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35431203
"My Hands are Aching"
Descripción
Mapa Mental sobre "My Hands are Aching", creado por Lelas A el 14/02/2022.
Mapa Mental por
Lelas A
, actualizado hace más de 1 año
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Creado por
Lelas A
hace más de 2 años
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Resumen del Recurso
"My Hands are Aching"
Anatomy of the HAND
Bones
Joints
Causes of Swollen Joints
Acute
Chronic
Osteoarthritis
Rheumatoid arthritis
Synovial Fluid Contents
Water
Inorganic salts & macromolecules
Hyaluronic acid
Lubricin
Aggrecans
Neutrophils, Lymphocytes, Monocytes, Macrophage
Intrinsic muscles
Blood supply
Innervation
Examination of the hand
extrinsic flexors
Flex thumb IP joint
Stabilize PIP and have patient flex each DIP in succession
Volar flex wrist
intrinsic muscles
Touch small finger to the thumb so the nails are parallel
Flex MCP and straighten PIP
Pinch paper between thumb and radial side of index finger in the first webspace
Neurological
Radial c5-c8
Median c5-T1
Ulnar c8-T1
Special tests:
Phalen’s Test (test for carpal tunnel syndrome)
Tinel’s Test (test for carpal tunnel syndrome)
Finkelstein’s Test (test for DeQuervain’s Tenosynovitis)
Autoimmunity: RHEUMATOID ARTHRITIS
Normal Immune tolerance mechanism:
Loss of self-tolerance
1- Bystander T cell activation
2- Molecular mimicry
3- Polyclonal lymphocyte activation
4- Altered self
5- Release of sequestered antigens
6- Availability of cryptic epitopes
Complications of RA:
Symmetric swelling of small peripheral joints
Symmetric swelling of elbows, shoulders, hips, and knees
Anemia in Rheumatoid Disease
due to reduction in RBC production by bone marrow.
Prognosis:
Progression when diagnosed
Presence of rheumatoid nodules
Positive for rheumatoid factor or anti-CCP
decrease life span by 10-15 years but highly variable
Pathogenesis of RA
Infiltration of synovial membrane with:
Lymphocytes
Plasma cells
Dendritic cells
Macrophages
Cytokines involved:
TNF, IL-1, IL6 and IL-15
Investigations:
From History + Physical Examination:
Morning stiffness
Symmetrical swelling of 3 or more joints
Rheumatoid nodules
Imaging & laboratory findings:
Radiographic changes of RA (X-ray\MRI)
High ESR or C-reactive protein
RF+ and\or Anti-ccp+
Management:
Pharmacological
Non-pharmacological
Psychological effect:
Epidemiology of RA:
Prevalence: 0.5-1%
3 cases per 10,000 population
More common in women
Recursos multimedia adjuntos
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