my hands are aching

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Medicine Mind Map on my hands are aching, created by yasmin alkhatib on 12/03/2017.
yasmin alkhatib
Mind Map by yasmin alkhatib, updated more than 1 year ago
yasmin alkhatib
Created by yasmin alkhatib about 7 years ago
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Resource summary

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