Spina Bifida and Pain Management
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Questions and Answers

What is a common cause of humeral fractures?

  • Bowel bladder issues
  • Spina bifida
  • Neurological issues
  • Osteoporosis (correct)

    • Which type of spina bifida is the least severe?

  • Myeloma
  • Meningcele
  • Occulta (correct)
  • Induration

    • What is a common symptom of spina bifida?

  • Humeral displacement
  • Decreased ROM
  • Leg weakness or paralysis (correct)
  • Pain management

    • What is the treatment for a humeral fracture?

    <p>Closed reduction and open reduction internal fixation</p> Signup and view all the answers

    What is a complication of humeral fractures?

    <p>Loss of wrist extension</p> Signup and view all the answers

    What is the most severe type of spina bifida?

    <p>Meningcele</p> Signup and view all the answers

    What is a common feature of spina bifida?

    <p>Incomplete closure of bone and membrane</p> Signup and view all the answers

    What is the term for changes to tissue beneath the surface?

    <p>Induration</p> Signup and view all the answers

    What is the primary cause of thoracic outlet syndrome?

    <p>Repetitive use and poor posture</p> Signup and view all the answers

    What is the treatment for a complete UCL rupture?

    <p>Surgical: Tommy John surgery</p> Signup and view all the answers

    What is the primary symptom of medial epicondylitis?

    <p>Radiating pain from the medial elbow down the forearm</p> Signup and view all the answers

    What is the treatment for olecranon osteophyte?

    <p>Surgical removal of the bone spurs and debridement of the osteophytes</p> Signup and view all the answers

    What is the primary cause of posterior elbow dislocation?

    <p>Fall on an outstretched arm</p> Signup and view all the answers

    What is the primary symptom of ulnar nerve entrapment?

    <p>Numbness and tingling in the elbow, hand, or wrist</p> Signup and view all the answers

    What is the treatment for radial head fracture?

    <p>Type II: surgery to remove bone fragments and sling for weeks</p> Signup and view all the answers

    What is the primary cause of elbow arthritis?

    <p>Breakdown of cartilage on articulating surfaces of bones</p> Signup and view all the answers

    What is the primary symptom of carpal tunnel syndrome?

    <p>Numbness, tingling, and pain in the fingers, hand, and arm</p> Signup and view all the answers

    What is the primary cause of Dequervain's tenosynovitis?

    <p>Repetitive use of the wrist and forearm</p> Signup and view all the answers

    What is the term for an involuntary twitch of a single motor unit that is NOT visible beneath the skin?

    <p>Fasciculation</p> Signup and view all the answers

    What is the term for a painful, involuntary contraction of a muscle?

    <p>Cramp</p> Signup and view all the answers

    What is the term for an involuntary contraction of multiple motor units that is visible beneath the skin?

    <p>Spasmodic contraction</p> Signup and view all the answers

    What is the term for an abnormal contraction of a muscle or group of muscles?

    <p>Abnormal contraction</p> Signup and view all the answers

    What can be a cause of spasmodic contractions?

    <p>Spinal cord injury</p> Signup and view all the answers

    What is the term for a sudden, involuntary contraction of a muscle or group of muscles?

    <p>Spasm</p> Signup and view all the answers

    What are some common accidents that can lead to injuries?

    <p>All of the above</p> Signup and view all the answers

    What is a result of sudden, forceful movements?

    <p>Herniated discs and muscle strains</p> Signup and view all the answers

    What type of joint is modified to have a hinge-like motion?

    <p>Synovial joint</p> Signup and view all the answers

    What is a common injury resulting from accidents?

    <p>Herniated discs and muscle strains</p> Signup and view all the answers

    What is the term for a group of injuries caused by sudden movements?

    <p>Unexpected exertion injuries</p> Signup and view all the answers

    What is a common feature of injuries caused by accidents?

    <p>All of the above</p> Signup and view all the answers

    What is the primary cause of Rheumatoid arthritis?

    <p>Untreated synovitis and tenosynovitis</p> Signup and view all the answers

    What is the name of the deformity that occurs when the MCP joint is flexed and the PIP and DIP joints are extended?

    <p>Swan-neck deformity</p> Signup and view all the answers

    What is the term for the lump that forms on the joints or tendons in the wrist or hand?

    <p>Ganglion cyst</p> Signup and view all the answers

    What is the term for the condition where the fascia of the palm thickens and eventually tightens, causing fingers to contract inward?

    <p>Dupuytren's contracture</p> Signup and view all the answers

    What is the name of the disease characterized by widespread chronic pain, tenderness, and stiffness?

    <p>Fibromyalgia</p> Signup and view all the answers

    What is the term for the sudden and severe pain in the joint, usually occurring at night?

    <p>Gout attack</p> Signup and view all the answers

    What is the age range for Rheumatoid arthritis to occur?

    <p>25-50 years old</p> Signup and view all the answers

    What is the prevalence of Rheumatoid arthritis worldwide?

    <p>1% worldwide</p> Signup and view all the answers

    What is the term for the substance that causes tissue breakdown in Rheumatoid arthritis?

    <p>Pannus</p> Signup and view all the answers

    What is the term for the surgical procedure where the sheath around the tendon is cut and then occupational therapy is given?

    <p>Fasciotomy</p> Signup and view all the answers

    What is the primary cause of Distal radius fractures?

    <p>Falling on outstretched hand</p> Signup and view all the answers

    What is the treatment for non-displaced Scaphoid fractures?

    <p>Thumb spike splint (8-10 weeks)</p> Signup and view all the answers

    What is the result of Avascular necrosis in Scaphoid fractures?

    <p>Death to bone tissue</p> Signup and view all the answers

    What is the primary cause of Chronic Neck pain?

    <p>Wear and tear on cervical spine</p> Signup and view all the answers

    What is a common feature of Cervical degenerative disc disease?

    <p>Discs are less hydrated</p> Signup and view all the answers

    What is a symptom of Cervical degenerative disc disease?

    <p>Feeling better in the morning</p> Signup and view all the answers

    What is the treatment for displaced Scaphoid fractures?

    <p>Surgical procedure</p> Signup and view all the answers

    What is a complication of Distal radius fractures?

    <p>Loss of sensation and strength</p> Signup and view all the answers

    What is a common symptom of a cervical herniated disc?

    <p>Pain and numbness in the arm</p> Signup and view all the answers

    What is the primary cause of cervical osteoarthritis?

    <p>Aging and abnormal growths on bones</p> Signup and view all the answers

    What is a complication of spinal stenosis?

    <p>Impaired bowel and bladder function</p> Signup and view all the answers

    What is a non-surgical treatment for cervical herniated discs?

    <p>Rest and NSAIDS</p> Signup and view all the answers

    What is a characteristic of cervical osteoarthritis?

    <p>Decreased range of motion</p> Signup and view all the answers

    What is a risk of surgery for spinal stenosis?

    <p>Paralysis</p> Signup and view all the answers

    Why do cervical herniated discs occur in the neck?

    <p>Because it is a common area of injury</p> Signup and view all the answers

    What is a common feature of spinal stenosis?

    <p>Possible myelopathy</p> Signup and view all the answers

    What is the primary cause of thoracic outlet syndrome?

    <p>Anatomical differences</p> Signup and view all the answers

    Which type of elbow disorder is characterized by inflammation of the medial tendon of the elbow?

    <p>Medial epicondylitis</p> Signup and view all the answers

    What is the primary symptom of radial head fracture?

    <p>Pain on the radial head</p> Signup and view all the answers

    Which type of treatment is usually recommended for olecranon bursitis?

    <p>Non-surgical treatment with antibiotics and NSAIDS</p> Signup and view all the answers

    What is the term for the breakdown of cartilage on the articulating surfaces of bones?

    <p>Arthritis</p> Signup and view all the answers

    Which type of treatment is usually recommended for carpal tunnel syndrome?

    <p>Non-surgical treatment with bracing and NSAIDS</p> Signup and view all the answers

    What is the primary cause of Dequervain's tenosynovitis?

    <p>Repetitive use of the wrist</p> Signup and view all the answers

    What is the primary symptom of ulnar nerve entrapment?

    <p>Numbness and tingling in the hand</p> Signup and view all the answers

    Which type of elbow disorder is characterized by a fracture of the radial head?

    <p>Radial head fracture</p> Signup and view all the answers

    What is the primary cause of posterior elbow dislocation?

    <p>Fall on an outstretched arm</p> Signup and view all the answers

    What is a common cause of injuries?

    <p>Both A and B</p> Signup and view all the answers

    Which of the following is a common injury resulting from accidents?

    <p>Both A and B</p> Signup and view all the answers

    What is a common feature of injuries caused by accidents?

    <p>Slips and falls</p> Signup and view all the answers

    What type of joint is modified to have a hinge-like motion?

    <p>Synovial joint</p> Signup and view all the answers

    What is a result of sudden, forceful movements?

    <p>Injuries</p> Signup and view all the answers

    Which of the following is a common accident that can lead to injuries?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of a full-thickness burn?

    <p>Charred black, bright red, tan, or pearly white, and dry</p> Signup and view all the answers

    What is the primary difference between a deep full-thickness burn and a full-thickness burn?

    <p>Involvement of tendon or muscle</p> Signup and view all the answers

    What is the characteristic of a burn that requires skin grafting and may result in loss of function?

    <p>Deep full-thickness burn</p> Signup and view all the answers

    What is the term for an involuntary contraction of a single muscle?

    <p>Fasciculation</p> Signup and view all the answers

    What is the term for a painful, involuntary contraction of a muscle?

    <p>Spasm</p> Signup and view all the answers

    What is the term for an involuntary contraction of multiple motor units that is visible beneath the skin?

    <p>Fasciculation</p> Signup and view all the answers

    What is the term for an abnormal contraction of a muscle or group of muscles?

    <p>Dystonia</p> Signup and view all the answers

    What can cause spasmodic contractions?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Induration

    • Changes to tissue beneath the surface
    • Decreased range of motion (ROM)
    • Pain management

    Spina Bifida

    • Birth defect due to incomplete closure of bone and membrane around the spinal cord
    • Varies in severity, with symptoms including:
    • Leg weakness/paralysis
    • Orthopedic issues
    • Bowel/bladder issues
    • Neurological issues
    • All types involve myelomeningocele (MMG)

    Types of Spina Bifida

    • Occulta (least severe)
    • Meningocele (most severe)
    • Myelomeningocele (most severe)

    Humeral Fractures

    • Common upper extremity fracture
    • Causes:
    • Osteoporosis
    • Aging
    • Injury
    • Symptoms:
    • Humeral displacement and location
    • Loss of wrist extension and dorsum hand sensation in ⅕ cases (20%) due to radial nerve damage
    • Treatment:
    • Closed reduction (manual)
    • Open reduction internal fixation (ORIF)
    • Sling immobilization and mobilization
    • Surgical repair

    Thoracic Outlet Syndrome

    • Causes:
    • Trauma
    • Repetitive use
    • Pregnancy
    • Anatomical differences
    • Poor posture
    • Symptoms:
    • Pain in the shoulders and neck
    • Numbness and tingling
    • Coldness in the fingers
    • Weakened grip
    • Thumb atrophy
    • Treatment:
    • Non-surgical: rest, activity modification
    • Surgical: cutting out part of the rib to open up space

    Fracture of the Shoulder

    • Causes:
    • Floor level falls
    • Sports injuries
    • MVA
    • Symptoms:
    • Pain, swelling, and bruising at the shoulder
    • Deformity
    • Grinding sensation
    • Treatment:
    • Non-surgical: immobilization, ice, NSAIDs
    • Surgical: plates, screws, internal fixation

    Elbow Disorders

    Medial Epicondylitis

    • Inflammation of the medial tendon of the elbow
    • Causes:
    • Repetitive use of the wrist and forearm
    • Symptoms:
    • Pain on the medial aspect of the elbow
    • Weakness
    • Stiffness
    • Treatment:
    • NSAIDs
    • Rest
    • Ice
    • ROM exercises
    • OT/PT

    Lateral Epicondylitis

    • Inflammation of the lateral tendon of the elbow
    • Causes:
    • Repetitive use of the wrist and forearm
    • Symptoms:
    • Pain or burning on the lateral side of the elbow
    • Weak grip strength
    • Treatment:
    • NSAIDs
    • Rest
    • Ice
    • ROM exercises
    • OT/PT

    Complete UCL Rupture

    • Causes:
    • Repetitive use
    • Fall on an outstretched arm
    • Symptoms:
    • Pain at the medial elbow
    • “Pop” after throwing
    • Tenderness
    • Swelling
    • Inability to throw or perform activity
    • Numbness in the ring and pinky fingers
    • Treatment:
    • Non-surgical: NSAIDS, ice, therapy
    • Surgical: Tommy John surgery

    Posterior Olecranon Osteophyte

    • Formation of bone spurs on the posterior olecranon
    • Symptoms:
    • Pain in the elbow with no mechanism of injury
    • Decreased ROM
    • Catching or locking of the elbow joint with movement
    • Treatment:
    • Surgery to remove bone spurs and debridement of osteophytes
    • PT/OT### Hand and Wrist Disorders
    • Splint: a preventative measure for thumb tendons, often used in combination with steroids and ice/heat to reduce pain and inflammation
    • Ganglion cysts: small, painless, non-cancerous lumps often found near tendons and joints in the wrist and hand
    • Swan-neck deformity: a deformity of the MCP joint caused by rheumatoid arthritis, characterized by flexion of the PIP joint and extension of the DIP joint
    • Boutonniere deformity: a deformity of the MCP joint caused by a forceful blow to the dorsum of the bent PIP joint, characterized by extension of the PIP joint and flexion of the DIP joint
    • Dupuytren's contracture: a condition caused by thickening of the fascia in the palm, leading to lumps, nodules, and cords that pull fingers inward

    Arthritic Diseases

    • Rheumatoid arthritis: an autoimmune disorder causing inflammation and joint damage, often resulting in bilateral involvement and joint deformity
    • Osteoarthritis: a degenerative joint disease causing joint pain, stiffness, and limited mobility
    • Fibromyalgia: a chronic condition characterized by widespread muscle pain, fatigue, and sleep disturbances
    • Gout: a metabolic disorder causing sudden and severe joint pain, often in the big toe, due to uric acid crystal buildup

    Skeletal Features

    • Cramp: a sudden, involuntary contraction of a muscle or group of muscles
    • Fasciculation: a visible, involuntary twitch of a muscle or group of muscles
    • Spasmodic contraction: an involuntary, painful contraction of a muscle or group of muscles

    Distal Radius Fractures

    • Falling on an outstretched hand can cause distal radius fractures
    • Symptoms include loss of sensation, strength, and range of motion (ROM)
    • Treatment options include open reduction (manual), open reduction internal fixation, splint or cast, and immobilization and mobilization with a schedule that varies depending on the case

    Scaphoid Fractures

    • Wrist hyperextension and radial deviation can cause scaphoid fractures
    • Symptoms include pain and tenderness that intensifies when trying to pinch or grasp objects
    • Non-displaced fractures can be treated with a non-surgical approach, including a thumb spike splint for 8-10 weeks, and may require an additional 6-8 weeks if the fracture is more distal
    • Displaced fractures require surgical treatment with a splint for 2-4 weeks

    Other Orthopedics

    Chronic Neck Pain

    • Causes of chronic neck pain include cervical degenerative disc disease, cervical osteoarthritis, spinal stenosis, and thoracic outlet syndrome
    • Symptoms of chronic neck pain include pain, stiffness, decreased ROM, headache, and crepitus (moving a joint and hearing it pop or crack)
    • Treatment options include non-surgical approaches such as rest, NSAIDs, modalities, exercise, and OT/PT, as well as surgical approaches such as repair of the disc and nucleus pulposus

    Cervical Degenerative Disc Disease

    • Wear and tear on the cervical spine can cause cervical degenerative disc disease
    • Symptoms include pain, stiffness, decreased ROM, and herniated discs
    • Treatment options include non-surgical approaches such as rest, NSAIDs, modalities, exercise, and OT/PT, as well as surgical approaches such as repair of the disc and nucleus pulposus

    Cervical Osteoarthritis

    • Aging can lead to increased stiffness in the discs and abnormal growths on the bones of the neck
    • Symptoms include pain, stiffness, decreased ROM, headache, and crepitus
    • Treatment options include non-surgical approaches such as rest, NSAIDs, modalities, exercise, and OT/PT, as well as surgical approaches such as repair of the disc and nucleus pulposus

    Spinal Stenosis

    • Narrowing of the spinal cord can cause spinal stenosis
    • Symptoms include pain, numbness, and possible myelopathy (weakness and decreased coordination in the arms or legs)
    • Treatment options include non-surgical approaches such as OT/PT, NSAIDs, and surgical approaches such as cervical depression

    Thoracic Outlet Syndrome

    • Trauma, repetitive use, pregnancy, and anatomical differences can cause thoracic outlet syndrome
    • Symptoms include pain in the shoulders and neck, numbness and tingling, and coldness in the fingers
    • Treatment options include non-surgical approaches such as rest, activity modification, and surgical approaches such as cutting out part of the rib to open up space

    Fracture of the Shoulder

    • Floor-level falls, sports injuries, and MVA can cause fractures of the shoulder
    • Symptoms include pain, swelling, and deformity, as well as grinding sensation
    • Treatment options include non-surgical approaches such as immobilization, ice, and NSAIDs, as well as surgical approaches such as plates, screws, and internal fixation

    Elbow Disorders

    Medial Epicondyli

    • Inflammation of the medial tendon of the elbow can cause medial epicondyli
    • Symptoms include pain, weakness, and stiffness, and are usually dominant in the hand
    • Treatment options include non-surgical approaches such as NSAIDs, rest, ice, ROM, taping, and OT/PT

    Lateral Epicondyli

    • Inflammation of the lateral tendon of the elbow can cause lateral epicondyli
    • Symptoms include pain, weakness, and stiffness, and are usually dominant in the hand
    • Treatment options include non-surgical approaches such as NSAIDs, rest, ice, ROM, brace, and OT/PT

    Complete UCL Rupture

    • Repetitive use, falls, and direct injury can cause complete UCL rupture
    • Symptoms include pain, swelling, and deformity, as well as numbness in the ring and pinky fingers
    • Treatment options include non-surgical approaches such as NSAIDs, ice, and therapy, as well as surgical approaches such as Tommy John surgery

    Posterior Olecranon Osteophyte

    • Formation of bone spurs on the posterior olecranon can cause posterior olecranon osteophyte
    • Symptoms include pain, decreased ROM, and catching or locking of the elbow joint
    • Treatment options include surgical approaches such as removing bone spurs and debridement of osteophytes

    Elbow Dislocation

    • Falls on an outstretched arm can cause elbow dislocation
    • Symptoms include partial or complete dislocation, pain, and deformity
    • Treatment options include non-surgical approaches such as relocation and immobilization, as well as surgical approaches such as repair of ligaments and external hinge

    Radial Head Fracture

    • Falls on an outstretched arm or in conjunction with elbow fractures can cause radial head fracture
    • Symptoms include pain, swelling, and decreased ROM
    • Treatment options include non-surgical approaches such as rest, sling, and NSAIDs, as well as surgical approaches such as removing bone fragments and repair of ligaments

    Olecranon Bursitis

    • Direct injury, prolonged pressure, infection, and other medical problems can cause olecranon bursitis
    • Symptoms include painful elbow, edema, redness, and warm skin
    • Treatment options include non-surgical approaches such as antibiotics, NSAIDs, and elbow pods, as well as surgical approaches such as removing the bursa and splinting

    Elbow Arthritis

    • Breakdown of cartilage on the articulating surfaces of bones can cause elbow arthritis
    • Symptoms include pain, decreased ROM, locking or grating sensation, and edema
    • Treatment options include non-surgical approaches such as NSAIDs, OT/PT, and corticosteroids, as well as surgical approaches such as arthroscopy or joint replacement

    Ulnar Nerve Entrapment

    • Subluxed nerve, prolonged pressure, swelling, and direct injury can cause ulnar nerve entrapment
    • Symptoms include pain, numbness, and weakened grip, as well as atrophy or hand musculature
    • Treatment options include non-surgical approaches such as modifying activities, nerve glide, and NSAIDs, as well as surgical approaches such as cubital tunnel release and transportation of the ulnar nerve

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