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Synarthrosis
- Imovable
- May fuse over time
- ex. bones of skull
-
Amphiarthrosis
- Slightly moveable
- ex tibia fibula
-
Diarthrosis (synovial)
- Freely movable
- 3 planes of movement
-
Monaxial movement
movement in one plane (forward backward)
-
Biaxial
- Movement in two planes
- Forward backward/left right
-
Triaxial
Forward, backward, left right rotation
-
Movement of a joint in a circular motion without involvement of a rotational movement
Circumduction
-
lateral/outward rotation
external rotation
-
Medial or inward rotation
inward rotation
-
turn wrist and hand from palm facing front to palm facing back
Pronation
-
Turns wrist and hand from palm facing back to facing front
Supination
-
Extention of ankle joing and elevation of the heal
Plantar flexion
-
Moving a body part anteriorly in the horizontal plane
Protaction
-
Moving a body part posteriorly in the horizontal plane
Retration
-
Movement of a structure in a superior direction
Elevation
-
Movement of a struction in an infeior direction
Depression
-
Sideward/bending movement of the vertebral colum
Lateral flexion
-
dull, deep throbbing pain
Bone pain
-
pain decreases with motino of affected part
Rheumatoid arthritis
-
Increases risk for osteopororis or osteomyelitis
- DM
- Sickel cell anemia
- Systemic lupus
- Erythematosus
- Osteoporosis
-
Familial tendency to develop these conditions
-
meds effecting muscle integ
-
Med alters electrolyte imbalance elading to muscle weakness
diruretics
-
Phalen's test tests what?
Carpel tunnel
-
Decreased ROM and crepitation seen in
osteoarthritis
-
Decreased strength and resistance seen in
muscle and joint disease
-
Hyperextenstion of metatarsophalangeal joing, flextion of proximal interphalangeal joint
hammer toe
-
Acute tender, painful swollen stiff joints
Acute rhematoid arthritis
-
Swelling and thickening of metacaropphalangeal and proximal interphalangeal joints
Chronic RA
-
-
Linger deviation toward ulnar side
Chronic RA
-
Boutonniere and swan neck deformities
Chronic RA
-
nontender, round, enlarged, swollen, fluid filled cyst
Ganglion
-
Herberden's nodes
Seen in osteoarthritis,, hard painless nodules over distal interphalangeal joints
-
Bouchard's nodes
- seen in osteoarthritis
- Hard painless nodules over proximanl interphalangeal joints
-
-
Corn
painful over bony prominence and pressure points
-
-
Hallus valgus
- laterial deviation of the great toe
- Enlarged, painful inflamed bursa
-
external abdonimnal oblique
outermost layer
-
internal abdominal oblique
middle layer
-
transverse abdominis
innermost layer
-
Hollow organs
- stomach
- gallbladder
- small intestine
- colon
- bladder
-
where is the liver found
below diaphragm in the RUQ of the abdomen
-
-
Spleen
above left kidney, below diphragm, at level of 9, 10, 11th rib
-
Kidneys
- HHigh and deep under diaphragm, posterior organs
- T12 -L3 vertabra
- tenderness assessed at costovertebral angle using blunt palpation
-
Uterus
- palpated at 12 weeks gestation
- Non pregnant and ovaries palpated during bimanual examination
-
Stomach
- LUQ
- Between liver and spleen
-
Large intestine (colon)
- Originates in RLQ
- Attaches to small intestine at ileocecal valve
-
Sigmoid colun
part of descending colon that takes a right turn and meets with the rectum
-
Liens the abdonminal cavity
Parietal peritoneum
-
Provides a protective covering for most of the internal abdominal organs
Visceral peritoneum
-
Parietal pain
- Localized to source
- Seen in appendicitis or peritonitis
-
Severe steady pain
Parietal
-
Pain travels from primary site
Referred pain
-
Highly localized at a distant site
Referred pain
-
Precipitates and exacerbates pancreatitits
Alcohol
-
What position exacerbates GERD?
Supine
-
Epigastric pain accompanied by black, tarry stools can idicate
ulcerative process high in GI system
-
Bloody mucoid stools a/w
inflammatory bowel diseases
-
Clay colored, fatty stools seen with
malabsorption syndromes
-
UTIs most common with
Older clients
-
Leads to permanent kidney damage
chronic kidney disease
-
can mask sxs of seiors GI disorders
antacids or histamine blockers
-
Grey turner sign
purpleing at the flanks, indicates bleeding in the abdominal wall, 2nd to trauma, kidney, prancreas, duodenum or pancreattitis
-
Scattered, fine veins
normal
-
spider angioma seen with
liver idsease or portal hyperension
-
dark purple straitions
Cushing's syndrome
-
Cullen's sign
- bluish or purple discoloration around umbilicus
- Indicates intra abdominal bleeding
-
Inverted or protruding not greater than >
.5cm
-
Enlarged everted umbilicus may indicate
umbilical hernai
-
9 f's of abdominal contour
- Fat
- Feces
- Fetus
- Fibroids
- Flatulence
- Fluid
- Full bladder
- False pregnacy
- Fetal tumor
-
Abdominal asymmetry seen with
- Organ enlargement
- Large masses
- Hernia
- Diastesis recti
- Bowel obstgruction
-
Abdomen does not bulge when head raised
Normal
-
how long to listen each quadrant to confirm absense of bowel sounds
minimum of 1 minute, 5 minutes max
-
normal bowel sounds
q 5 to 15 seconds
-
Mor ethan 30 clicks per minute
hyperacgtive bowel sounds
-
what side of stehoscope to listen for bruits over abdominal aorta
bell
-
Tenderness or sharp pain over CVA
- Pylonephritis
- Rnal calculi
- hydroeprosis
-
right side guarding
associated with cholecystis & apenditis
-
Assess pulsation of abdominal aorta what age
50 and/or hypertension, assess width of the aorta
-
Normal size of aorta
2.4-3 cm wide
-
do not palpate over
- polycystic kidneys
- wilms tumor
- transplated organ
- Suspected splenic trauma
-
bladder not palpable
Normal
-
Test for blumber's sign and rovsings sign for
appendicitis
-
Psoas sign
right leg up, client shoudl try to keep it up while pusehd down. RLQ pain is a/w irritation of the iliopsosas muscle due to appendicitis
-
Obturators sign
Hip flex, rotate leg internally and externally...normal no pain, abnormal RLQ indicates appendix
-
RUQ tenderness
Cholecystitis
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