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OCCT 1006 Test 3
Terms in this set (47)
Umbrella term for over 100 diseases that all have JOINT INVOLVEMENT in common. Besides that, they each have their own diagnostic criteria, signs/symptoms, course, and prognosis.
2 most common Rheumatic Disorders seen by OTs
1. Rheumatoid Arthritis
2. Degenerative Joint Disease
Some other Rheumatic Disorders...
-Systemic Lupus Erythematosus
-Degenerative Joint Disease (Osteoarthritis)
-A chronic inflammatory disease of the joints and other body systems. In other words it's ARTICULAR and SYSTEMIC.
-There is an immune response to something going on in different body tissues. In the joint, the immune reaction targets the SYNOVIUM.
What happens as a result of the immune reaction targeting the synovium?
-Thickening of synovium
-Overproduction of synovial fluid (becomes too watery, and does not serve its purpose as a joint lubricant)
2 ways damage can occur in joint
1. Overstretching of soft tissue supporting structures.
2. Presence of an enzyme that destroys articular cartilage.
What happens as a result of the overstretching of soft tissue supporting structures?
-Weakening of the joint capsule
-Misalignment of the bones
-Incorrect pull of tendons crossing the joint
-Ultimately deformities, cartilage damage, and decreased joint space.
Sex and Age involved in RA
-3 in 4 cases are in women
-Greatest onset between 25-45
-In children called Juvenile R.A.
What characterizes R.A.?
Exacerbation and Remession
How does R.A. first present itself?
-First with general fatigue
-Followed by morning stiffness and aching
-Then the gradual, symmetrical appearance of polyarthritis in the small joints of the hands and feet.
How do doctors confirm Dx of RA?
1. Blood Tests
3. Rheumatoid Nodules
What kinds of blood test will a doctor perform for R.A. Dx?
1. Complete Blood Test
2. Erythrocyte Sedimentation Rate (for inflammation)
3. Antibody Tests
What will a complete blood test show in a +Dx of R.A.?
Low RBC count = anemia
High WBC count = infection
What will an Antibody test look for?
Rheumatoid Factor. This is an antibody against a component in the blood's Gamma Globulin.
In plasma. Holds antibodies.
fibrous knots on pressure points
Symptoms of R.A. can be...
Articular involvement in R.A.
-Usually bilateral and symmetrical.
-Begins distally (hands, wrists, feet, ankles)
-Progresses proximally (knee, hip, elbow, shoulder, spine)
What contributes to decreased range of motion in RA?
Lack of movement ->weakness->more lack of movement + enlarged joints + pain = decreased range of motion
Early hand involvement in RA
Typically starts in PIP joints, giving "fusiform" shape to fingers.
3 types of swelling
In all or most of an extremity throughout tissues spaces.
Inflammation w/ localized joint swelling.
Inflammation w/ localized swelling of synovial filled sacks over tendons.
How does joint involvement in RA evolve?
Starts in the soft tissue w/ bone changes (ankylosis) occurring later.
1. Swan Neck
3. Ulnar Drift
Swan Neck Deformity
Deviation of MCP's towards ulna.
Occurs at wrist or MCPs
A compensation for Ulnar Drift. Radial deviation of wrist to bring back deviated fingers.
Systemic Involvement (6 areas)
3. Respiratory System
6. Nervous System
Generalized systemic involvement of RA
Involves whole body.
-Malaise (general discomfort)
Heart Involvement - RA
Inflammation of any part of the heart or nodules.
Respiratory Involvement - RA
-Inflammation of lining or lung tissue.
Ocular Involvement - RA
Inflammation or nodules in any part of the eye. Results in:
-hypersensitivity to light
Skin Involvement - RA
-Some spontaneous skin breakdown (usually LE distally)
Nervous Involvement - RA
Nerve compression due to:
Psychosocial problems - RA
-Depression due to progressive loss of function
-Difficulty dealing with altered body image
-Fear of pain and anticipated pain
-Stress. Increases exacerbations.
Degenerative Joint Disease
-A slowly progressive, non-inflammatory, non-systemic disease of the joints w/ identifiable cause.
-Deterioration of articular cartilage followed by the formation of Osteophytes (bone spurs).
DJD signs and symptoms
1. Joint pain during movement
2. Aching during weather changes/cold weather
3. Stiffness after prolonged rest
4. Crepitation when joint is moved
5. Limited joint motion
6. Joint deformity due to osteophyte formation
grating, popping, and cracking that is audible and palpable.
Sex and Onset Age - DJD
Any age. Males are at increased risk due to typical occupational and avocational activities that are stressful on joints.
Onset can be caused by or is secondary to...
2. Infection of joint
3. Excessive joint stress over time.
4. Structural abnormalities
5. Metabolic Disturbances
Factors that can cause joint stress
-avocational activities (leisure)
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