NR509 Mid-Term Study Guide
• Articular structures include joint capsule and articular cartilage, the synovium and synovial fluid, intra-articular ligaments and juxta-articular bone
o Articular disease involves:
Swe
...
NR509 Mid-Term Study Guide
• Articular structures include joint capsule and articular cartilage, the synovium and synovial fluid, intra-articular ligaments and juxta-articular bone
o Articular disease involves:
Swelling
Tenderness of the joint
Crepitus
Instability “locking”
Deformity
Limits active and passive range of motion due to stiffness or pain
• Extra-articular structures include periarticular ligaments, tendons, bursae, muscle, fascia, bone, nerve and overlying skin
o Extra-articular disease involves:
“point of focal tenderness in regions adjacent to articular structures
Limits active range of motion
RARELY causes swelling, instability, joint deformity
Know the sources of joint pain (pg. 627 algorithm)
• Nonarticular conditions: trauma/fracture, fibromyalgia, polymyalgia rheumatica, bursitis, tendinitis
• Intra-articular (acute, < 6 weeks): acute arthritis
o infectious arthritis
o gout
o pseudogout
o Reiter syndrome
• Intra-articular (chronic, > 6 weeks): chronic inflammatory arthritis vs chronic noninflammatory arthritis
o Chronic inflammatory arthritis with 1-3 joints involved:
Indolent infection
Psoriatic arthritis
Reiter syndrome
Periarticular JA
o Chronic inflammatory arthritis with >3 joints involved:
Psoriatic arthritis or Reiter syndrome (no symmetry)
rheumatoid arthritis if not RA then systemic lupus, scleroderma, polymyositis
*Know what causes saddle numbness and urinary retention (pg. 678?)
• CES (cauda equina syndrome) most commonly results from a massive herniated disc in the lumbar region.
• A single excessive strain or injury may cause a herniated disc.
• However, disc material degenerates naturally as a person ages, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.
The following are other potential causes of CES:
• Spinal lesions and tumors
• Spinal infections or inflammation
• Lumbar spinal stenosis
• Violent injuries to the lower back (gunshots, falls, auto accidents)
• Birth abnormalities
• Spinal arteriovenous malformations (AVMs)
• Spinal hemorrhages (subarachnoid, subdural, epidural)
• Postoperative lumbar spine surgery complications
• Spinal anesthesia
[Show More]
