Chapter 3 Answers.docx

Pathology Chapter 3 Muscular Dystrophy What is the best description of muscular dystrophy? A group of neuromuscular diseases from genetic anomalies What causes muscular dystrophy? Genes, most commonly x-linked from the mother to son What are the two most common forms of muscular dystrophy? Duchenne...

Pathology Chapter 3 Muscular Dystrophy What is the best description of muscular dystrophy? A group of neuromuscular diseases from genetic anomalies What causes muscular dystrophy? Genes, most commonly x-linked from the mother to son What are the two most common forms of muscular dystrophy? Duchenne MD and Becker MD What is the most severe form of muscular dystrophy? Duchenne MD What does early-stage muscular dystrophy look like? Toddler will have trouble walking, pain in legs and will develop a waddling gait. Calves will seem disproportionately large. What complications exist for muscular dystrophy? Pain Pressure injuries Postural deviations Spasms / Cramps What is the best description of a spasm / cramp Involuntary contraction of skeletal muscles What are the most common contributing factors to spasms / cramps? Nutrition, ischemia and exercise If cramping occurs in athletes, what is it often related to? Dehydration, electrolyte imbalance or hyperthermia Strains What is the best description of a strain? An injury involving the tearing of myofibers and production of scar tissue. What situations are most likely to lead to a strain? Trauma, overuse What is the best description of the most common strain symptoms? Local pain with stretching and resisted ROM Osteosarcoma What is osteosarcoma? Cancer that originates in bone tissue What are the most common contributing factors to osteosarcoma? Who is most likely to develop osteosarcoma? Young adults and adolescents What are the most common early symptoms of osteosarcoma? Asymptomatic until well established Osgood-Schlatter What is Osgood-Schlatter disease? Irritation and inflammation at the site of the quadriceps attachment on the tibia What happens with Osgood-Shlatter to cause symptoms? Any activity that stresses and stretches the quadriceps Who is the most likely to develop Osgood-Schlatter? Athletic adolescents What are the major signs and symptoms of Osgood-Schlatter? Sore, tender, hot, swollen knee Osteoporosis? What is Osteoporosis? Calcium being removed from the bones faster than it is replaced What is the asymptomatic precursor to osteoporosis? Osteopenia What risk factors for osteoporosis can be controlled? Hormone levels, Vitamin D, medications, being sedentary, Diet, Tobacco or alcohol use. What risk factors for osteoporosis cannot be controlled? Gender, age, body size, ethnicity, and family history How can calcium absorption in the diet be promoted? Vitamin D and K improve absorption, and it requires an acidic environment in the stomach/ What events promote calcium loss and reduce bone density? Sweat, urination, menopause, and other underlying disorders. What are the late-stage signs of osteoporosis? Spontaneous fractures, vertebral collapse, hyperkyphosis and loss of height, acute, chronic back pain. What fractures are a common complication of osteoporosis? Hip fractures, compression fractures, brittle ribs and wrists What strategies can help prevent osteoporosis? Dietary calcium from absorbable sources, exercise, vitamin D, avoid substances and behaviors that decrease bone density Postural Deviations What is a postural deviation? Overdeveloped spinal curves, or a S or C-curve. What kind of postural deviation is associated with asymmetrical and inefficient use of postural muscles? Functional What kind of postural deviation occurs when ligaments and bones adapt to long-term postural and movement patterns? Structural What term is used to describe an overexaggerated thoracic term? Hyperkyphosis What term is used to describe an overexaggerated lumbar curve? Hyperlordosis This is the term used to describe a lateral deviation of the spine. Scoliosis This is a type of scoliosis including twisting and bowing. Rotoscoliosis Where is pain likely to be experienced with hyperkyphosis? Shoulders Frozen Shoulder What is the best description of adhesive capsulitis? Connective tissues at the GH joint become inflamed and restrictive Who is the most likely to have frozen shoulder? Most common in people 50-60 years old, seen in people with diabetes, hyperthyroidism and high triglycerides. What are the three phases of adhesive capsulitis? “Freezing”, “Frozen”, “Thawing” What are the major symptoms associated with the first, second, and third phases of adhesive capsulitis? Freezing – sever and slowly progressing pain in 1 shoulder, at night Frozen – Stiff and not painful. AROM and PROM are limited. Thawing – Full or nearly full function returning Baker Cysts What is the best description of a Baker Cyst? Synovial cysts in the popliteal fossa What complication is an adult with a Baker cyst likely to have? Joint problems like OA, RA, lupus, gout or knee injuries What is a serious complication that can occur as a result of a baker cyst? Possible for cyst to impede flow through the lesser saphenous vein causing DVT or thrombophlebitis Gout What is the best description of gout? Joint inflammation related to chemical imbalances. Who is the most likely to develop gout? Men 40-50 years old with “rich” diets high in purines What is the most frequent location to develop gout? Feet What is the best description of the pain associated with gout? Sudden onset – swelling: hot, red and shiny. May present with a fever. What serious condition can occur with serious untreated gout? Kidney stones leading to renal failure, HBD leading to atherosclerosis or stroke Why is gout related to renal function? Hyperuricemia can occur, leading to a gout attack Joint Disruptions What is the difference between a subluxation and a dislocation? Subluxation: Bones are out of optimal alignment Dislocation: Articulating bones don’t touch What is a joint disruption? Any situation where articulating bones are out of optimal relationship What’s the most likely contributing factor for joint dysplasia? Congenital abnormal acetabulum/femoral head connection What are the three types of joint disruptions? Subluxation, dislocation, dysplasia What are the most likely signs and symptoms of an acute joint dislocation? Swelling, pain, obvious structural changes. A person with a history of repeated dislocations of the shoulder is at an increased risk for... Spontaneous dislocation in future Joint Replacement Surgery What is another name for joint replacement surgery? Arthroplasty What condition is most likely to lead to the need for joint replacement surgery? Osteoarthritis Who is most likely to need joint replacement surgery? People 40+ years old with arthritis Which joints are most frequently replaced? Knees, hips and shoulders How is range of motion affected by joint replacement surgery? ROM is diminished after joint replacement Lyme Disease What is Lyme Disease? An infection caused by a spirochetal bacterium called Borrelia burgdorferi What are the early-stage signs and symptoms of Lyme disease? Bull’s-eye rash, high fever, night sweats, swollen lymph nodes, could look like a cold or flu What are the late-stage signs and symptoms of Lyme disease? Extreme inflammation in one or more larger joints What complication can occur from unsuccessful Lyme Disease treatment? Post-treatment Lyme disease syndrome – chronic muscle and joint pain. What precautions can be taken to protect against contracting Lyme disease? Long sleeves/pants when outdoors in high tick infested areas. Osteoarthritis What is the best description of osteoarthritis? Condition in which the synovial joints lose healthy cartilage What is likely to lead to osteoarthritis? Wear and tear, biomechanical factors, consequences of inflammation What are the major signs and symptoms of osteoarthritis? Deep pain, stiffness, possible crepitus and may be triggered by the weather Patellofemoral Syndrome What is patellofemoral pain syndrome? A group of conditions in which the patellar cartilage becomes irritated, affects the tracking of the patella, may also be a precursor to osteoarthritis of the knee What factors commonly contribute to patellofemoral pain syndrome? Overuse/overloading, poor alignment – exaggerated Q angle. What condition can occur at the knee if patellofemoral syndrome is not corrected? Osteoarthritis What condition is frequently confused with patellofemoral pain syndrome? Tendinosis Spondylolisthesis What is spondylolisthesis? A structural problem in the lumbar spine allows one or more vertebral bodies to slip anteriorly. What structure in the lumbar spine, if compromised and weak, can lead to spondylolisthesis? Pars interarticularis What are the major signs and symptoms of spondylolisthesis? Central low back pain, tight hamstrings, spasm of lumbar paraspinal muscles and pain radiating into buttocks and thighs When can spondylolisthesis become an emergency? When pressure s directly on the spinal cord causing cauda equina syndrome. Spondylosis What is spondylosis? A degenerative problem involving protrusion of an intervertebral disc If there is no nerve involvement, what are the symptoms of spondylosis? May be asymptomatic, When an osteophyte exerts pressure on a nerve root, what is the resulting pain called? Myelopathy Sprains What is a sprain? Tears to ligaments What is the most commonly sprained joint? Anterior talofibular What happens to connective tissue fibers in a sprain? Partially or fully tears What are the possible outcomes of a poorly healed sprain? Scar tissue can become dense and constrictive, increased risk of re-injury and reduced weight bearing capacity What are the major signs and symptoms of sprains? Pain, heat, redness, swelling, muscle splinting. What does PRICE stand for? Protection, Rest, Ice, Compression, Elevation Temporomandibular Joint Disorders What is TMJD? Temporomandibular Joint Disorder What are the most common contributing factors to TMJ disorder? Bruxism, loose ligaments in the jaw, malocclusion What are the most likely symptoms of TMJ Disorder? Jaw, neck, shoulder pain, limited ROM, popping or clicking, lockjaw, bruxism, ear pain, HA’s, subluxation at CV Compartment Syndrome What is the best description of compartment syndrome? An injury or repetitive stress raises pressure inside a fascial compartment What are the main contributors to acute compartment syndrome? Complication of fracture or crushing injury What are the main contributors to chronic compartment syndrome? Repetitive athletic activity causing tight fascial compartments What type of compartment syndrome is most likely to be a medical emergency? Acute Dupuytren Contracture What is the best description of Dupuytren Contracture? Palmar fasciitis What triggers Dupuytren Contracture? Work with vibration, smoking, alcohol, and diabetes Ganglion Cysts What is a ganglion cyst? CT pouches filled with fluid Where are ganglion cysts usually found? Wrist, hand, top of foot. What is the most common presentation of a ganglion cyst? Connective tissue pouch filled with fluid at the wrist Hammer Toe What is a hammer toe? A foot deformity of the lateral toes, usually the 2nd toe What is the main contributing factor of a hammer toe? Footwear What are the major signs and symptoms of hammer toe? Visible deformity, involuntary contraction of foot muscles, pain at friction sites, flexible tissue becomes hard over time Hernias What is a hernia? Hernia means hole – we are talking about a hole in the abdominal wall What is the main contributing factor to hernias in men? Inguinal canal is a weak spot for men What is the most common type of hernia in men? Direct inguinal hernia What type of hernia is related to overstretching of the opening for the esophagus in the diaphragm? Hiatal hernia What are the major signs and symptoms of an inguinal hernia? Sharp or mild pain, feeling of fullness, palpable bulge What are the major signs and symptoms of a hiatal hernia? GERD, shortness of breath What complication can occur to structures entrapped by a hernia? Structures will become trapped and strangulated Morton Neuroma What is a Morton neuroma? CT sheath of common digital nerves becomes thickened. What causes the symptoms of Morton Neuroma? Common digital nerve is compressed by a connective tissue sheath Plantar Fasciitis What is plantar fasciitis? Degeneration and irritation of collagen on the plantar fascia What happens to the connective tissue on the arch of the foot with plantar fasciitis? Breaks down, degenerates What are consistent contributors to plantar fasciitis? Bad footwear, overweight, change in activity levels, problems with gait/feet, tight calf muscles, complications of other conditions (gout, RA, diabetes) Pes Planus / Cavus What is pes planus? Flat feet What is pes cavus? Caved feet What are some common factors seen with pes planus? Weakness in tibialis posterior tendon, HT at peroneus muscles on the lateral side What are some common factors seen with pes cavus? Underlying diseases like muscular dystrophy and Charcot-Marie-Tooth Syndrome What are common repercussions of living with pes planus or pes cavus? Arthritis in feet, plantar fasciitis What are the common symptoms seen with pes planus / pes cavus? Gait and movement compensations. Lateral foot pain, callus and ankle instability with pes cavus Carpal Tunnel Syndrome What is the best description of carpal tunnel syndrome? A set of signs and symptoms connected to entrapment of the median nerve at the carpal tunnel What factors contribute to carpal tunnel syndrome? Repetitive movements with the hands What causes the symptoms of carpal tunnel syndrome in most patients? Pressure on nerve or blood flow to nerve What other injury can cause carpal tunnel syndrome symptoms? Neck injury, herniated disc. When the median nerve is compressed and swells along the entire length, causing pain, what is it called? Multiple crush syndrome What area of the hand is affected by median nerve compression? Palmar surface of the first three digits, and the palm What are the signs and symptoms of carpal tunnel syndrome? Tingling, pins and needles and weakness Disc Disease What is disc disease? What is another name for it? Problems with the nucleus pulposis and/or the annulus fibrosis of IV discs Introvertebral disc degeneration IDD In what direction do discs usually protrude? Posterolaterally What combination of activities is most likely to cause a disc injury? Lifting – twisting What is a herniated disc? Bulge, protrusion, extrusion, rupture What is degenerative disc disease? Small, cumulative tears of the annulus, along with decreased disc height and dehydration of the nucleus. What are the major signs and symptoms of disc disease? May be asymptomatic, paresthesia, pain may be intermittent Myofascial Pain Syndrome Myofascial pain syndrome includes the presence of _____. Trigger points What causes trigger points to develop? Multifactorial, normally they develop from micro-injuries leading to pain-spasm cycle and also can be from problems at the motor end plate synapse What are the signs and symptoms of active trigger points? Taut bands or nodules, predictable TrP map, referred pain patter and regional pain. How is myofascial pain syndrome different from fibromyalgia? Fibromyalgia have tender points in specific spots of the body and trigger points can be random Thoracic Outlet Syndrome What is thoracic outlet syndrome? Neurovascular entrapment of the brachial plexus and blood vessels running into the arm What factors most likely contribute to thoracic outlet syndrome? Repetitive movements with arms and shoulders, carrying heavy loads, spend time with arms above head, in women more than men What areas can cause impingement with Thoracic Outlet Syndrome? First rib, clavicle, scalenes, coracoid process Bunions What is a bunion? Distortion at the 1st phalanx of the great toe, joint capsul is stretched, a bursa grows and callus thickens What causes most of the acute pain associated with bunions? Footwear that squeezes the toes or forces weight onto the medial aspect of the foot. What is the likely cause of the majority of bunions? Footwear What signs and symptoms are associated with bunions? Large lump on medial side of great toe, may be palpably hot and swollen Bursitis What is bursitis? Inflammation of a bursa, the internal cells proliferate, generate excess fluid and causes pain and limitation What leads to the loss of range of motion seen with bursitis? Inflammation, obstruction, friction What are the signs and symptoms of bursitis? Pain on PROM and AROM, limited ROM. Shin Splints What are shin splints? A group of lower leg problems What are the major contributors to shin splints? Physical activity. Ie. Runners, gymnasts, dancers What are the types of shin splints? Medial tibial stress syndrome, tibialis anterior/posterior injury, periostitis, stress fractures What is the most common type of shin splints? Medial tibial stress syndrome What are the signs and symptoms of shin splints? Pain (mild to severe), worse with activity, not visibly inflamed but palpation is painful Tendinopathies What are tendinopathies? Injury, damage to tendon, tenosynovial sheaths Where are tendinopathies most likely to develop? Rotator cuff and biceps tendon What intrinsic factors contribute to the development of tendinopathies? Direct or shearing forces transferred through the tendon, over-use without recovery time, poor flexibility, underlying disease or a history of corticosteroid injection What extrinsic factors contribute to the development of tendinopathies? Training problems and injuries What types of tendinopathies are there? Tendinitis, tendinosis, tenosynovitis Whiplash What is whiplash? Mixture of accident related injuries What factors determine the seriousness of a whiplash injury due to a motor vehicle accident? Direction of impact, speed and wight of vehicle, seat belt use, position of head, and awareness of impeding collision Which muscles are most likely to be affected by whiplash? SCM, scalenes and splenius cervicis. What injuries are most likely to contribute to whiplash symptoms? Sports injuries, falls What are the typical symptoms of a whiplash injury? Ligament sprains, damaged facet joints, subluxated CV, damaged discs, muscle spasm, TrP’s, CNS damage, TMJD, HA’s