Questions and Answers
What is a precursor to osteoporosis?
What factors may interfere with bone mass accrual during adolescence?
Pregnancy during adolescence, eating disorders, poor calcium intake
Bone loss accelerates with menopause.
True
What is the primary role of alkaline phosphatase in bone health?
Signup and view all the answers
What symptoms may indicate the need for an MRI for a fracture?
Signup and view all the answers
What common symptoms are associated with carpal tunnel syndrome?
Signup and view all the answers
What is Paget's disease characterized by?
Signup and view all the answers
What are the Ottawa ankle rules used for?
Signup and view all the answers
What does radiculopathy refer to?
Signup and view all the answers
Vitamin D deficiency can affect bone health.
Signup and view all the answers
What is a Colles fracture?
Signup and view all the answers
A Reverse Colles fracture occurs from a fall on a flexed hand.
Signup and view all the answers
What is the primary treatment for a non-displaced fracture?
Signup and view all the answers
Stress fractures are caused by multiple microfractures due to repeated pressure on a ______.
Signup and view all the answers
Which of the following is a secondary sign of fractures?
Signup and view all the answers
What type of fracture is most common in adults at the elbow?
Signup and view all the answers
The Salter Harris classification for pediatric fractures assesses injuries to the _______.
Signup and view all the answers
What is the prognosis for a Salter Harris Type I fracture?
Signup and view all the answers
What is Brown-Sequard syndrome?
Signup and view all the answers
Which movement disorder is characterized by abrupt irregular movements?
Signup and view all the answers
What are common symptoms of Myasthenia Gravis?
Signup and view all the answers
Parkinson's disease involves the accumulation of ______ bodies.
Signup and view all the answers
What is the anatomical basis of Wilson's disease?
Signup and view all the answers
What is considered a precursor for osteoporosis?
Signup and view all the answers
Which of these factors may interfere with bone mass accrual? (Select all that apply)
Signup and view all the answers
What is a common presentation of osteoporosis?
Signup and view all the answers
Women over 65 should be screened for osteoporosis only if they have risk factors.
Signup and view all the answers
What is osteoporosis characterized by?
Signup and view all the answers
What vitamin deficiency can affect bone health?
Signup and view all the answers
The most common ankle injury is an ______.
Signup and view all the answers
What are the Ottawa ankle rules used for?
Signup and view all the answers
Which of the following is a symptom of radiculopathy? (Select all that apply)
Signup and view all the answers
What diagnostic tests are often performed together to assess nerve and muscle function?
Signup and view all the answers
What is a common elastic band symptom associated with carpal tunnel syndrome?
Signup and view all the answers
What typically causes a Colles fracture?
Signup and view all the answers
What is a Reverse Colles fracture?
Signup and view all the answers
What is the typical intervention for a Snuff Box fracture?
Signup and view all the answers
What are the signs of a radial head fracture in adults?
Signup and view all the answers
Which of the following is involved in pediatric fractures?
Signup and view all the answers
What type of fracture is described as a partial compression of the cortex?
Signup and view all the answers
What is a common cause of Chorea?
Signup and view all the answers
Which symptom is not associated with Parkinson's disease?
Signup and view all the answers
What is the effect of alpha-synuclein accumulation in Parkinson's disease?
Signup and view all the answers
Myoclonus is characterized by sustained muscle contractions.
Signup and view all the answers
What are common signs of Wilson's disease?
Signup and view all the answers
Which type of fracture classification is typically associated with poor prognosis?
Signup and view all the answers
What is Brown-Sequard syndrome?
Signup and view all the answers
What is a common first-line treatment for Myasthenia Gravis?
Signup and view all the answers
What is a Colles fracture?
Signup and view all the answers
A Reverse Colles fracture occurs from a fall on an extended hand.
Signup and view all the answers
What is a Snuff Box fracture associated with?
Signup and view all the answers
What is the usual treatment for a non-displaced fracture?
Signup and view all the answers
Which type of fracture is typically caused by multiple microfractures from repeated pressure?
Signup and view all the answers
What is a characteristic sign of pediatric incomplete fractures?
Signup and view all the answers
What classification is used for pediatric fractures?
Signup and view all the answers
Parkinson's disease is primarily characterized by resting tremors.
Signup and view all the answers
What accumulates in neurons and contributes to the progression of Parkinson's disease?
Signup and view all the answers
What causes chorea?
Signup and view all the answers
What is a major clinical feature of Wilson's disease?
Signup and view all the answers
Brown-Sequard syndrome is caused by which of the following?
Signup and view all the answers
What kind of therapy is administered for myasthenic crisis?
Signup and view all the answers
What is a precursor for osteoporosis?
Signup and view all the answers
Which factors may interfere with bone mass accrual?
Signup and view all the answers
What are common presentations of osteoporosis?
Signup and view all the answers
What age should women be screened for osteoporosis?
Signup and view all the answers
What biochemical markers are tested for in osteoporosis evaluation?
Signup and view all the answers
Bone turnover markers are primarily for patients with confirmed osteoporosis.
Signup and view all the answers
What is the active form of Vitamin D produced in the body?
Signup and view all the answers
What does the Ottawa ankle rule include?
Signup and view all the answers
What diagnostic tests are often performed together to assess nerve and muscle function?
Signup and view all the answers
What symptoms are commonly associated with radiculopathy?
Signup and view all the answers
What is the most common ankle injury?
Signup and view all the answers
Which ligament is most commonly injured in an ankle sprain?
Signup and view all the answers
Paget's disease spreads to other bones after those initially affected.
Signup and view all the answers
Study Notes
Types of Fractures
- Colles Fracture: Common wrist fracture due to a fall on an outstretched hand, affecting distal radius and ulna.
- Reverse Colles Fracture: Caused by falling on a flexed wrist; treated with surgery or splinting for four weeks.
- Snuff Box Fracture: Resulting from extreme dorsiflexion and outstretched hand impacting scaphoid, diagnosed via MRI and treated with a thumb splint.
- Non-Displaced Fracture: Treatment involves thumb splint followed by casting, with re-imaging needed weeks later.
- Displaced Fractures: Require surgical fixation to safeguard the delicate blood supply to the scaphoid.
- Stress Fractures: Caused by repeated microfractures, often undetected on X-rays; diagnosed using MRI or bone scans.
- Secondary Signs: Include joint effusion, periosteal reactions, or callus formation indicating potential fractures.
- Radial Head Fracture: Most common elbow fracture in adults, correlated with the presence of extra synovial fat; similar signs seen in children as supracondylar fracture.
- Hills Sachs Deformity: Associated with anterior shoulder dislocations.
- Spiral Fracture: Extending to joint space, posing clinical implications.
- Pathologic Fracture: Characterized by bone density abnormalities, often associated with geographic lytic lesions.
Pediatric Fractures
- Growth Plate Considerations: Pediatric fractures often involve the epiphyseal "growth plate" categorized by Salter-Harris classification.
-
Salter-Harris Classification:
- Type I: Through growth plate, good prognosis.
- Type II: Through growth plate and metaphysis, also good prognosis, most common.
- Type III: Through growth plate and epiphysis; risk of premature fusion and osteoarthritis.
- Type IV: Through growth plate, epiphysis, and metaphysis; similar risks as Type III.
- Type V: Crush injury to growth plate with poor prognosis and possible vascular injury.
Incomplete Fractures
- Characteristics: Common in children, involve partial cortex damage.
- Toris/Buckle Fracture: Involves bulging or compression without definitive fracture lines; treated with immobilization and pain control.
- Greenstick Fracture: Involves partial cortex; often requires complete breakage for proper healing, long-term immobilization follows.
- Supracondylar Fracture: Most prevalent elbow fracture in children, identified by posterior fat pad sign; requires immediate ortho consultation due to neurovascular risk.
- Apophyseal Avulsion Fracture: Occurs with muscle overuse, e.g., at anterior superior iliac crest in athletes.
- Toddler's Fracture: Spiral fracture of distal tibia, typically due to aggressive pivoting; not indicative of child abuse.
Secondary Signs on X-Ray
- Healing Indicators: Include periosteal reactions, soft and hard callus formations around fractures.
- Discontinuity and Displacement: Identify fractures via heterogeneous cortical and trabecular bone patterns; abnormal fat pad elevations serve as additional indicators.
Parkinson's Disease Characteristics
- Nature: Progressive neurodegenerative disorder affecting movement due to dopaminergic neuron loss in the substantia nigra.
- Symptoms: Include tremors (resting), rigidity, and bradykinesia, along with balance issues.
- Pathophysiology: Degeneration of neurons in the direct pathway leads to disrupted motor control due to the accumulation of Lewy bodies consisting of alpha-synuclein.
- Risk Factors: Include pesticide exposure, heavy metal inhalation, and trauma; more common in males.
Chorea and Related Movements
- Definition: Involuntary, abrupt movements; linked to Huntington’s and Wilson’s diseases, and influenced by toxic and immunologic factors.
- Dystonia: Hyperkinetic disorder characterized by sustained muscle contractions leading to abnormal postures; can be idiopathic or secondary to other neurological diseases.
- Myoclonus: Sudden, brief muscle contractions; managed with medications like clonazepam and valproate.
- Tics: Stereotyped movements or vocalizations, can be suppressed; treated with dopamine agonists or SSRIs.
- Tremors: Vary by type, including resting (Parkinson's), postural (essential tremor), and action tremors tied to cerebellar lesions.
Wilson's Disease Pathophysiology
- Genetics: Autosomal recessive disorder leading to copper accumulation in organs due to defective metabolism.
- Clinical Signs: Brown-green Kayser-Fleischer rings in the iris, with symptoms resembling hyperkinetic movements, cognitive impairments, and movement disorders.
- Diagnosis: Includes serum copper levels, ceruloplasmin, and 24-hour urine copper testing; liver biopsy can confirm.
-
Symptom Acronym ABCD:
- A: Asterixis
- B: Basal ganglia degeneration
- C: Cirrhosis and corneal deposits
- D: Dementia
Brown-Sequard Syndrome
- Description: Condition caused by hemisection of the spinal cord, leads to ipsilateral weakness and sensory loss, with contralateral loss of pain and temperature perception.
Management and Diagnosis of Conditions
- ALS Clinical Presentation: Limb weakness, muscle cramps, and speech difficulties; asymmetrical to symmetrical muscle weakness over time; features spasticity and atrophy.
- Myasthenia Gravis (MG): Characterized by muscle weakness, can be ocular or generalized; treated with acetylcholinesterase inhibitors and potential thymectomy.
- Indications for MRI in Fractures: MRI is preferred for complex or suspected soft tissue injuries, such as stress fractures or when X-ray results are unclear.
Factors Affecting Bone Health in Women
- Osteopenia and Osteoporosis: Causative factors include decreased estrogen and lifestyle; screening advisable for women over 65 or those with risk factors.
- Vitamin D Deficiency: Key factor in calcium metabolism, primarily sourced from diet and sun exposure.
Ottawa Ankle Rules
- Criteria: Assess when to obtain X-ray imaging; includes pain over specific malleoli or along distal tibia/fibula, serving as a guideline for injury evaluation.
Electromyography (EMG) and Nerve Conduction Studies (NCS)
- Purpose: Diagnostic tools that measure electrical activity in muscles, providing insights into nerve and muscle function during rest and contraction.
Carpal Tunnel Syndrome Assessment
- Overview: Evaluated based on median nerve compression signs, can involve physical examination techniques to confirm diagnosis.### Carpal Tunnel Syndrome
- Predisposing factors: obesity, female gender, short stature, and history of fractures.
- Common symptoms include numbness in the radial 3 and ½ digits, heaviness in hands, and decreased grip strength.
- Pain is typically felt in the volar aspect of the hand.
- Patients may experience electric shock sensations, particularly at night.
- Tinel's sign is positive if tingling occurs when tapping over the median nerve.
- A compression test can replicate symptoms by fully compressing the carpal tunnel.
- Electromyography (EMG) studies are used to confirm diagnosis.
Paget's Disease
- Prevalent in the UK, Australia, South Africa, and the USA.
- Characterized by chaotic osteoclast function leading to increased, but weaker, bone remodeling.
- Etiology remains unclear, and hypervascularity is noted.
- Often results in asymmetrical enlargement of one or more bones (pelvis, lumbar spine, skull, femur).
- 90% of patients remain asymptomatic; however, bowed lower extremities and enlarged skull may occur.
- Increased risk of fractures in femur, tibia, and radius.
- Uncommon effects include hearing loss, vertigo, and hypercalcemia during immobilization.
- Elevated levels of IGF1 and alkaline phosphatase (often exceeding 500) are significant markers.
- X-ray findings include various phases: osteoporosis, mixed phases, and sclerosis.
- Treatment options include bisphosphonates, alendronate, and risendronate.
Ankle Sprain Management
- Ankle sprains are the most common ankle injury, usually caused by inversion or supination stress.
- The anterior talofibular ligament is the most frequently injured.
- Symptoms include swelling, decreased range of motion (ROM), warmth, visible deformity, and bruising.
- Ottawa ankle rules guide the need for X-rays based on specific pain points and weight-bearing capacity.
- Treatment involves PRICE: Protection, Rest, Ice, Elevation, along with potential use of air or gel casts, acupuncture, and NSAIDs.
- Injuries may be accompanied by tibiofibular interosseous membrane strain and posterior fibular head malfunction.
- Myofascial release may help some cases but should be avoided in acute sprains or fractures.
Radiculopathy
- Radiculopathy, commonly referred to as a pinched nerve, occurs when spinal nerves are damaged or compressed.
- Can affect cervical, thoracic, or lumbar regions of the spine.
- Symptoms vary based on the nerve roots affected and commonly include pain, weakness, numbness, altered sensation, and difficulty controlling muscles.
Types of Fractures
- Colles Fracture: Common wrist fracture due to a fall on an outstretched hand, affecting distal radius and ulna.
- Reverse Colles Fracture: Caused by falling on a flexed wrist; treated with surgery or splinting for four weeks.
- Snuff Box Fracture: Resulting from extreme dorsiflexion and outstretched hand impacting scaphoid, diagnosed via MRI and treated with a thumb splint.
- Non-Displaced Fracture: Treatment involves thumb splint followed by casting, with re-imaging needed weeks later.
- Displaced Fractures: Require surgical fixation to safeguard the delicate blood supply to the scaphoid.
- Stress Fractures: Caused by repeated microfractures, often undetected on X-rays; diagnosed using MRI or bone scans.
- Secondary Signs: Include joint effusion, periosteal reactions, or callus formation indicating potential fractures.
- Radial Head Fracture: Most common elbow fracture in adults, correlated with the presence of extra synovial fat; similar signs seen in children as supracondylar fracture.
- Hills Sachs Deformity: Associated with anterior shoulder dislocations.
- Spiral Fracture: Extending to joint space, posing clinical implications.
- Pathologic Fracture: Characterized by bone density abnormalities, often associated with geographic lytic lesions.
Pediatric Fractures
- Growth Plate Considerations: Pediatric fractures often involve the epiphyseal "growth plate" categorized by Salter-Harris classification.
-
Salter-Harris Classification:
- Type I: Through growth plate, good prognosis.
- Type II: Through growth plate and metaphysis, also good prognosis, most common.
- Type III: Through growth plate and epiphysis; risk of premature fusion and osteoarthritis.
- Type IV: Through growth plate, epiphysis, and metaphysis; similar risks as Type III.
- Type V: Crush injury to growth plate with poor prognosis and possible vascular injury.
Incomplete Fractures
- Characteristics: Common in children, involve partial cortex damage.
- Toris/Buckle Fracture: Involves bulging or compression without definitive fracture lines; treated with immobilization and pain control.
- Greenstick Fracture: Involves partial cortex; often requires complete breakage for proper healing, long-term immobilization follows.
- Supracondylar Fracture: Most prevalent elbow fracture in children, identified by posterior fat pad sign; requires immediate ortho consultation due to neurovascular risk.
- Apophyseal Avulsion Fracture: Occurs with muscle overuse, e.g., at anterior superior iliac crest in athletes.
- Toddler's Fracture: Spiral fracture of distal tibia, typically due to aggressive pivoting; not indicative of child abuse.
Secondary Signs on X-Ray
- Healing Indicators: Include periosteal reactions, soft and hard callus formations around fractures.
- Discontinuity and Displacement: Identify fractures via heterogeneous cortical and trabecular bone patterns; abnormal fat pad elevations serve as additional indicators.
Parkinson's Disease Characteristics
- Nature: Progressive neurodegenerative disorder affecting movement due to dopaminergic neuron loss in the substantia nigra.
- Symptoms: Include tremors (resting), rigidity, and bradykinesia, along with balance issues.
- Pathophysiology: Degeneration of neurons in the direct pathway leads to disrupted motor control due to the accumulation of Lewy bodies consisting of alpha-synuclein.
- Risk Factors: Include pesticide exposure, heavy metal inhalation, and trauma; more common in males.
Chorea and Related Movements
- Definition: Involuntary, abrupt movements; linked to Huntington’s and Wilson’s diseases, and influenced by toxic and immunologic factors.
- Dystonia: Hyperkinetic disorder characterized by sustained muscle contractions leading to abnormal postures; can be idiopathic or secondary to other neurological diseases.
- Myoclonus: Sudden, brief muscle contractions; managed with medications like clonazepam and valproate.
- Tics: Stereotyped movements or vocalizations, can be suppressed; treated with dopamine agonists or SSRIs.
- Tremors: Vary by type, including resting (Parkinson's), postural (essential tremor), and action tremors tied to cerebellar lesions.
Wilson's Disease Pathophysiology
- Genetics: Autosomal recessive disorder leading to copper accumulation in organs due to defective metabolism.
- Clinical Signs: Brown-green Kayser-Fleischer rings in the iris, with symptoms resembling hyperkinetic movements, cognitive impairments, and movement disorders.
- Diagnosis: Includes serum copper levels, ceruloplasmin, and 24-hour urine copper testing; liver biopsy can confirm.
-
Symptom Acronym ABCD:
- A: Asterixis
- B: Basal ganglia degeneration
- C: Cirrhosis and corneal deposits
- D: Dementia
Brown-Sequard Syndrome
- Description: Condition caused by hemisection of the spinal cord, leads to ipsilateral weakness and sensory loss, with contralateral loss of pain and temperature perception.
Management and Diagnosis of Conditions
- ALS Clinical Presentation: Limb weakness, muscle cramps, and speech difficulties; asymmetrical to symmetrical muscle weakness over time; features spasticity and atrophy.
- Myasthenia Gravis (MG): Characterized by muscle weakness, can be ocular or generalized; treated with acetylcholinesterase inhibitors and potential thymectomy.
- Indications for MRI in Fractures: MRI is preferred for complex or suspected soft tissue injuries, such as stress fractures or when X-ray results are unclear.
Factors Affecting Bone Health in Women
- Osteopenia and Osteoporosis: Causative factors include decreased estrogen and lifestyle; screening advisable for women over 65 or those with risk factors.
- Vitamin D Deficiency: Key factor in calcium metabolism, primarily sourced from diet and sun exposure.
Ottawa Ankle Rules
- Criteria: Assess when to obtain X-ray imaging; includes pain over specific malleoli or along distal tibia/fibula, serving as a guideline for injury evaluation.
Electromyography (EMG) and Nerve Conduction Studies (NCS)
- Purpose: Diagnostic tools that measure electrical activity in muscles, providing insights into nerve and muscle function during rest and contraction.
Carpal Tunnel Syndrome Assessment
- Overview: Evaluated based on median nerve compression signs, can involve physical examination techniques to confirm diagnosis.### Carpal Tunnel Syndrome
- Predisposing factors: obesity, female gender, short stature, and history of fractures.
- Common symptoms include numbness in the radial 3 and ½ digits, heaviness in hands, and decreased grip strength.
- Pain is typically felt in the volar aspect of the hand.
- Patients may experience electric shock sensations, particularly at night.
- Tinel's sign is positive if tingling occurs when tapping over the median nerve.
- A compression test can replicate symptoms by fully compressing the carpal tunnel.
- Electromyography (EMG) studies are used to confirm diagnosis.
Paget's Disease
- Prevalent in the UK, Australia, South Africa, and the USA.
- Characterized by chaotic osteoclast function leading to increased, but weaker, bone remodeling.
- Etiology remains unclear, and hypervascularity is noted.
- Often results in asymmetrical enlargement of one or more bones (pelvis, lumbar spine, skull, femur).
- 90% of patients remain asymptomatic; however, bowed lower extremities and enlarged skull may occur.
- Increased risk of fractures in femur, tibia, and radius.
- Uncommon effects include hearing loss, vertigo, and hypercalcemia during immobilization.
- Elevated levels of IGF1 and alkaline phosphatase (often exceeding 500) are significant markers.
- X-ray findings include various phases: osteoporosis, mixed phases, and sclerosis.
- Treatment options include bisphosphonates, alendronate, and risendronate.
Ankle Sprain Management
- Ankle sprains are the most common ankle injury, usually caused by inversion or supination stress.
- The anterior talofibular ligament is the most frequently injured.
- Symptoms include swelling, decreased range of motion (ROM), warmth, visible deformity, and bruising.
- Ottawa ankle rules guide the need for X-rays based on specific pain points and weight-bearing capacity.
- Treatment involves PRICE: Protection, Rest, Ice, Elevation, along with potential use of air or gel casts, acupuncture, and NSAIDs.
- Injuries may be accompanied by tibiofibular interosseous membrane strain and posterior fibular head malfunction.
- Myofascial release may help some cases but should be avoided in acute sprains or fractures.
Radiculopathy
- Radiculopathy, commonly referred to as a pinched nerve, occurs when spinal nerves are damaged or compressed.
- Can affect cervical, thoracic, or lumbar regions of the spine.
- Symptoms vary based on the nerve roots affected and commonly include pain, weakness, numbness, altered sensation, and difficulty controlling muscles.
Types of Fractures
- Colles Fracture: Common wrist fracture due to a fall on an outstretched hand, affecting distal radius and ulna.
- Reverse Colles Fracture: Caused by falling on a flexed wrist; treated with surgery or splinting for four weeks.
- Snuff Box Fracture: Resulting from extreme dorsiflexion and outstretched hand impacting scaphoid, diagnosed via MRI and treated with a thumb splint.
- Non-Displaced Fracture: Treatment involves thumb splint followed by casting, with re-imaging needed weeks later.
- Displaced Fractures: Require surgical fixation to safeguard the delicate blood supply to the scaphoid.
- Stress Fractures: Caused by repeated microfractures, often undetected on X-rays; diagnosed using MRI or bone scans.
- Secondary Signs: Include joint effusion, periosteal reactions, or callus formation indicating potential fractures.
- Radial Head Fracture: Most common elbow fracture in adults, correlated with the presence of extra synovial fat; similar signs seen in children as supracondylar fracture.
- Hills Sachs Deformity: Associated with anterior shoulder dislocations.
- Spiral Fracture: Extending to joint space, posing clinical implications.
- Pathologic Fracture: Characterized by bone density abnormalities, often associated with geographic lytic lesions.
Pediatric Fractures
- Growth Plate Considerations: Pediatric fractures often involve the epiphyseal "growth plate" categorized by Salter-Harris classification.
-
Salter-Harris Classification:
- Type I: Through growth plate, good prognosis.
- Type II: Through growth plate and metaphysis, also good prognosis, most common.
- Type III: Through growth plate and epiphysis; risk of premature fusion and osteoarthritis.
- Type IV: Through growth plate, epiphysis, and metaphysis; similar risks as Type III.
- Type V: Crush injury to growth plate with poor prognosis and possible vascular injury.
Incomplete Fractures
- Characteristics: Common in children, involve partial cortex damage.
- Toris/Buckle Fracture: Involves bulging or compression without definitive fracture lines; treated with immobilization and pain control.
- Greenstick Fracture: Involves partial cortex; often requires complete breakage for proper healing, long-term immobilization follows.
- Supracondylar Fracture: Most prevalent elbow fracture in children, identified by posterior fat pad sign; requires immediate ortho consultation due to neurovascular risk.
- Apophyseal Avulsion Fracture: Occurs with muscle overuse, e.g., at anterior superior iliac crest in athletes.
- Toddler's Fracture: Spiral fracture of distal tibia, typically due to aggressive pivoting; not indicative of child abuse.
Secondary Signs on X-Ray
- Healing Indicators: Include periosteal reactions, soft and hard callus formations around fractures.
- Discontinuity and Displacement: Identify fractures via heterogeneous cortical and trabecular bone patterns; abnormal fat pad elevations serve as additional indicators.
Parkinson's Disease Characteristics
- Nature: Progressive neurodegenerative disorder affecting movement due to dopaminergic neuron loss in the substantia nigra.
- Symptoms: Include tremors (resting), rigidity, and bradykinesia, along with balance issues.
- Pathophysiology: Degeneration of neurons in the direct pathway leads to disrupted motor control due to the accumulation of Lewy bodies consisting of alpha-synuclein.
- Risk Factors: Include pesticide exposure, heavy metal inhalation, and trauma; more common in males.
Chorea and Related Movements
- Definition: Involuntary, abrupt movements; linked to Huntington’s and Wilson’s diseases, and influenced by toxic and immunologic factors.
- Dystonia: Hyperkinetic disorder characterized by sustained muscle contractions leading to abnormal postures; can be idiopathic or secondary to other neurological diseases.
- Myoclonus: Sudden, brief muscle contractions; managed with medications like clonazepam and valproate.
- Tics: Stereotyped movements or vocalizations, can be suppressed; treated with dopamine agonists or SSRIs.
- Tremors: Vary by type, including resting (Parkinson's), postural (essential tremor), and action tremors tied to cerebellar lesions.
Wilson's Disease Pathophysiology
- Genetics: Autosomal recessive disorder leading to copper accumulation in organs due to defective metabolism.
- Clinical Signs: Brown-green Kayser-Fleischer rings in the iris, with symptoms resembling hyperkinetic movements, cognitive impairments, and movement disorders.
- Diagnosis: Includes serum copper levels, ceruloplasmin, and 24-hour urine copper testing; liver biopsy can confirm.
-
Symptom Acronym ABCD:
- A: Asterixis
- B: Basal ganglia degeneration
- C: Cirrhosis and corneal deposits
- D: Dementia
Brown-Sequard Syndrome
- Description: Condition caused by hemisection of the spinal cord, leads to ipsilateral weakness and sensory loss, with contralateral loss of pain and temperature perception.
Management and Diagnosis of Conditions
- ALS Clinical Presentation: Limb weakness, muscle cramps, and speech difficulties; asymmetrical to symmetrical muscle weakness over time; features spasticity and atrophy.
- Myasthenia Gravis (MG): Characterized by muscle weakness, can be ocular or generalized; treated with acetylcholinesterase inhibitors and potential thymectomy.
- Indications for MRI in Fractures: MRI is preferred for complex or suspected soft tissue injuries, such as stress fractures or when X-ray results are unclear.
Factors Affecting Bone Health in Women
- Osteopenia and Osteoporosis: Causative factors include decreased estrogen and lifestyle; screening advisable for women over 65 or those with risk factors.
- Vitamin D Deficiency: Key factor in calcium metabolism, primarily sourced from diet and sun exposure.
Ottawa Ankle Rules
- Criteria: Assess when to obtain X-ray imaging; includes pain over specific malleoli or along distal tibia/fibula, serving as a guideline for injury evaluation.
Electromyography (EMG) and Nerve Conduction Studies (NCS)
- Purpose: Diagnostic tools that measure electrical activity in muscles, providing insights into nerve and muscle function during rest and contraction.
Carpal Tunnel Syndrome Assessment
- Overview: Evaluated based on median nerve compression signs, can involve physical examination techniques to confirm diagnosis.### Carpal Tunnel Syndrome
- Predisposing factors: obesity, female gender, short stature, and history of fractures.
- Common symptoms include numbness in the radial 3 and ½ digits, heaviness in hands, and decreased grip strength.
- Pain is typically felt in the volar aspect of the hand.
- Patients may experience electric shock sensations, particularly at night.
- Tinel's sign is positive if tingling occurs when tapping over the median nerve.
- A compression test can replicate symptoms by fully compressing the carpal tunnel.
- Electromyography (EMG) studies are used to confirm diagnosis.
Paget's Disease
- Prevalent in the UK, Australia, South Africa, and the USA.
- Characterized by chaotic osteoclast function leading to increased, but weaker, bone remodeling.
- Etiology remains unclear, and hypervascularity is noted.
- Often results in asymmetrical enlargement of one or more bones (pelvis, lumbar spine, skull, femur).
- 90% of patients remain asymptomatic; however, bowed lower extremities and enlarged skull may occur.
- Increased risk of fractures in femur, tibia, and radius.
- Uncommon effects include hearing loss, vertigo, and hypercalcemia during immobilization.
- Elevated levels of IGF1 and alkaline phosphatase (often exceeding 500) are significant markers.
- X-ray findings include various phases: osteoporosis, mixed phases, and sclerosis.
- Treatment options include bisphosphonates, alendronate, and risendronate.
Ankle Sprain Management
- Ankle sprains are the most common ankle injury, usually caused by inversion or supination stress.
- The anterior talofibular ligament is the most frequently injured.
- Symptoms include swelling, decreased range of motion (ROM), warmth, visible deformity, and bruising.
- Ottawa ankle rules guide the need for X-rays based on specific pain points and weight-bearing capacity.
- Treatment involves PRICE: Protection, Rest, Ice, Elevation, along with potential use of air or gel casts, acupuncture, and NSAIDs.
- Injuries may be accompanied by tibiofibular interosseous membrane strain and posterior fibular head malfunction.
- Myofascial release may help some cases but should be avoided in acute sprains or fractures.
Radiculopathy
- Radiculopathy, commonly referred to as a pinched nerve, occurs when spinal nerves are damaged or compressed.
- Can affect cervical, thoracic, or lumbar regions of the spine.
- Symptoms vary based on the nerve roots affected and commonly include pain, weakness, numbness, altered sensation, and difficulty controlling muscles.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
