Biomechanics and MS Phys Flashcards

1
Q

What is Wolff’s Law

A

Tissues adapt to the forces applied to them

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2
Q

What must be considered for a patient to return to function?

A

How can we get them to use the leg immediately

Balancing enticing to use limb vs protecting underlying condition

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3
Q

What is important about fracture repair

A

Early weight bearing is necessary for return to function

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4
Q

What are the components of the joint?

A

Joint capsule
Synovial fluid
Articular cartilage
Subchondral bone

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5
Q

What are the sections and functions of the joint capsule?

A

Outer fibrous: mechanical support, originates from periosteum - Sensitive to pain or stretching to joint
Inner Synovial: composed of synoviocytes - needed for phagocytosis, hyaluoronic acid production

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6
Q

What is synovial fluid composed of?

A

Plasma ultrafiltrate and hyaluronic acid

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7
Q

Where does cartilage receive its nutrition

A

Synovial fluid - has no blood or lymph supply

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8
Q

What are the functions of synovial fluid?

A
  • Supports articular cartilage
  • removes metabolic waste
  • Lubricates joint - inflammation leads to decreased viscosity - decreased lubrication
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9
Q

What factors are necessary for joint nutrition and waste removal?

A

Weight bearing and joint motion

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10
Q

What are the function of chondrocytes in articular cartilage

A

Produce proteoglycans (needed for compressive strength

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11
Q

What is the function of collagen in articular cartilage

A

Produces tensile strength

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12
Q

What is the function of articular cartilage

A

Absorb shock

- Has lots of water

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13
Q

Why is cartilage bad at healing

A
  • Lots of water

- No blood or lymph supply

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14
Q

What is subchondral bone and what is its function?

A
  • Absorb and distribute forces

- Decrease load on cartilage

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15
Q

What law of physics is important for returning to function

A

Force = mass x acceleration

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16
Q

What are factors that destroy cartilage?

A

High impact loading - abnormal forces on a normal joint

High contact pressures: normal forces on an abnormal joint

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17
Q

What are examples of an abnormal joint?

A
  • Injury to joint or surrounding tissues

- Surgical alterations to joint (e.g TPLO)

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18
Q

What are examples of abnormal pressures to a normal joint?

A

Overuse and high impact secondary to sport

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19
Q

How can forces be decreased to a joint?

A

Decrease mass (weight loss vs UW treadmill)
Low impact training (derease acceleration)
- Minimize inflammation during initial acute inflammation

20
Q

What are side-effects of immobilizing jionts

A
  • Proliferation of adhesion
  • Cartilage atrophy
  • Decreased proteoglycan and collagen
  • Decreased synovial fluid
21
Q

How should mobilization, be reintroduced to limb after being imobilized?

A

Slow and gradual

- High intensity exercises damage limb

22
Q

What effects do continued high impact have on joints?

A

Decreased PG synthesis
SC bone sclerosis
Damage to cartilage

23
Q

What are the benefits to long-term low-impact cartilage

A
  • Maintains joint health

- Low-impact activity does not degenerate joint in long-term

24
Q

What is osteoarthritis

A

Irreversible articular cartilage degeneration, fibrillation, erosion

25
Q

What are changes noted in an arthritic joint

A
  • Joint capsule becomes thickened (decreased ROM)
  • Synovial fluid becomes less viscous
  • Cartilage becomes eroded
  • Subchondral bone becomes thickened/ sclerotic
26
Q

What does decreased range of motion typically lead to

A

Compensation in another joint

27
Q

What is the function of a tendon?

A

Connects muscle to bone

- Bad at healing

28
Q

What is the function of a ligament?

A

Connects bone to bone

- Bad at healing

29
Q

What is the issue with chronic overuse of tendons or ligaments?

A

Microfractures that can lead to progressive disruption or failure over time

30
Q

What part of the tendon is most susceptible to injury

A

Myotendinous junction

31
Q

What is a tendinopathy?

A

Generic term including clinical and pathologic damage to tendon

32
Q

What is tendinitis?

A

Active inflammation of the tendon

33
Q

What is tendinosis?

A

Degenerative condition with lack of inflammation

  • Painful
  • Results in chronic pain pathway remodeling
34
Q

What occurs with chronic over-use injury?

A

Neuromuscular remodeling attempting to cause a negative feedback mechanism

35
Q

What is the return to function for tendons after injury in 6 weeks? 1 year?

A

50%

80%

36
Q

What is a motor unit?

A

A single neuron and all the muscle fibers innervated by it

  • All units should simultaneously fire when stimulated
  • Fiber number equivalent to amount of control needed
37
Q

What are type I muscles needed for

A

Postures - aerobic

38
Q

What are type IIa used for

A

Aerobic/ anaerobic exercise

39
Q

What type of muscle atrophy will be seen with denervation injury?

A
  • Rapid loss of type II fibers primarily

- Seen very rapidly due to muscle size

40
Q

What type of muscle atrophy will be seen with immobilization injury?

A
  • Loss of type I fibers
41
Q

What factors influence mechanical properties of tissues?

A
  • Temperature (e.g. ultrasound)
  • Load rate
  • Frequency of loading
42
Q

What functions are controlled by ventral nerve roots?

A

Motor

43
Q

What functions are controlled by dorsal nerve roots?

A

Sensory

- Dorsal rami supply epaxial muscles

44
Q

What are common injuries seen with peripheral nerves?

A
  • Stretch: tail or brachial plexus avulsion
  • Compression: crushing injury with secondary ischemia
  • Neuropraxia: nerve conduction block without anatomic disruption
45
Q

How fast does nerve grow?

A

1 mm/ day