technique is specifically recognized for measuring bone mineral density?
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Which condition is not considered a major risk factor for falls associated with osteoporosis?
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What is the threshold T-score for diagnosing osteoporosis?
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Which of the following is considered a psychosocial intervention in the management of osteoporosis?
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What characterizes osteoporosis?
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Which of the following is a common risk factor for osteoporosis?
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Which type of osteoporosis is characterized by a clear cause such as medications or other health issues?
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What effect does aging have on bone tissue?
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What is the term for decreased bone density that can lead to osteoporosis?
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Which of the following factors is NOT considered modifiable when addressing osteoporosis risk?
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What is the primary change in bone metabolism seen in osteoporosis?
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What is one of the primary preventative measures for osteoporosis?
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What condition is characterized by a thickening and tightening of tissue under the skin of the hand?
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What is the primary goal of treatment for Carpal Tunnel Syndrome?
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Which muscular dystrophy type is known to be the most severe and typically has an onset between ages 2-6?
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Which assessment method is NOT typically used in diagnosing Carpal Tunnel Syndrome?
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What symptom is commonly associated with Duchenne Muscular Dystrophy?
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In which condition does the great toe drift laterally, causing an enlargement of the first metatarsal head?
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What is NOT a commonly mentioned treatment option for Carpal Tunnel Syndrome?
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Which of the following is NOT a characteristic symptom of Ganglion Cyst?
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What is the primary goal of treatment for MD?
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Which diagnostic test is typically used for identifying osteomalacia?
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What deficiency is primarily associated with osteomalacia?
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Which of the following is a common clinical manifestation of osteomalacia?
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Which treatment option is NOT typically considered for osteomalacia?
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What is a significant risk factor for developing osteomalacia?
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Which of the following is a key treatment goal for patients with MD?
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In the context of MD, what does the term 'palliative care' refer to?
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Which method is NOT recommended for the prevention of flexion contractures?
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What is the primary treatment method for scoliosis that may be suggested for moderate cases?
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Which postoperative intervention is critical for enhancing tissue perfusion?
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Which pharmacological treatment is incorrectly matched with its purpose in managing conditions related to pain?
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In managing patients with scoliosis, which diagnostic tool is primarily utilized for confirmation after initial physical assessment?
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What is the primary sequence of events in the infection cycle of osteomyelitis?
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Which factor is a common risk for developing osteomyelitis?
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Which characteristic is associated with chronic osteomyelitis rather than acute osteomyelitis?
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What is the purpose of an ankle-brachial index (ABI) assessment prior to an amputation?
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Which of the following represents a type of amputation conducted due to congenital conditions?
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Which intervention is commonly part of the treatment plan for osteomyelitis?
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What complication is frequently associated with amputations?
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What signifies an ABI value of less than 0.5?
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Which method is used to diagnose osteomyelitis?
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What should be prioritized in the emergency care of traumatic amputations?
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Which type of cell is primarily responsible for the reabsorption of bone tissue?
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What medication category is used as a last resort for treating phantom limb pain?
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Which complication is most commonly associated with surgery?
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What is a recommended prevention method for flexion contracture?
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Which diagnostic method can be used to identify neuromas?
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What condition may result from inadequate nutritional factors such as low vitamin D or calcium?
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How can impaired mobility in lower extremities post-surgery be effectively prevented?
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What role does phosphorus play in relation to calcium?
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What is the first-line treatment for carpal tunnel syndrome?
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Which condition is characterized by an involuntary contraction of the fingers, often associated with diabetes?
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Which treatment is often required as a last resort for a ganglion cyst if initial methods do not resolve the issue?
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What is a common surgical procedure for hallux valgus that can increase fall risk in patients?
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Which treatment method is considered effective for plantar fasciitis?
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What is the first priority in the emergency care of a traumatic amputation?
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When stabilizing an attached limb after a traumatic amputation, which action is recommended?
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What is the appropriate method for preserving a detached limb?
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Which of the following is NOT part of the emergency care procedure for traumatic amputation?
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What should be avoided if the limb is still attached during an amputation emergency?
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Study Notes
Bone Metabolism Review
- Bone metabolism is a complex process involving nutrients, hormones, and cell activity.
- Nutrients like carbs, fats, and proteins are vital for energy production and cell repair.
- Hormones act as chemical messengers regulating bone growth and remodeling.
- Catabolism breaks down existing bone tissue; anabolism builds new bone tissue.
Bone Cells
- Osteoblasts are responsible for building new bone tissue.
- Osteoclasts break down existing bone tissue.
Bone Remodeling
- An ongoing process where old bone is broken down and replaced with new bone.
- Helps to repair damaged bone and maintain bone strength.
Aging Bones
- As we age, bone density decreases, and the rate of bone loss increases.
- Calcium resorption slows down, leading to weaker bones.
- Vertebrae shorten, intervertebral discs thin, and kyphosis (hunchback) can develop.
- Cartilage in joints breaks down, potentially leading to bone spurs and arthritis.
Osteoporosis
- A chronic metabolic disease characterized by bone demineralization, leading to decreased density and increased fracture risk.
- Often called the "silent disease" due to its lack of symptoms in early stages.
- Osteoclastic activity exceeds osteoblastic activity.
- Most common in postmenopausal Caucasian women.
- Prevention is crucial.
- Primary Osteoporosis: Age-related bone loss.
- Secondary Osteoporosis: Bone loss caused by underlying medical conditions or medications.
- Regional Osteoporosis: Bone loss in a specific area of the body.
Osteoporosis - Risk Factors
-
Non-modifiable risk factors:
- Age greater than 50.
- Family history of osteoporosis.
- History of low-trauma fractures after 50 years old.
-
Modifiable risk factors:
- Low body weight, thin build.
- Chronic low calcium or vitamin D intake.
- Excessive or deficient protein intake.
- Estrogen or testosterone deficiency.
- Gender confirmation.
- Smoking.
- High alcohol intake.
- Excessive caffeine or carbonated beverage consumption.
Osteoporosis - Screening
-
Who Should Have a Bone Density Test?
- Women 65 years and older.
- Men 70 years and older.
- Individuals who have broken a bone after the age of 50.
- Women who have gone through menopause and have risk factors for osteoporosis.
- Postmenopausal women under 65 with risk factors.
- Men aged 50-69 with risk factors.
-
Other Indications for a Bone Density Test:
- X-ray of the spine showing a fracture or bone loss.
- Back pain with a possible fracture in the spine.
- Height loss of ½ inch or more within one year.
- Total height loss of 1½ inches from original height.
Secondary Osteoporosis
-
Medical conditions associated with secondary osteoporosis:
- Diabetes.
- Hyperthyroidism.
- Hyperparathyroidism.
- Cushing’s syndrome.
- Growth hormone deficiency.
- Metabolic acidosis.
- Female hypogonadism.
- Rheumatoid arthritis.
- Prolonged immobilization.
- Bone cancer.
- Cirrhosis.
-
Medications associated with secondary osteoporosis:
- Aluminum.
- Anticonvulsants.
- Cytotoxic drugs.
- Glucocorticoids.
- Gonadotropin-releasing hormone agonists.
- Immunosuppressants.
- Lithium.
- Long-term Heparin use.
- Progesterone.
- Tamoxifen (postmenopausal use).
- TPN.
- Alcohol.
- Thyroid hormones.
Osteoporosis vs. Osteoarthritis
-
Osteoporosis:
- A silent disease.
- A chronic metabolic disease.
- Bones become less dense and more prone to fractures.
- Can be managed and prevented through a diet rich in calcium and vitamin D, regular weight-bearing exercise, and a healthy lifestyle.
-
Osteoarthritis:
- A painful disease.
- A degenerative joint disease often caused by repetitive overuse from specific tasks or carrying excess body weight.
- Treatments focus on controlling pain and stiffness.
Osteoporosis - Manifestations
-
Clinical Manifestations:
- Loss of height.
- Progressive spinal curvature, leading to a "dowager’s hump."
- Low back pain.
- Fractures.
- Constipation.
- Reflux.
- Respiratory complications.
Osteoporosis - Diagnosis
-
Imaging:
- X-rays: Visualize bone structure and fractures.
- Bone Mineral Density (BMD) Tests:
- DEXA Scan: Dual-energy X-ray absorptiometry uses T-scores to evaluate bone density.
- T-score of -1.0 and above is considered normal.
- T-score between -1.0 and -2.49 indicates low bone mass (osteopenia).
- T-score of -2.5 and below indicates osteoporosis.
- cDXA: Central DEXA scans measure bone density in the spine and hips.
- pDXA: Peripheral DEXA scans evaluate bone density in the heel or forearm.
- pQUS: Peripheral quantitative ultrasound densitometry uses sound waves to assess bone density.
- DEXA Scan: Dual-energy X-ray absorptiometry uses T-scores to evaluate bone density.
- MRI: Provides more detailed images of bone and soft tissues.
- FRAX: Fracture risk assessment tool calculates an individual's 10-year risk of fracture based on factors like age, sex, weight, medical history, and medications.
-
Labs:
- Serum calcium.
- Vitamin D.
- Alkaline phosphatase.
- Phosphorus.
- Urinary calcium.
- Serum protein.
- Thyroid function tests.
- Serum & Urinary Bone Turnover Markers: Track bone formation and breakdown.
Osteoporosis - Treatment
- Priority problem: Potential for fractures due to weak, porous bone tissue.
-
Pharmacological treatment:
- Calcium.
- Vitamin D.
- Bisphosphonates:
- Alendronate (Fosamax)
- Risedronate (Actonel)
- Ibandronate (Boniva)
- Newer Bisphosphonates:
- IV Zoledronic acid (Reclast)
- IV pamidronate (Aredia)
- Estrogen Agonists/Antagonists:
- Raloxifene (Evista)
- Monoclonal antibodies/RANKL inhibitors:
- Denosumab (Prolia)
- Calcitonin.
- Parathyroid hormone-related protein drugs:
- Teriparatide (Forteo)
- Abaloparatide (Tymlos)
-
Other Treatments:
- Diet therapy: Focus on calcium and vitamin D rich foods.
- Exercise: Weight-bearing exercises and strength training help build bone density.
- Pain management: Medications or physical therapy can help relieve pain.
- Orthotic devices: Braces or supports can offer stability and reduce stress on bones.
- Psychosocial support: Counseling and support groups can help individuals adjust to living with osteoporosis.
- Community Resources: Organizations offer education, support, and resources for individuals with osteoporosis.
Fall Prevention
-
Major risk factors:
- Delirium.
- Dementia.
- Immobility.
- Muscular weakness.
- History of falls.
- Visual or hearing deficits.
- Current medications.
- Environmental hazards.
- Malnutrition.
- Agitation.
-
Prevention Strategies:
- Remove rugs, carpets, and other tripping hazards.
- Ensure adequate stair rails and grab bars.
- Improve accessibility to showers and baths.
- Encourage use of assistive devices.
Hand & Foot Disorders
- Dupuytren’s Contracture: Gradual thickening and tightening of tissue under the skin of the hand.
- Ganglion Cyst: Small, round, fluid-filled sac growing out of the tissues surrounding a joint.
- Hallux Valgus (Bunion): Great toe drifts laterally, and the first metatarsal head becomes enlarged.
- Hammer Toe: Dorsiflexion of metatarsophalangeal (MTP) joint with plantar flexion of the proximal interphalangeal (PIP) joint next to it.
- Plantar Fasciitis: Inflammation of plantar fascia.
- Carpal Tunnel Syndrome (CTS): Very common, characterized by median nerve compression causing loss of grip strength, chronic presentation, associated with RA, repetitive stress injury, and genetics.
CTS - Assessment & Diagnostics
- Symptoms: Pain, numbness, paresthesia, and motor changes.
- Physical Examinations: Inspection, palpation, Phalen Maneuver, Tinel’s Sign.
- Imaging: X-ray, MRI, Ultrasound.
- Nerve Conduction Study: Examines nerve function.
CTS - Treatment
- Goal: Relieve nerve compression.
- Medications: NSAIDs, steroids, and diuretics.
- Immobilization: Rest and immobilization of the wrist.
- Surgery: Endoscopic carpal tunnel release (ECTR), Open carpal tunnel release (OCTR), Synovectomy.
Carpal Tunnel Release Post-op Care
- Monitoring: Monitor vital signs, dressings, pain levels, and neurovascular checks hourly.
- Treatment: Elevate extremity, pain relief, wrist splint, and restrictions on lifting.
Muscular Dystrophies
- Muscular Dystrophy (MD): A group of genetic diseases causing progressive weakness and loss of muscle mass.
- Types of MD: Duchenne, Becker, Limb-Girdle, Facioscapulohumeral, Myotonic, Congenital, Distal, Emery-Dreifuss, Oculopharyngeal.
- Duchenne & Becker MD: X-linked disorders that differ in severity, affecting the dystrophin gene, predominantly in males.
Duchenne & Becker MD: Symptoms
- Early Symptoms: Muscle weakness when learning to walk, ride a bike, or climb stairs, frequent falls, waddling gait, lordosis, Gower sign, pseudohypertrophy, cardiomyopathy, and cognitive impairment.
- Duchenne: Most severe, onset at 2-6 years old, loss of mobilization by age 12, and rare survival past 20 years old.
- Becker: Less severe than Duchenne, onset in adolescence or early adulthood.
Gower's Sign
- A characteristic sign of MD: Difficulty rising from a sitting or lying position, requiring the use of hands to "walk" up the legs to stand.
MD - Diagnosis
- Physical Examination: Assessment for muscle weakness and other symptoms.
- Genetic Testing: DNA testing to identify the specific gene mutation.
- Muscle Biopsy: To examine the muscle tissue for abnormalities.
- Neurological Tests: To assess nerve function.
- Serum Creatine Kinase: Enzyme found in muscle tissue, elevated levels indicate muscle damage.
- Myoglobulin: Protein found in muscle tissue, elevated levels indicate muscle breakdown.
MD - Treatment
- No Cure: Current treatments focus on managing symptoms and maintaining function.
- Primary Goal: Maintain optimal functioning.
- Secondary Goal: Prevent contractures.
- Treatments: Physical therapy, corticosteroids, stretching, strength, muscle training, breathing exercises, ROM exercises, surgery, and supportive care for respiratory and cardiac complications.
- Supportive Care: Palliative care, Noninvasive ventilation (BiPAP, CPAP), Tracheostomy, Mechanical Intestinal Environment (MIE), and extensive cardiac evaluation.
Osteomalacia
- Definition: Softening of the bones due to deficiency or malabsorption of Vitamin D.
- Children: Called rickets when it occurs in children.
- Risk Factors: Decreased sunlight exposure, dietary deficiency of Vitamin D, malabsorptive syndromes, dark skin, obesity, elderly, medications that cause vitamin D deficiency, renal or hepatic disease.
Osteomalacia - Clinical Manifestations
- Hypocalcemia: Low calcium levels in the blood.
- Pain: Pain in the arms, legs, and spine, often worse at night.
- Musculoskeletal: Waddling gait, decreased muscle tone, fractures, bowed legs, pigeon chest.
- Other: Restlessness at night and fever.
Osteomalacia - Diagnostics
- Imaging: X-ray, Bone Mineral Density Scan.
-
Laboratory Tests:
- Blood Tests: To check calcium, phosphate, and Vitamin D levels.
- Urine Tests: To check calcium levels.
Osteomalacia - Treatment
- Supplements: Vitamin D, calcium, and phosphorus supplements.
- Sunlight Exposure: Increase sunlight exposure.
- Dietary Intake: Increase dietary intake of Vitamin D.
- Corrective Measures: Corrective braces and surgery to correct bone deformities.
- Monitoring: Routine laboratory draws to monitor calcium and Vitamin D levels.
Comparing Osteoporosis and Osteomalacia
- Osteoporosis: Decreased bone mass, lack of calcium & hormones, leading to fractures, calcium levels low-within normal limits, phosphate within normal limits, PTH within normal limits, ALP within normal limits.
- Osteomalacia: Bone softening, lack of Vitamin D, fractures, calcium levels < 8.5 mg/dL, phosphate levels low < 1.0 mg/dL, PTH > 330 pg/mL, ALP > 85 IU/L
Osteomyelitis
- Severe infection of the bone and surrounding tissues
- Requires immediate intervention
-
Infection Cycle:
- Pathogen Invasion
- Tissue inflammation
- Edema formation
- Decreased blood flow to bone
- Bone necrosis
- Bone abscess
-
Classification
- Exogenous: From outside the body
- Endogenous: Carried by the bloodstream
- Contiguous: From the skin of adjacent tissue
- Acute vs Chronic
-
Assessment:
- Vital Signs, fever expected
- Pain, tenderness, and inflammation
- Signs and symptoms of infection
- Vomiting and dehydration
- Limping or hesitation
- Malaise
- Drainage
-
Acute vs Chronic:
- Acute: Temperature above 101°F, swelling, erythema/heat, tenderness, bone pain that is constant, localized, pulsating, and intensifies with movement
- Chronic: Ulceration of the skin (foot), sinus tract formation, constant localized pain, drainage
-
Diagnostics:
- Labs: Blood cultures, wound cultures
- Imaging: X-ray, needle aspiration of the bone, open bone biopsy, radionuclide bone scans, MRI
-
Treatment:
- Antibiotic therapy
- Home vs Outpatient
- Contact Precautions/Infection Control
- Wound care
- Pain control
- Hyperbaric O2 Therapy
- Surgical intervention
- Sequestrectomy
- PMMA beads
- Bone grafts
- Muscle flaps
- Amputation
- Antibiotic therapy
Amputation
-
Types:
- Congenital
- Surgical vs Traumatic
-
Risk Factors:
- Diabetes Mellitus (DM)
- Peripheral Vascular Disease (PVD)
- Arteriosclerosis
- Infection
- Cancer
- Dysfunction
- Trauma
-
Traumatic Amputations - Field Care:
- ABCs
- Salvage the body part if possible
- Promote perfusion
- Prevent hemorrhage
- Hospital ASAP
-
(Pre)Amputation - Assessment:
- Health History
- Subjective
- Objective
- Psychosocial
- Knowledge deficits
-
(Pre)Amputation - Diagnostics:
-
Ankle-Brachial Index (ABI)
- Calculated by dividing ankle systolic pressure by brachial systolic pressure
- Doppler Ultrasound
- Laser Doppler Flowmetry
-
Ankle-Brachial Index (ABI)
-
ABI Values:
- Greater than 1.4: Calcification/Vessel Hardening - Refer to vascular specialist
- 1.0 - 1.4: Normal - None
- 0.9-1.0: Acceptable - None
- 0.8-0.9: Some Arterial Disease - Treat risk factors
- 0.5-0.8: Moderate Arterial Disease - Refer to vascular specialist
- Less than 0.5: Severe Arterial Disease - Refer to vascular specialist
-
Amputation Surgery:
- Successful healing
- Function preservation
- Prosthetic ability
- Standard Amputation
- Osseointegration
- Interdisciplinary
-
Lower Extremity
- Partial foot amputation: Removing part of the foot (toe, midfoot, syme)
- Syme ankle disarticulation: Removing the foot after separating it from the lower leg at the ankle
- Below-the-knee amputation: Removing the foot and part of the lower leg by cutting across the bones of the lower leg (tibia and Fibula)
- Knee disarticulation: Removal of the lower leg by separating it from the upper leg at the knee
- Above-the-knee amputation: Removal of the lower leg, the knee, and part of the upper leg by cutting across the upper leg bone (femur)
- Hip disarticulation: Removal of the entire leg by separating it from the pelvis at the hip joint
-
Upper Extremity
- Partial hand amputation: Removing part of the hand
- Wrist disarticulation: Removing the hand after separating it from the lower arm at the wrist
- Below-the-elbow amputation: Removing part of the lower arm by cutting across the bones of the lower arm (radius and ulna)
- Elbow disarticulation: Removing the lower arm after separating it from the upper arm at the elbow
- Above-the-elbow amputation: Removing the lower arm, elbow, and part of the upper arm by cutting across the upper arm bone (humerus)
- Shoulder disarticulation: Removing the entire arm after separating it from the shoulder
- Forequarter amputation: Removing the arm and part of the shoulder girdle
-
Amputation - Surgery Complications:
- Hemorrhage
- Infection
- Impaired mobility
- Neuromas
- Flexion contractures
- Phantom Limb Pain
-
Phantom Limb Pain
- Occurs frequently
- Real pain! Multiple triggers
- Interference with ADLs
-
Treatment:
- Physical Therapy, Massage, Heat, TENS
- Mirror therapy
- Pharmacological: Calcitonin IV, Beta-blockers, Anticonvulsants, Antispasmodics, Opioids, Antidepressants, NMDA
-
Flexion Contractures
- Muscle or tendon shortening
- May prevent the use of a prosthetic limb
-
Prevention is key:
- Exercises
- Splinting
- No pillow under the knee
-
Post-Op Interventions:
- Assess and maintain tissue perfusion
- Pain Management
- Prevent infection, promote wound healing
- Improve mobility
- Prostheses preparation
- Promotion of body image
- Lifestyle adaptations
-
Amputation - Prosthetics
-
Preop:
- Preparation
-
Postop:
- Prevent secondary disabilities
- Proper fitting can take weeks
- Stump conditioning/shrinking
- Rehabilitation
- Education
-
Preop:
Scoliosis
-
Assessment:
- Uneven shoulders
- One shoulder blade appears more prominent
- Uneven waist
- One hip higher than the other
- One side of the rib cage jutting forward
- A prominence on one side of the back when bending forward
-
Diagnosis:
-
Physical Exam:
- Adams forward bend test
- Plumb line test
- Scoliometer
-
Confirmed with:
- X-ray
- Ultrasound
- MRI
-
Physical Exam:
-
Treatment:
- Close monitoring with x-rays
- Brace
-
Surgery:
- Spinal fusion
- Expanding rod
- Vertebral body tethering
Bone Cells
- Osteoblasts build bone tissue.
- Osteoclasts break down and reabsorb bone tissue.
- Osteogenic cells are stem cells that can develop into other bone cells.
- Osteocytes maintain bone tissue.
Phantom Limb Pain
-
Medications:
- Anticonvulsants: Lyrica, Neurontin
- Calcitonin (IV)
- Antispasmodics
- Opioids (last resort)
- Beta-blockers: Propranolol (for dull or aching pain)
- NMDA receptor antagonists
- Antidepressants
- Cymbalta
- Baclofen
Common Post-Surgery Complications
- Bleeding/Hemorrhage: leading to hypovolemic shock (most common)
- Infections: such as osteomyelitis
- Flexion contracture: increased risk of mobility issues (knee, hip, elbow, shoulder)
- Body image concerns
- Phantom limb pain
- Neuroma: bundle of blocked nerves, treated with ice, gabapentin, steroid injections (avoid long-term use)
-
Impaired Mobility:
- Lower extremities: prevented by PT, OT, assistive devices, early ambulation
- Upper extremities: prevented by occupational therapy (higher risk of ADL difficulties, lower risk of falls)
Neuroma Diagnosis
- Ultrasound
Flexion Contracture Treatment
- Positioning: avoid pillows under joints, use firm bed
- Mobility: encourage movement and muscle strengthening through stretching
- Positioning: supine for 20-30 minutes every 3-4 hours
Modifiable Risk Factors for Flexion Contracture
- Low vitamin D or calcium
- Low body weight
- Sedentary lifestyle
- Increased/decreased protein intake
- Sex hormone deficiency
- Tobacco use
- High caffeine/calorie intake
- Gender confirmation surgery
- Most common: low body weight and thin build
Nutritional Considerations
- Vitamin D: sunlight and supplementation needed for calcium absorption
- Calcium: supplementation needed if levels are low
- Parathyroid hormone: increased if calcium is low
- Phosphorus: binds to calcium, avoid carbonated, seltzerized water
Factors Affecting Estrogen and Testosterone Levels
- Increased or decreased levels of both hormones
Limb Viability Assessment (Prior to Ambulation)
- Ankle Brachial Index (ABI)
- Ultrasound Doppler
- Laser Doppler Flowmetry
- Transcutaneous Oxygen Pressure
Example Application of Limb Viability Assessment
- Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
- Compression of the median nerve
- Risk factors: repetitive tasks, pregnancy
- Treatment:
- First-line: NSAIDs
- Steroids
- Surgery:
- Open
- Endoscopic (longer pain, less complications)
Dupuytren's Contracture
- Risk Factors:
- Diabetes
- Male descent
Hallux Valgus
- Most common in females
- Treatment:
- Bunionectomy (surgery)
- Risk: falls due to post-surgery boot
Hammer Toe
- Most common in women
- Treatment: surgery
Plantar Fasciitis
- Inflammation in the foot
- Treatment:
- Ice
- Rest
- NSAIDs
- Steroids
- Splinting
- Stretching
Ganglion Cyst
- Also known as "Bible Bump"
- Can be self-limiting
- May recur unless the cyst's root is addressed
- Treatment:
- Aspiration (last resort)
- Incision and Drainage (I&D) if aspiration fails
Traumatic Amputation Emergency Care
- Airway, Breathing, and Circulation (ABCs) are the initial priorities.
-
Salvage the amputated body part:
- Clean the part gently with sterile saline.
- Wrap it in a clean, damp cloth or gauze.
- Seal the wrapped part in a plastic bag.
- Place the bag in a cooler filled with ice water.
-
Promote Perfusion:
- If the amputated limb is still attached, stabilize it and do not attempt to detach it.
- Avoid a tourniquet.
- Elevate the injured extremity.
- Transport the patient to the hospital immediately.
-
Control Hemorrhage:
- Immediately apply direct pressure to the bleeding site if possible.
-
Hospital Visit:
- Seek immediate medical attention for a traumatic amputation.
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Description
Explore the intricate processes of bone metabolism, including the roles of nutrients, hormones, and various bone cells. Understand the dynamics of bone remodeling and how aging affects bone density and strength. This quiz covers essential concepts related to osteoporosis and bone health.
