1. rheumatic disease
    any disease or condition involving the musculoskeletal system

    autoimmune disorders-antibodies attack healthy normal cells and tissues
  2. arthritis
    inflammation of one or more joints
  3. osteoarthritis and rheumatoid arthritis
    oa-noninflammatory, localized, not systemic, not an autoimmune disease

    ra-systemic, inflammation
  4. osteoarthritis
    progressive deterioration and loss of cartilage in one or more joints (articular cartilage)-60-80% water

    osteophytes-bone spurs occur

    the bodys repair process can not overcome the rapid process of degeneration

    crepitus-when pieces of bone float in diseased joint and make a grating sound caused by loosened joint and cartilage
  5. primary OA
    aging, genetics, obesity, smoking,
  6. secondary OA
    can happen from other musculoskeletal conditions such as rheumatoid arthritis, manual occupations, trauma to joints
  7. OA VS. RA
    OA- chronic joint pain and stiffness, pain diminishes with rest, worsens after activity, inflammation with OA indicates secondary synovitis

    • heberdens nodes (distal interphalangeal joints)
    • bouchards nodes (proximal)

    • infrapatellar notch (area directly below the knee)
    • suprapatellar area (directly above knee)

  8. labs for OA
    erythrocyte sedimentation rate and high sensitivity c reactive protein may be elevated in secondary synovitis
  9. if acetaminophen and topical agents do not help OA what do you give?
  10. capsaicin
    hot peppers-WEAR GLOVES
  11. glucosamine
    decrease inflammation
  12. chrondroitin
    strengthens cartilage
  13. total joint arthroplasty/total joint replacement
    surgical creation of a joint
  14. osteonecrosis
    bony necrosis secondary to lack of blood flow usually from trauma or chronic steriod therapy
  15. primary arthroplasty
    first time a pt receives a total joint arthroplasty
  16. revision arthroplasty
    fix implant
  17. when are clotting meds discontinued before surg?
    1 week
  18. neuroaxial
    epidural or spinal

    reduces blood loss and incidence of dvt
  19. subluxation
    partial dislocation
  20. major problem with post op THA
    partial or total hip dislocation
  21. most important life threatening complication of THA is?
    VTE and pulmonary embolism

    anti coags
  22. thrombocytopenia
    decreased platelets
  23. drainage=?
    less than 50 ml/8 hr
  24. when do you get out of bed from a joint surgery?
    the night of
  25. what degree should the hips not be flexed past
  26. length of stay
    traditional surg=3 days

    MI=2nd post op day or day of surg.
  27. adlea
    refined capsaisin products placed directly into the surgical joint
  28. peripheral nerve blockade
    anestesiologist injects femoral or sciatic nerve with local anestetic by portable pump
  29. articulations
    joint surfaces
  30. hemiarthroplasty
    replacement of part of the joint
  31. Rheumatoid arthritis
    common connective tissue disease that can be the most destructive to the joints, chronic, progressive, systemic inflammatory autoimmune disease, affects primarily the synovial joints
  32. systemic
    means that it affects the body system affecting many joints and other tissues
  33. pannus
    vascular granulation tissue composed of inflammatory cells, it erodes the articular cartilage and eventually destroys bone
  34. vascultitis
    blood vessel involvement
  35. PG. 1116-1118
  36. bone biopsy
    extract a specimen of bone tissue for microscopic examination
  37. techniques for bone biopsy
    1) needle (closed)

    2) incisional (open)
  38. muscle biopsy
    done for diagnostic and inflammation
  39. EMG

    used to evaluate diffuse or localized muscle weakness
  40. arthroscopy
    fiberoptic tube inserted into a joint for direct visualization of the ligaments, menisci, and articular surfaces of the joint
    flex the knee at least 40 degrees
  42. page 1155-1156
  43. open reduction with internal fixation
    reducing and immobilizing a fracture

    open reduction-allows the surgeon to see the fracture site

    internal fixation-metal pins, screws, rods, plates or prostheses to immobilize the fracture during healing
  44. external fixation with closed reduction
    for patients with soft tissue injury (open fracture)
  45. external fixation
    system in which pins or wires are inserted through the skin and affected bone and then connected to a rigid external frame
  46. electrical bone stimulation
    delivers small continuous electrical charge directed toward the non healed bone
  47. low intensity pulsed ultrasound
    used for slow healing fractures or for new fractures
  48. iontophoresis
    method for absorbing dexamethasone through the skin near the painful area to decrease inflammation and edema
  49. compartment syndrome
    can begin 6-8 hours after injury, can take up to 2 days to appear
  50. pg. 1159-1163
  51. intracapsular
    within the joint capsule
  52. extracapsular
    outside the joint capsule
  53. kyphoplasty
    inserting a balloon into the vertebra space to restore height to vertebra
  54. pg 1172
  55. synovectomy
    removal of excess synovium
  56. rice
    rest, ice, compression, elevation
  57. tendon transplant
    tendon reconstruction
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