Zusammenfassung der Ressource
my hands
are aching
- anatomy of the hand
- joints in the hand
- Ellipsoid
- radiocarpal joint
- metacarpophalangeal of
the fingers
- carpometacarpal
of the fingers
- hinge
- metacarpophalangeal
of the thumb
- interphalangeal
- plane
- intercarpal
- saddle
- carpometacarpal
of the thumb
- anatomy of the carpal tunnel
- carpal tunnel syndrome
- compression to the median nerve
causing numbness in the thumb
and index and middle fingers
- nerve supply
- median
nerve
- radial
nerve
- ulnar nerve
- blood supply
- anatomy of tendon sheath
- layers
- fibrosis tendon sheath
- synovial sheath
- synovial fluid
- functions
- reduction of friction
- shock absorption
- nutrient and waste
transportation
- composition
- lubricin
- hyaluronan
- proteinases
- proteins
- 27 bonres
- 8 carpals
- 5 metacarpals
- 14 bones in thefingers
- muscles
- physiology of the hand
- wrist joint
- ulnar deviation
- radial deviation
- flexion
- extention
- fingers
- thumb
- oppostion
- abduction
- adduction
- Rheumatoid arthrities
- signs & symptoms
- morning stiffness
- due to the swelling
- joint pain, swelling
- more than one joint is effected
- especially small joints
- joints at both sides
- characteristic deformity of the
hands
- Z deformity of the thumb
- button hole deformity
- swan neck deformity
- diagnostic criteria ( 4 criteria
present for 6 weeks)
- RF+
- Rheumatoid nodules
- radiographic changes erosions
- symmetric arthritis
- arthritis of hand joints
- morning stiffness >1 hour
- unequivocal periarticular osteopenia
- arthritis of > 3 joints areas
- defenition
- an autoimmune disease in which the
immune system attacks the joints
- pathophysiology
- infiltration of the synovial membrane
with lymphocytes, plasma cells,
dendritic cells, macrophages
- interactions between T cells and B
cells lead to the production of
cytokines and autoantibodies (RF)
- synovial macrophages produce
proinflammatory cytokines (
TNF, IL-1, IL-6, IL-15)
- act on the synovial fibroblasts
to promote swelling of the
synovial membrane
- activation of osteoclasts and chondrocytes
- lab test
- latex test and RF
- CRP
- an acute phase serum protein
that acts as a surrogate for the
proinflammatory IL-6
- ESR
- in inflammation some proteins
cause RBCs to stick together and
fall more quickly than normal
- anemia of chronic inflammation
- bone marrow is producing high
amount of WBCs so it's crowded
and less RBCs are produced
- stages of RA
- moderate RA ( stage II)
- stage IV
- severe RA ( stage III)
- Early stage ( stage I)
- complications
- Eye problems
- kidney and liver problems
- peripheral neuropathy
- vasculitis
- pregnancy complications
- radiograph of RA
- other systemic effects of RA
- cardiac disease
- renal disease
- skin manifestation
- haematologic manifestation
- pulmonary manifestation
- epidemiology
- most common in
autoimmune disease
- occurs at twice the rate in
women than men
- the incidence
increase with
Age
- management of RA
- NSAIDs
- DMARDs
- mechnism of actin
- methotrexate, sulfasalazine ,
hydroxychloroquine, azathioprine
- physiotherapy
- cold\hot application
- electrical stimulation
- hydrotherapy
- rahabilitative treatment
- therapeutic exercise
- massage therapy
- therapy gloves
- rest and splinting
- to help decrease inflammation
- properly position joints
- examination of the hand
- look
- dorsum, palm, nails, fingers, skin
- feel
- muscles, tendons, joints, nerves
- move
- wrist, fingers, thumb
- special tests
- finkelstein's test
- phalen's test
- tinel's test
- beliefs and compliance
- the patient feels susceptible to
the illness or it's complications
- patients are worried about diminishing
effectiveness of medication over time
- patients are afraid of dependence
on the long-term medication
- cultural and superstitious beliefs
contradict the treatment