Terms Bifida, Osteoporosis, Respiratory Conditions
Terms
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Has:
Lack of folic acid ?? Occurs during first month of pregnancy
3-5% of all live births - Causes of Spina Bifida
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Occulta
Myelocele
Myelomeningeocele
Rachiscele - Spina Bifida Varieties
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Hair present at site; means
concealed, no neurological findings; can be closed within first 2 days - Occulta
- Spinal cord protrusion; spinal fluid leakage; causes pressure which can cause SC damage;
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Mylocele or
Meningocele -
portion of the spinal cord andmembranes protruding;hydrocephalus -
spinal fluid on brain - - Mylomeningeocele
- complete protrusion of cord and membranes; opening is present;hydrocephalus; fetus ususally doesn't make it past 24 weeks; imminent death
- Rachiscele
- At or above the lesion there is weakness; below there may be paralysis; hip dislocation
- Motor S&S - Spina Bifida
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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
- Osteoporosis
- Effects 25 million /yr; asymptomatic; effects bone density
- Osteoporosis
- Beginning stages of bone density loss
- Osteopenia
- 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
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Pt ed to understand disease, give info about bevavior modification, exercise program, home modifications for safety
Limited contras - Tx of Osteoporosis and Osteopenia
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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
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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
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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
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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
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ORIF inserting hardware
to fix fraction - Open Reducation Internal Fixation
- THA interchangeable with THR
- Total Hip Arthroplasty
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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
- CPM
- 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
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Exhbition of signs and symptoms
- flare up- disease is angry - Exacerbation
- Perpetuated by cont. unknown immune reaction in the synovial tissue
- RA
- 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
- Pannus
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NSAIDS, Steroids, disease modif drugs, heat vs. ice (ice for acute - heat with remission); splinting (quiets joints),
ROM as indicated; Rest - TX RA
- This is the typical one; AKA degenerative joint disease
- Osteoarthritis
- Cart degeneration, remodel of sub chondral bone causes overgrowth, joint infection can occur, NOT systemic;
- Osteoarthritis
- Develops without an external causative or predisposing factor; Is familial
- Primary type of OA
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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
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Joint pain, motion limitation,
Crepitus (creeking), enlarged joint - Clinical findings OA
- Chronic condition; constriciton of surrounding airway; swelling and irritaion; secretions become present
- Asthma
- Muscles surrounding bronchial tubes contract (bronchospasms), narrowing airways
- Asthma
- lining is red and swollen causes more narrowing; sticky mucuous block airways
- Asthma
- 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
- Emphysema
- Lose elasticity of lungs, exhaling difficult, effortful breathing - PINK PUFFER need to breathe faster
- Empysema
- 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
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Pt has all 3 or combo of 2
Asthma, Chronic Bronchitis, Emphesema - COPD