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Terms Bifida, Osteoporosis, Respiratory Conditions


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Lack of folic acid ?? Occurs during first month of pregnancy
3-5% of all live births
Causes of Spina Bifida
Spina Bifida Varieties
Hair present at site; means
concealed, no neurological findings; can be closed within first 2 days
Spinal cord protrusion; spinal fluid leakage; causes pressure which can cause SC damage;
Mylocele or
portion of the spinal cord andmembranes protruding;hydrocephalus -
spinal fluid on brain -
complete protrusion of cord and membranes; opening is present;hydrocephalus; fetus ususally doesn't make it past 24 weeks; imminent death
At or above the lesion there is weakness; below there may be paralysis; hip dislocation
Motor S&S - Spina Bifida
Kyphosis - hunching over; poor kinesthesia and proprioception;
poor posture control - lack of mobility biggest issue
Motor S&S - Spina Bifida
low visual and auditory discrimination; dim. body scheme; dim. or absent steriognosis
Sensory/Visual/Perceptual S&S- Spina Bifida
Decreased attention and memory; Learning disabilities; Impaired executive functioning - ability to judge, problem solving
Cognitive S&S - Spina Bifida
Bowel and bladder issues; diff washing and dressing; diff in independent living
Self Care - Spina Bifida
Dim play skills; lim. social skills; Lesure skills; all based on mobility - being biggest issue
Psychosocial and productivity - Spina Bifida
Early Intervention; School based therapy; community integration; vocational; if intellect is intact - same a paraplegia
Tx of Spina Bifida
Means porous bone; most common cond in aging pop; bone weakness leads to fracture; hip fracture most common
Effects 25 million /yr; asymptomatic; effects bone density
Beginning stages of bone density loss
Caffeine, nicotine, alcohol, lack of physical activity
Behavioral factors - Osteoporosis
Review; family history, meds, fall risk
Clinical Eval of Osteoporosis
Exercise, post menopausal meds, calcium intake, behavioral factors - change behaviors
Prevention strategies to maximize bone density - Osteoporosis
Pt ed to understand disease, give info about bevavior modification, exercise program, home modifications for safety
Limited contras
Tx of Osteoporosis and Osteopenia
Bed rest if vetebral Fracture;
balance activities and assmt, always tell of risk of fracture
Intervention for Osteoporosis
Haematoma with inflammation and granulation tissue
1st stage after Fracture
Callus visible at 2-3 weeks upper limb and lower limb;
beginning of bone formation
2nd stage after Fracture
Callus and cartilaginous occurs at 6-8 weeks upper limb, 12-16 weeks lower limb, cart. turn into bone can do weight bearing
3rd Stage after Fracture
Indicated when function is impeded and Pt is invested;
more than 120,00/yr
Joint Replacement
severe arthritis; fracture; avascular necrosis, bone tumors, trauma
Predisposing conditions - Joint Replacement
Severe obesity, systemic infection, med conditions give complications after surgery ie
heart condition
Contras - Joint Replacement
THR remove joint and put new one in
Total Hip Replacement
ORIF inserting hardware
to fix fraction
Open Reducation Internal Fixation
THA interchangeable with THR
Total Hip Arthroplasty
No IR(internal rotation)
ADD (adduction crossing legs)
Flex (flexion)
during first 6-8 wks
Precautions after THR
Does not carry post surgery precautions - just weight bearing
Precautions after ORIF
Continuous passive motion
Need to keep joint moving; non WB; partial WB; TDWB (toe down weight bearing); WBAT - (weight bearing as tolerated) Full WB
Weight bearing precautions - Joint Replacement
Edema Massage very important
After surgery precautions - Joint Replacement
Chronic inflammatory disease of the synovium; exacerbations and remissions; sometimes presents like the flu
Rheumatoid Arthritis
Exhbition of signs and symptoms
- flare up- disease is angry
Perpetuated by cont. unknown immune reaction in the synovial tissue
Inflammation; hypertrophy of synovium (increased mass)weakening of the capsule and ligaments; eventual dest. of cart and bone
Etiology of RA
increased pain, deformity; irreversible damage
Pathology RA
Effects women/men 0 5:1
RA statistic
Blood test; X-ray to detect decrease joint space; subcutaneous nodules
Diagnostic criteria RA
Synovial fluid becomes thick like sand in oil; granulation tissue effects joint capsule and lig; pannus forms and eats the cart and bone; nodule is formed
Pathology RA
The actual process breaks down joint capsule
NSAIDS, Steroids, disease modif drugs, heat vs. ice (ice for acute - heat with remission); splinting (quiets joints),
ROM as indicated; Rest
This is the typical one; AKA degenerative joint disease
Cart degeneration, remodel of sub chondral bone causes overgrowth, joint infection can occur, NOT systemic;
Develops without an external causative or predisposing factor; Is familial
Primary type of OA
Due to a Predisposing factor ie
trauma, obesity, sports injury
Secondary type of OA
1. effects entire joint 2. as the joint deteriorates joint instability occurs 3. Bone spur formation may develop in joint margins
Progression of OA
Joint pain, motion limitation,
Crepitus (creeking), enlarged joint
Clinical findings OA
Chronic condition; constriciton of surrounding airway; swelling and irritaion; secretions become present
Muscles surrounding bronchial tubes contract (bronchospasms), narrowing airways
lining is red and swollen causes more narrowing; sticky mucuous block airways
Smoking, dust mites, pets, mold, allergies, activity, weather, pollen
Etiology Asthma
Productive cough for 3 months in a row for 2 yrs in a row
Chronic Bronchitis
Barrel chested, blue skin color (BLUE BLOATER), cough present, sputum present, limited exhalation can't get dioxide out
S&S Chronic Bronchitis
Have to be exposed to some kind of toxin - alveoli destroyed
Lose elasticity of lungs, exhaling difficult, effortful breathing - PINK PUFFER need to breathe faster
Shortness of breath; feels like can't get enough air; breathless ness followed by coughing during exertion even slight.
S&S Emphysema
Coughing, wheezing and chronic mucus production; may not happen until middle age; worsen with time
S&S Emphysema
Pt has all 3 or combo of 2
Asthma, Chronic Bronchitis, Emphesema

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