Ankle(2) Ankylosing (2) Bursitis Cancer – Flashcards
Unlock all answers in this set
Unlock answersquestion
What 3 ligaments are involved in Ankle Injuries?
answer
Anterior Talofibular Ligament Posterior Talofibular Ligament Calcaneofibular Ligament
question
Grades of ankle sprains and descriptions
answer
USSUALLY CAUSED BY INVERSION INJURY Grade I sprain - mild stretch of ligaments fibers able to bear weight Grade II - some tearing of ligaments, swelling, generally can bear weight Grade III - complete tear of one or more ligaments, significant swelling, bruising, may demonstrate instability.
question
When a patient presents with ankle injury, what are the most important things you should rule out?
answer
determine whether there is a major fracture or a dislocation or simple soft tissue injury.
question
Tests for ankle sprain
answer
Squeeze malleoli (tenderness) Anterior Draw Exam Talar Tilt Exam Foot and Achilles tendon exam
question
What are signs of an ankle fracture?
answer
Bony tenderness Squeeze tibia and fibula Unable to bear weight Palpate fifth metatarsal if they point to a bone
question
How to treat ankle injury?
answer
RICE (GOLD STANDARD) Compression wrap is most important, prevent swelling, bleeding and edema Proper compression is essential. Horshoe or donut over medial and lateral malleoli 24-36 hours NSAIDS Contrast bath (ice water for 1 min, hot water for 5)
question
is casting better than elastic wrap?
answer
There was no difference but elastic wrap is better because it dosent weaken muscles
question
When can patient return to normal functioning? how long does it take for ligament to fully heal?
answer
3-6 weeks 6 months
question
What does Ankylosing spondylitis mean?
answer
An inflammatory arthritis affecting the spine and large joints. Ankylosing-become stiffened or united by ankylosis Spondylitis--is an inflammation of the vertebrae
question
Does Ankylosing spondylitis affect the ligaments and tendons?
answer
Yes, causes inflammation of the ligaments and tendons where they connect the vertebrae. Body tries healing itself by creating new bone but This bony growth replaces the elastic soft tissue and can fuse the joints of the vertebrae.
question
In Ankylosing spondylitis, where in the spine does the stiffness and pain begin? and then where does it move?
answer
Stiffness and pain usually begins in the pelvis and near the base of the spine and progresses upward through the back to the neck. It can also affect the hips and shoulders, the other larger joints of the arms and legs, and the heels.
question
What is a syndesmophyte?
answer
A syndesmophyte is a bony growth originating inside a ligament, commonly seen in the ligaments of the spine, specifically the ligaments in the intervertebral joints leading to fusion of vertebrae.
question
What are Spondyloarthropathies?
answer
Group of chronic joint diseases reactive arthritis, psoriatic arthritis, Arthritis
question
Reactive arthritis
answer
Reactive Arthritis- an arthritic disorder that often affects several joints in the legs such as knees, the feet, ankles, and sacroiliac joint following a triggering intestinal or genital infection.
question
Psoriatic arthritis
answer
Psoriatic arthritis- a form of arthritis associated with scaly skin lesions (psoriasis), especially on the fingers and toes.
question
Arthritis (bowel)
answer
associated with inflammatory bowel disease ,Crohn's disease and ulcerative colitis.
question
Symptoms of Ankylosing Spondylitis?
answer
Gradual onset of back pain before the age of 35 The pain usually begins low and slowly progresses up the spine Early morning stiffness and pain that subsides with movement and heat Pain relieved by movement and not by rest Symptoms last more than three months Fatigue Weight loss, in the early stages
question
If Ankylosing Spondylitis gets so severe, what happens?
answer
cause complete fusion of the spine (ankylosis) This fusion can cause a forward curvature of the upper torso (kyphosis ) and can keep the ribs from expanding, which can make breathing difficult.
question
Where would you expect to find tenderness in ankylosing spondylitis?
answer
Sacroiliac joint
question
What are bursae
answer
Bursae, are sac-like structures lined with endothelial cells. They are generally present between tendon and bone or skin, and serve TO facilitate a gliding motion at points of high friction.
question
most common causes of bursitis?
answer
most common- chronic inflammatory bursitis traumatic, hemorrhagic bursitis, crystal deposition(gout) and infection (superficial bursa)
question
Inflammatory bursitis is caused by?
answer
Repetitive subactue injury to the bursa Results in local vasodilation and increased vascular permeability. (which adds fluids and proteins to bursa)
question
What is hemorrhagic bursitis caused by?
answer
direct blow to overlying tissues which results in hemorrhage This usually happens in superficial bursae
question
Examples of crystal deposition bursitis?
answer
Rheumatoid arthritis, gout, pseudogout
question
Infectious bursitis occurs in superficial or deep bursae? What are they caused by? What signs and symptoms will they have?
answer
Superficial Bursae Staphylococcus aureus or Staphylococcus epidermidis (BACTERIA) Tenderness, erythema, significant warmth
question
When infectious bursitis get severe what happens?
answer
Lympadenitis (inflamed lymph nodes) Cellulitis (red inflamed skin)
question
Ischiogluteal Bursitis (Weaver's Bottom).
answer
Bursa is Deep to Glut Max and is people that sit too long
question
Treatment for ischioglutealbursitis?
answer
PRICE foam pad/air filled doghnut
question
What is greater trochanter bursitis and what population does it happen in?
answer
Occurs in overweight, middle aged women. Caused by active trauma, overuse. pain in lateral hip, extends into buttocks, tenderness, PAIN WITH ABD, ER
question
treatment for trochanteric bursitis
answer
PRICE WEIGHT LOSS conditioning
question
How many bursae around the knee? How many are commonly involved in injuries?
answer
11 in total 5 involved in injuries the pes anserine bursa, prepatellar bursa, medial collateral ligament bursa and the bursae of the popliteal space (medial gastrocnemius bursa or semimembranosus bursa), commonly referred to as popliteal cysts.
question
Where is pes anserine bursa? What muscles attach there? What population does it happen in?
answer
Behind the medial hamstring Sartorius, Gracilis, Semitendinosus Overweight, middle aged women
question
What is prepatellar bursitis?
answer
housemaid's knee, or coal miner's knee swelling in anterior to knee cap
question
What is Cancer?
answer
disease where abnormal cells divide without control and invade other tissues. Also spreads to other parts through blood and lymph systems.
question
What are the three malignant properties of cancers? Do benign Cancers have these properties?
answer
Agressive-- Grow and divide without respect to normal limits Invasive- Invade and destroy adjacent tissues. Metastic- Spread to other locations in the body NO BENIGN CANCERS DONT HAVE IT!
question
what is carcinoma?
answer
cancer that begins in skin or in tissues that line or cover internal organs derived from epithelial cells. MOST COMMON TYPE OF CANCER Breast, Prostate, Lung, Colon
question
What is sarcoma?
answer
cancer that begins in bone, cartilage, fat, muscle, blood vessels Derived from Connective tissue or mesenchymal cells
question
What is leukemia?
answer
cacncer that starts in blood-forming tissue such as bone marrow and causes large numbers of abnormal blood cells to be produced and enters the blood. Dervied from hematopoetic (blood forming) cells
question
what is lymphoma/ myeloma?
answer
cancers that begin in the cells of the immune system. Dervied from hematopoetic (blood forming) cells
question
What is germ cell tumor?
answer
Tumors derived from totipotent (immature or stem cell) cells. Ex- testicle, ovary cancer
question
What is relative risk?
answer
Is a measure of the strength of the relationship between risk factors and a particular cancer. For example, male smokers are about 23 times more likely to develop lung cancer than nonsmokers, so their relative risk is 23.
question
What is a tumor? what is a neoplasm?(another word is neoplasm)
answer
Tumor-- can be any swelling or mass Neoplasm-- abnormal proliferation of genetically altered cells. Pretty much the same thing..the words are used interchangeably.
question
What is Generation Time? How does generation time get affected when it comes to Cancer.
answer
time required for a cell to complete a cycle in cell division and make 2 daughter cells. Cancer cells have a shorter generation time than noncancer cells.
question
How do tumors get nutrients? How is local growth done?
answer
Directly from circulation. Local growth is facilitated by enzymes that destroy adjacent tissues.
question
What two genes does cancer affect?
answer
Oncogenes-- Cancer promoting and are activated in cancer cells, giving those cells new properties such as hyperactive growth and division and protection against cell death. Tumor suppressor genes-- are inactivated in cancer cells..this results in loss of normal function of these cells.
question
What is a benign tumor?
answer
Tumor that has self limiting growth and does not invade other tissues nor metastasize (spread to other areas in body) NOT CANCEROUS
question
Pre-malignancy/Pre-cancer
answer
noninvasive neoplasm that may not form an obvious mass but has potential to be progress to cancer if untreated. EX- Atypia, Dysplasia(abnormal cells in a tissue) , Carcinoma in situ (is a group of abnormal cells. )
question
Local SIGNS AND SYMPTOMS OF CANCER Can be divided into 3 groups
answer
1. lumps/swelling 2. Hemorrhage 3. Pain/ ulceration enlarged lymph nodes cough and hemoptysis (coughing up blood) Bone pain Fracture of bones
question
Systemic signs and symptoms of cancer
answer
Weight loss poor appetite Cachexia (weakness and wasting of body) Sweating Anemia (deficiency in RBC)
question
Signs of breast cancer?
answer
Breast Mass Dominant mass- lump that is different from the surrounding breast tissue upper outer quadrant are more characteristic of cancer thickening in one breast but not the other
question
How to diagnose breast cancer?
answer
Pre biopsy bilateral mammogram
question
What is the stage of cancer based on?
answer
size of tumor and if tumor has spread or not.
question
What is the best prognostic factor
answer
Nodal status correlates with disease-free and overall survival better than other prognostic factors. YOU HAVE A BETTER CHANCE OF LIVING IF YOU ARE NODE NEGATIVE
question
What is Breast-sparing surgery
answer
operation to remove the cancer but not the breast also called lumpectomy, segmental mastectomy and partial mastectomy.
question
What is Mastectomy
answer
operation to remove the breast (ussualy the whole thing)
question
What is External/Internal Radiation
answer
External-- Radiation from a large machine outside of body Internal-- implants that hold a radioactive substance are put directly in the breast.
question
What type of hormone therapy can you do to treat Breast Cancer?
answer
Cancer needs hormones to grow and spread. It needs estrogen and progesterone. So a doctor will prescribe TAMOXIFEN--which blocks Estrogen. or remove OVARIES (since thats what makes estrogen)
question
What does chemotherapy do to cancer? Is it more effective at killing cells that rapidly or slowly divide?
answer
Goal of chemotherapy- is to stop cell division Works by damaging the RNA/DNA that tells cells how to divide. If the cells cant divide they die The faster that cancer cells divide, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. MOST RAPIDLY DIVIDING CELLS-- The mouth, intestines, skin, hair, bone marrow are commonly affected by chemotherapy.
question
What is the problem with chemotherapy?
answer
Does not know the difference between cancer cells and normal cells. so it kills cells in mouth, stomach, bowel, hair follicles.
question
What are cell-cycle specific drugs What are cell-cycle non-specific drugs?
answer
Specific- Drugs that kill cancer cells only when they are dividing Non specific- kills cells when they are at rest
question
What is cachexia? Is it fatal?
answer
Cachexia-Physical wasting with loss of weight and muscle mass caused by disease The formal definition of cachexia is the loss of body mass that cannot be reversed nutritionally: even if the affected patient eats more calories, lean body mass will be lost, indicating there is a fundamental pathology in place Cachexia can occur in people who are eating enough, but who cannot absorb the nutrients. Yes this increases chance of death
question
What are Paraneoplastic syndromes? EXAMPLES OF SYMPTOMS
answer
are symptoms that occur at sites distant from a tumor or its metastasis. EXAMPLES: fever night sweats anorexia cachexia. itching pigmented skin lesions Hypertrichosis ( is an abnormal amount of hair growth over the body) Herpes Zoster (shingles, rash)
question
What is a DVT? Where is a DVT usually found? What happens if it dislodges?
answer
Blood clot form in a vein Lower legs and thighs If it dislodges it can travel to the lung and form a pulmonary embolism and this is deadly.
question
What is an embolus?
answer
Clot that travels
question
What situations does DVT ussually happen in?
answer
Hospitalized patients Bed ridden patients Legs immobilized (plane ride)
question
What is Virchow's Triad?
answer
DVT is result of these 3: 1. Reduced or stagnant blood flow in deep veins (venous stasis-slow blood flow in vein) 2. Injury to blood vessel wall 3. increase in the activity of the blood clotting substances. (hypercoagulability)
question
What conditions can increase risk of DVT?
answer
Heart failure--BLOOD FLOW IS SLOW Pregnancy- fetus is pressing on large veins, which makes veins stagnant. Certaint cancers
question
S&S of DVT
answer
Pain, Tenderness, Swelling, Warmth, Redness in Leg DF aggrevates it
question
What tests are used to determine if there is a DVT?
answer
Ultrasound- MOST COMMON technique which uses harmless high frequency sound waves to measure blood flow in deep veins. Venography-- gold standard-- Xray to measure blood flow in deep veins. DYE INJECTED IN VEIN BLood test coagulability-- Asses the activity of blood clotting factors. TIME TAKEN FOR BLOOD TO CLOT
question
What is a pulmonary embolism?
answer
serious complication of DVT BLOCKS OFF PULM ARtery..Which brings blood from heart to lungs
question
S&S of Pulm Embolism
answer
Shortness of breath Chest pain with breathing Bloody Sputum
question
Treatment of DVT
answer
Prevent worsening of clot prevent clot from going to lung Blood thinners (heparin, warafin) Bed rest w leg elevated Compression stockings
question
What are the two blood thinner medications? How are they taken?
answer
Heparin-- anticoagulant drug of choice.. injected by IV.. KICKS IN RIGHT AWAY Warfarin-- Taken by mouth. LASTS MUCH LONGER
question
How to prevent DVT?
answer
LOVENOX-- INJECTS HEPARIN UNDER SKIN IN LOW DOSE IPC ASPRIN/Warafin--blood thinner
question
What is Fibromyalgia?
answer
Chronic Systemic pain disorder that is neither degenerative or progressive
question
What is criteria for Fibromyalgia?
answer
Widespread pain and tenderness pain in all 4 quadrants tenderness 11/18 points right and left sides of body Above and below waist longer than 3 months
question
How are the tender points broken up? What are the areas?
answer
11/18 for diagnosis 4 pairs anterior 5 pairs posterior Suboccipital Lower anterior cervical c5-c7 trapezius supraspinatus 2nd rib Lateral epicondyle Gluteus max greater trochanter knee
question
What chemical is low in fibromyalgia patients? What chemical is high in fibromyalgia patients?
answer
LOW SEROTONIN LEVELS low atp High Substance P levels it is a pain mediator so increased levels means increased sensitivity to pain
question
S&S of Fibromyalgia
answer
Pain Fatigue Sleep issues swelling, numbness, tingling Confusion, forgetfullness DEPRESSION/ANXIETY They are likely to also have TMJ and sleep disorders
question
Treatment of Fibromyalgia
answer
PT (get them moving) Aerobic LOW dosage med ANTIDEPRESSANTS (trazodone, Tricyclics) AMbien (treat insomnia) Muscle relaxant Melatonin--to help to go to sleep
question
What is the most common type of heart disease?
answer
Coronary Heart disease Coronary Artery disease Coronary arteries-- supply the heart with oxygen and nutrients These arteries become narrow Buildup of cholesterol in the blood vessel.
question
what is plaque?
answer
Deposits of cholesterol and other fat like substances build in blood vessels and form a bump in the vessel wall.
question
What is atherosclerosis?
answer
hardening of the arteries due to plaque build up and vessel hardening. This reduces or blocks blood flow to heart
question
Risk factors for Heart disease
answer
High cholesterol levels High BP Smoking Overhweight Inactivity Stress
question
What is cholesterol?
answer
waxy substance made by liver forms parts of every cell It maintains cell membrane Makes hormones Makes vitamin D GET IT FROM ANIMAL PRODUCTS
question
IMPORTANT: What does each contain: High-density lipoproteins Low density lipoproteins Very low density lipoproteins
answer
HDL-- mostly protein LDL-- Mostly cholesterol VLDLs- mostly cholesterol and triglycerides HDL-- GOOD LDL-BAD
question
How do HDL Cholesterol help the body?
answer
Helps to remove cholesterol from walls of arteries and transports it to liver for elimination. GETS RID OF LDL and VLDLs
question
What are angioplasty and vascular stenting?
answer
Angioplasty (imaging used to guide) a baloon tipped catheder into a vessel and then balloon is inflated to open vessel. stenosis/narrowing happened temporarily after Therefore, A metal stent was used to keep the vessel open.
question
Coronary Artery Bypass surgery?
answer
uses blood vessels from another part of body to go and bypass blocked or narrowed coronary. THIS IS DONE WITH HEART STOPPED
question
How does a heart attack or MI (myocardial infarction) happen?
answer
Blood clot blocks flow of blood through a coronary artery. This damages/ destroys a part of the heart muscle.
question
S&S of Heart Attack/MI
answer
USSUALLY LEFT SIDE pressure in the center of your chest pain to shoulder arm chest back Shortness of breath sweating fainting nausea and vomiting. MOST COMMON SIGN-- mid chest and left arm and shoulder pain
question
What is angina pectoris
answer
NOT A TRUE HEART ATTACK chest pain due to ischemia (inadequate blood supply to heart) due to obstruction or spasm of coronary arteries. weak relationship between severity of pain and degree of oxygen deprivation
question
What is unstable angina
answer
Severe angina sudden onset angina at rest angina lasting more than 15 minutes
question
Tests to diagnose heart attack?
answer
Electrocardiogram (ECG/EKG)- This test records the electrical activity of the heart via electrodes attached to the skin. Blood Tests--Heart enzymes leak out of injured heart Nuclear scan-- radioactive material injected in blood stream.. areas of reduced blod flow will appear as dark spots on the scan Echocardiogram-- identify if area of heart is damaged by a heart attack
question
***What is an arrhythmia?
answer
Abnormal heart rhythms due to damaged heart ANY CHANGE IN NORMAL SEQUENCE OF IMPULSES ***THIS CAUSES CLOTS
question
What is the most common type of arrhythmia?
answer
Atrial fibrillation (AFIB) irregular heartbeat that leads to clots, stroke, heart failure.. Upper chambers of the heart (atria) beat irregularly instead of effectively to move blood to ventricles MOST COMMON ARRHYTHMIA
question
What is the worst type of arrhythmia?
answer
Ventricular Fibrillation-- disorganized electrical signals makes ventricles quiver. THIS MUST BE TREATED ASAP with DEFRIRILLATION
question
How to fix AFIB?
answer
CARDIOVERSION-- 2 types electrical cardioversion-- reset heart rhythm by shocking. Cardioversion with drugs-- medications called anti-arrhythmics to restore normal rhythm IF THIS DOSENT WORK.. surgery is done to destroy that area causing the rhythm.
question
What happens when a blood clot gets pumped to the brain?
answer
This causes a stroke (embolic stroke) (cardioembolic stroke)
question
What is heart failure?
answer
damaged heart tissue is so extensive that the heart cant pump blood out of heart.. this decreases blood flow to all the organs in the body and you have shortness of breath, fatigue and welling in ankles and feet.
question
What is a heart rupture?
answer
after a heart attack, certain areas of the heart are so weak that they rupture, leaving a hole in the heart. THIS IS FATAL
question
**What medicine can you take for heart Issues?
answer
Aprin and blood thinners VERY IMPORTANT **Thrombolytics-- clot busters.disolve blood clots Nitroglycerin-- treat chest pain..opens blood vessels beta blockers-- relax heart..slow heartbeat and decrease BP
question
**What medicine is a clot buster?
answer
Thrombolytic- Tissue plasminogen activator (tPA) you have a better chance of surving a heart attack if you recieve this drug within 12 hours after heart attack. Ideally after 90 minutes!
question
What happens in R sided heart failure? What happens in L sided heart failure?
answer
R sided-- heart cant pump enough O2 to lungs fluid to build up in feet, ankles, legs L sided- heart cant pump enough O2 to rest of body. Shortness of breath and fatigue Eventually its both sided.
question
What is the difference between normal heart failure and congestive heart failure?
answer
Congest Heart failure includes EDEMA which is buildup of fluid.
question
Dyspnea is a sign of what?
answer
Dyspnea is SOBOE and an early symptom of pulmonary congestion
question
What is orthopnea? What is Ascites?
answer
Cannot breathe unless sitting up, (the more pillows the worse the CHF is) Ascites is fluid in the peritoneal cavity
question
is pulmonary edema due to Congestive heart failure of left ventricle or right ventricle?
answer
Left ventricle-- ventricle cant pump blood out of body fast enough so there is a buildup of blood in the lungs...This causes pulmonary edema.
question
Is enlarged veins and abdomen a sign of left or right sided heart failure
answer
Right sided-- right ventricle cant pump blood to lungs as fast as it returns from the body through the veins.. SO RIGHT SIDE OF HEART AND VEINS are enlarged.. EDEMA IN FEET AND LEGS
question
How do the kidneys compensate for a failing heart?
answer
They retain more salt and water to increase the volume of blood. THIS CAUSES EDEMA
question
How to cure heart failure?
answer
HEART TRANSPLANT But its manageable with medicines, diet, excercise
question
When palpating in abdomen what will PT feel on patient?
answer
Liver is enlarged skin of fingers and toes have bluish tint Fluid in lungs Heart is enlarged
question
**What are diuretics and what do they do?
answer
Makes patients urinate more often by eliminating excesss salt and water from kidneys.. This reduces swelling and fluid build up. TREATS HYPERTENSION TREATS CHF
