PATIENTS SCREENED, HANDLED AND REFERRED BY

A PHYSICAL THERAPIST & THE NATURE OF THEIR PROBLEM

NEUROMUSCULAR CONDITIONS

Disorders of the Neuromuscular System can be: Inherited Acquired a. Trauma b. Infection c. Arise secondary to disorders affecting body systems d. Part of the aging process

Two most common Neuromuscular Disorders are:1. Stroke2. Alzheimer’s Disease

Frequency of intervention will vary according to:3. Patient’s condition4. Stage of illness5. Setting of service delivery

COMMON CONDITIONS STROKE or Cerebrovascular Accident

(CVA)-neurologic problems arising from

disruption of blood flow in the brainCAUSES Hemorrhage Blockage from a clotSYMPTOMS Complete paralysis Partial weakness on the side opposite

the site involved

TRAUMATIC BRAIN INJURY (TBI)-most common cause of death and

disability in children and young adults-the brain trauma may be associated

with fractures, dislocations, lacerationsCAUSES Motor vehicle accidents Falls and violence

SPINAL CORD INJURY (SCI)CAUSES Motor vehicle accidents, falls, violence, and

sportsSpinal cord damage can also be precipitated by other diseases and conditions, and in these instances older patients are affected more commonly.Levels of Injury Tetraplegia - all limbs may be affected Paraplegia - the lower part of the trunk

and legs may be affected

VESTIBULAR DISORDERSThe vestibular system helps detect head position and movement. It consists of two components: (1) the peripheral apparatus(2) the connections between the peripheral and central componentsSYMPTOMS Dizziness Unsteadiness Vertigo Nausea

MULTIPLE SCLEROSIS (MS)

-disease in which patches of demyelination in the nervous system lead to disturbances in the conduction of messages along the nervesCAUSE UnknownSYMPTOMS Visual problems Sensory problems (tingling and numbness) Weakness Fatigue Problems with balance Speech disturbances

PARKINSON DISEASE- a progressive condition first described

by James Parkinson in 1817- also referred to as paralysis agitans

and idiopathic (cause unknown) parkinsonismCAUSE deficiency in dopamine

TRIAD OF SYMPTOMS Tremor Rigidity Bradykinesia

INTEGUMENTARY CONDITIONS

INTEGUMENTTwo layers:

1.Epidermis-very thin,0.06mm to 0.10mm

2.Dermis-1 to 4 mm in thickness-two subdivisions: the papillary dermis and

the reticular dermis. Subcutaneous Tissue

-Consist of connective tissue-Binds the skin to the organ below it in a fashion that allows a reasonable amount of movement without displacement or damage.

Roles: Protective organ, temperature control and provides important sensory information regarding the environment.

Consequences of wounds or impairment in skin:Inflammation, pain, edema, and scar formation can

lead to significant functional limitations and disability. PT and PTA

-Must be aware of the importance of the integumentary system in normal human function. -provide programs or interventions to prevent loss of skin integrity.

-Appropriate management of patients with various impairments of the skin.

WOUND HEALING

Inflammatory Phase Proliferative Phase Maturation or Remodeling

Phase

VASCULAR COMPROMISE AND TRAUMA

Vascular compromise- Wounds caused by arterial insufficiency are

most commonly situated on the foot or ankle, but they also occur at other locations.

-These wounds are caused by primary loss of vascular flow to an anatomic site, which leads to tissue death.

Arterial  Wounds.  Wounds caused by arterial insufficiency are commonly found on the lower part of the leg, including the feet and toes. Because of the poor circulation to the wound, minimal, if any, exudate is seen.

Venous Ulcers.  Wounds caused by venous insufficiency are commonly found on the lower part of the leg. Exudate and edema are present

Neuropathic Ulcers.  Neuropathic ulcers are usually located on the plantar surface of the foot at pressure points or bony prominences. The wound may bleed easily unless the condition is coupled with arterial insufficiency.

Pressure Ulcers. Pressure ulcers may be located in diverse sites on the body but are generally found over bony prominences.

Trauma -Primary medical intervention.

Wounds: Abrasions

Lacerations Puncture wound Avulsion injuries Degloving injuriesBurn injuries.

DISEASES

Inflammatory skin diseases -Generally inflammation of the skin.

Dermatitis-symptoms: itching and some scaling of the epidermis.-Warts, rashes, acne etc.

Neoplastic skin diseases (skin cancer)-include basal cell carcinoma, squamous cell carcinoma, and malignant melanoma.-commonly caused by extreme exposure to the sunlight.

SCAR TISSUE

Vancouver Burn Scar Scale -This scale rates characteristics of

scars, including pigmentation, vascularity, pliability, and height.

Scars are generally referred to as either hypertrophic scars or keloid scars.

PREVENTION

Lotions(Water-repellant lotions and absorbent products)

Positioning Self-inspection/Observation Appropriate dressings Compressions

WOUND MANAGEMENT

Grafting to close the wounds. Appropriate dressings. Rest(Bed rest) Moisturizer(Skin products) Cream or Ointment

GERIATRIC CONDITION

Geriatrics or geriatric medicine is a specialty that focuses on health care of elderly people.

It aims to promote health by preventing and treating diseases and disabilities in older adults.

The term geriatrics comes from the greek geron meaning "old man" and intros meaning "healer".

COMMON CONDITIONS OSTEOARTHRITIS - also known

as degenerative arthritis, degenerative joint disease, or osteoarthrosis, is a type of joint disease that results from breakdown of joint cartilage and underlying bone.

CAUSE - previous joint injury, abnormal joint or limb development, and inherited factors. Risk is greater in those who are overweight, have one leg of a different length, and have jobs that result in high levels of joint stress.

SYMPTOMS - joint swelling, decreased range of motion, and when the back is affected weakness or numbness of the arms and leg.

RHEUMATOID ARTHRITIS

- is a long lasting disorder that primarily affects joints.

-Most commonly the wrist and hands are involved with typically the same joints involved on both sides of the body.

CAUSE - cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors.

SYMPTOMS - typically result in warm, swollen, and painful joints.

OSTEOPOROSIS - a disease where decreased bone strength

increases the risk of a broken bone. It is the most common reason for a broken bone among people who are old.

CAUSE - may be due to lower than normal peak bone mass and greater than normal bone loss. Bone loss increases after menopause due to lower levels of estrogen. Osteoporosis may also occur due to a number of diseases or treatments including alcoholism, anorexia, hyperthyroidism, surgical removal of the ovaries, and kidney disease. 

SYMPTOMS - ntil a broken bone occurs there are typically no symptoms.

HIP FRACTURE- - is a femoral fracture that occurs in

the proximal end of the femur (the long bone running through the thigh), near the hip.

- - The term "hip fracture" is commonly used to refer to four different fracture patterns.

CAUSE - often due to osteoporosis; in the vast majority of cases, a hip fracture is a fragility fracture due to a fall or minor trauma in someone with weakened osteoporotic bone. Most hip fractures in people with normal bone are the result of high-energy trauma such as car accidents, falling from heights, or sports injuries.

SYMPTOMS - The classic clinical presentation of a hip fracture is an elderly patient who sustained a low-energy fall and now has pain and is unable to bear weight. On examination, the affected extremity is often shortened and unnaturally, externally rotated compared to the unaffected leg.

DIABETES

- Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period.

CAUSE - due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced.

SYMPTOMS - frequent urination, increased thirst, and increased hunger.