Name the thirteen signs and symptoms of hepatic disease
-GI symptoms
-Ascites
-Dark urine
-jaundice- eyes
-clay colored stool
-musculoskeletal - right shoulder
-oteoporosis
Describe the tremor observed with hepatic disease and how one would test for it.
Asterixis (flapping tremor)
-quick stretch, wrist in extension
What is cirrhosis? What is a sign of cirrhosis? (hint - "too full")
chronic inflammation - causes liver tissue damage
-necrosis forms fibrous bands - leads to scars
What is Fulminant hepatitis
rapid liver inflammation or liver failure
-lead to encephalopathy or even death
Which type of hepatitis is dependent upon Hepatitis B to develop? Will the vaccine for Hepatitis B help prevent this type of Hepatitis?
Hepatitis D
-Yes, HBV vaccine
Describe the referred pain patterns of liver cancer which a PTA should be aware of.
-right shoulder pain
-elevated diaphragm
-tumor thoracic spine
What is pancreatitis? Briefly describe the difference between acute and chronic
inflammatory disease of pancreas where the enzymes of pancreas auto-digest the organ
Acute- reversible
Chronic- irrreversible
What is the significance of the Virchow's node? Where is this located?
-is a lymph node in the left supraclavicular fossa that is enlarged and a sign of metasitis
What is cholelithiasis? What occurs?
-gall stone disease
-gall bladder with stones
What are the symptoms of cholethiasis (and other gall bladder diseases)?
-pain in back or upper right abdomen
-indigestion
-cramping in abdomen
Name the thirteen signs and symptoms of Gastrointestinal Disease.
-anorexia
-heartburn
-GI bleeding
-abdominal pain
-apalachia
-dysphagia- difficulty swallowing
-constipation
What implications do the signs and symptoms have for the PTA treating a patient with GI disease?
-excessive diarrhea
- dehydration (depleted electrolytes)
-cramping
-tight muscles
Why is it important for a person with GERD to control the inflammation of their esophagus?
How is GERD managed medically
-could lead to esophageal cancer
-proton pump inhibitors
-no spicy foods, alcohol, or nsaids
-sleep elevation and on left side
Refer to table E4-6 on page E4-21 to answer. Under "pathogenesis", what are the primary differences between Crohn's Disease and Ulcerative Colitis?
Chron's
-inflammatory - skip lesions intestinal wall around valve
-depressed lumen
-joint pain
-sacroiliac pain
Ulcerative Colitits
-continuous lesions
-mucosal - submucosal
Name five clinical manifestations of Crohn's Disease and Ulcerative Colitis (ten total).
Chron's
-weight loss
-joint pain
-abdominal pain mass
Ulcerative
-diarrhea
-blood in stool
-fever
Describe how Clostridium difficile can cause colitis and symptoms of infection. What are the complications if left untreated?
to much antibiotics - opportunistic
-watery diarrhea
-severe abdominal pain
-perforated colon - lead to death
What is diverticular disease and what are the symptoms?
-little pouches in intestines
-seed caught in there - inflammation
-pain in abdomen
What conditions or procedures can be responsible for the development of a functional obstruction? What are the two types and their possible causes?
Anterior spinal fusion or spinal cord injury
ogelbies- surgery to hip or pevlic fracture
Describe the signs and symptoms of appendicitis
-ilium and umbilicus region
-nausea
-vomiting
-mid- lower abdomen pain
What is a hemorrhoid? Name five possible causes of hemorrhoids (see box E4-1 on page E4-6).
swollen veins in the rectum and anus cause discomfort and bleeding
-Straining during bowel movements.
-Sitting for long periods of time on the toilet.
-Chronic diarrhea or constipation.
-Obesity.
-Pregnancy.
Which is the most common type of prostatitis and what are the symptoms?
Category III: Chronic prostatitis, chronic pain syndrome
-: pelvic pain > 3 months not related to UTI; fatigue, arthralgia, difficulty sitting, pain radiation to pain/rectum, urinary frequency/urgency
Define Benign Prostatic Hyperplasia and name four symptoms.
An age-related nonmalignant enlargement of the prostate gland
-Urine flow restricted due to narrowing of urethra
-Difficulty initiating or continuing urine stream
-Susceptible to UTI's
-Residual urine left in bladder - urinary frequency/nocturia
What are the four questions which a PT/PTA should ask a male patient over 50 years old? What does a "yes" answer indicate?
-Do you urinate often, especially during the night?
-Do you have trouble starting or continuing your urine?
-Do you have weak ?ow of urine or interrupted urine stream?
-Does it feel like your bladder is not emptying completely?
A yes to any - needs medica
What are the risk factors for prostate cancer (seven)?
-Age >50 years
-African American
-Residence in United States or Scandinavian countries
-Family history; inherited gene mutation
-Environmental exposure to cadmium
-High-fat diet
-Alcohol consumption
Describe the signs and symptoms of testicular cancer?
-Initial sign - enlargement with pain, swelling, hardness
-Aching in abdomen or scrotum with sense of heaviness
-May have back or pelvic pain (psoas muscle invasion)
-Mets - back pain, abdominal mass, hemoptysis
What are the components of the upper and lower urinary tract?
Upper urinary tract
-Kidneys: Filter waste products and remove excess fluid from the blood; process 200 qt. liquid/day
-Ureters
Lower urinary tract
-Bladder
-Urethra
What are the signs and symptoms of a urinary tract infection?
-Urinary frequency
-Urinary urgency
-Nocturia
-Pain - shoulder, flank, pelvis, lower abdomen
-Costovertebral tenderness
-Fever and chills
-Hyperesthesia of dermatomes
-Dysuria
-Hematuria
-Pyuria
-Dyspareunia
-Older patients - malaise, anorexia, and mental
Describe the clinical signs of renal cancer.
-Often confused with endocrine disorders because tumors produce hormones similar to parathyroid, glucagon, insulin
-Metastasis - potential to be initial symptom
Most often occurs in lungs, regional lymph nodes, bones and liver
What should a PTA be aware of when treating a patient with polycystic kidney disease?
-Awareness of diagnosis and need for awareness of HTN and UTI
-Patients are at increased risk of developing cerebral and aortic aneurysms
What are the clinical signs of renal calculi (kidney stone)?
-Acute flank pain which may radiate to groin or perineal areas with hematuria
-Pain is severe - unable to find comfortable position
-Abdominal pain if stone is higher
-UTI symptoms
-May have ANS signs - nausea, vomiting, severe abdominal cramping
What is chronic kidney disease? What are the three most common causes?
-Alteration of kidney function or structure greater than three months duration
-Three most common causes: Diabetes mellitus, HTN, Glomerulonephritis (acute kidney inflammation)
What are the exercise guidelines for a patient with chronic kidney disease?
-low to moderate intensity exercise to improve blood pressure
-Strength training - mild to moderate intensity - will require longer duration
-Aerobic exercise with stretching warm up and cool down phases
-Can exercise before, during and after peritoneal d
Name four clinical signs of bladder cancer.
-Painless hematuria - microscopic/gross
-Voiding dysfunction - frequency, urgency, and dysuria
-Lymphedema
-Back pain - metastases to vertebrae
-Mets also to liver and lungs
What is neurogenic bladder? What are the three treatment goals for neurogenic bladder?
-Voiding dysfunction associated with neurologic pathology
-Clean intermittent catheterization
-Medication - anticholinergic agents when detrusor hyperactive
-Bladder training
-Biofeedback
Name the four types of incontinence and briefly describe each one.
-Functional incontinence - normal urine output but unable to reach toilet in time
-Stress incontinence - urine loss with increased intra-abdominal pressure
-Urge incontinence - sudden, unexpected urge to urinate with uncontrolled loss of urine
-Overflow i