Biomedical Flashcards

1
Q

what is inflammation

A

response of vascularized tissues to infection and damage that brings cells and molecules of hose defense from the circulation to cites where they are needed in order to eliminate offending agents

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2
Q

what 3 main things does inflammation do

A
  • rid the host of the initial cause of injury
  • remove necrotic cells and tissues
  • initiate the process of tissue repair
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3
Q

what are the cardinal signs of inflammation (medical language)

A

rubor, calor,tumor, dolor, functio laesa

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4
Q

what are the cardinal signs of inflammation (normal words)

A

redness, heat, swelling, pain, loss of function

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5
Q

what cells in the blood participate in inflammation

A

platelets & leukocytes (neutrophils, monocytes, lymphocytes)

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6
Q

what cells in the tissue participate in inflammation

A

sentinel cells

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7
Q

what are sentinel cells

A

immune cells that reside in tissues

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8
Q

what are the 3 key features of sentinel cells

A
  • surface/cytosolic receptors invading microbes/ substances released by necrotic tissues
  • binging, ingesting and phagocytize microbes and necrotic tissues
  • release cytokines and other inflammatory mediators
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9
Q

what are cytokines

A

signaling molecules secreted by immune cells in response to injury/infection that induce and modulate the immune response (both pro and anti inflammatory)

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10
Q

what are examples of cytokines

A

interleukins, interferon, TGT-beta, TNF

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11
Q

what is the job of pro-inflammatory cytokines

A

induce fever, inflammation & tissue destruction in response to injury

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12
Q

what is the job of anti-inflammatory cytokines

A

suppress actions of pro-inflammatory

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13
Q

what is histamine

A

molecule released by mast cells that cause vasodilation and increase capillary permeability

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14
Q

what is produced in response to cytokines

A

prostoglandins and leukotrienes

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15
Q

what is the job of prostaglandins and leukotrienes

A

contribute to vasodilation, pain, platelet activation

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16
Q

what is hemostasis

A

immediate response to traumatic injury to prevent blood loss

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17
Q

what is caused by the mediators released by endothelial cells during hemostasis

A

vasoconstriction, platelet activation, fibrin clot formation

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18
Q

what occur during platelet formation

A
  • platelets adhere to lesion/each other
  • cause attraction of other platelets
  • initiate coagulation cascade leading to fibrin production
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19
Q

what are the five steps of the inflammatory process

A
  • recognition of injury
  • recruitment of white blood cells to area of injury
  • removal of injurious agent/damaged tissue
  • regulation of response
  • resolution
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20
Q

how is injury recognized

A

sentinel cells in tissue and leukocytes in blood stream

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21
Q

what are the primary roles of recognition in the inflammatory process

A

ingestion and phagocytosis of microbes and necrotic tissues, cause the release of mediators that trigger recruitment

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22
Q

what mediators trigger recruitment

A

cytokines, histamines, prostaglandins, bradykinins, leukotrienes

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23
Q

how are cells recruited?

A

cytokines and inflammatory mediators act on endothelial cells of local blood vessels causing vasodilation, increased vessel permeability and vascular stasis

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24
Q

describe vasodilation during recruitment

A

triggered by histamine and other mediators released by mast cells; results in increased blood flow accompanied by decreased velocity of flow

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25
Q

describe vessel permeability in recruitment

A

permeability increased due to endothelial cell retraction; allows for plasma and proteins to lean into tissue causing edema

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26
Q

describe vascular stasis in recruitment

A

results from increased blood flow and decreased velocity and hemoconcentraion; accounts for redness and warmth of inflamed tissue, facilitates extravasation of leukocytes into tissues

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27
Q

how are leukocytes recruited into tissues

A

activation, extravasation and chemotaxis

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28
Q

describe activation of leukocyte recruitment

A

cytokines produced by mast cells and activated by platelets “turn on” leukocytes

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29
Q

describe extravasation of leukocyte recruitment

A

vascular endothelial cells express surface proteins that “grab” leukocytes causing tehm to roll, adhere and migrate through the endothelium into tissue

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30
Q

describe chemotaxis of leukocyte recruitment

A

once in the tissue, leukocytes migrate to area of damage

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31
Q

how is damaged tissue removed?

A

1st wave:neutrophils

2nd wave: macrophages

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32
Q

describe 1st wave removal by neutrophils

A

microbes and damaged tissues are ingested and destroyed through phagocytosis; neutrophils then quickly die via apoptosis

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33
Q

describe 2nd wave removal by macrophages

A

phagocytize remaining microbes, necrotic tissue, and dead neutrophils, cleaning up the mess that was made. macrophages also produce anti-inflammatory cytokines that begin to down regulate inflammation

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34
Q

how is inflammation regulated?

A

once activated, leukocytes have short half lives. anti- inflammatory signals are activated to down regulate inflammation

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35
Q

how does inflammation resolve?

A

leukocyte activation triggers proliferation and migration of fibroblasts to restore normal tissue function

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36
Q

what can go wrong with the inflammatory response?

A

too little inflammation, misdirected inflammation, inflammation in response to normally harmless substances, inflammation is excessively prolonged or repetitive

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37
Q

what can result from too little inflammation

A

infections go unchecked, wounds/tissues don’t heal

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38
Q

what can result from misdirected inflammation

A

inflammation against body native tissues; autoimmune diseases

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39
Q

what can result from inflammation in response to normally harmless substances

A

hypersensitivity and allergies

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40
Q

what can result from excessively prolonged or repetitive inflammation

A

chronic inflammation

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41
Q

what is our role in examination revolving around inflammation

A
  • observe: quality of inflammation & impact on movement/gait
  • assess history: how it happened and the pain
  • tests and measures: ROM, strength, Gait/movement, edema
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42
Q

what is edema?

A

excessive fluid in interstitial space

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43
Q

what are the key observations of edema

A

increased girth of body part, tight, shinny skin, indentation of skin under clothes, weeping/leaking

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44
Q

why is edema a problem?

A

interferes with normal movement (decreased ROM & control, pain) may indicate a health problem

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45
Q

what health problems could be indicated by inflammation

A

tissue injury, DVT, heart failure, liver or kidney disease

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46
Q

what are the 3 types of edema

A

inflammatory, non-inflammatory, effusion

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47
Q

what characterizes inflammatory edema

A

red, hot, painful; typically due to trauma, swelling or inflammatory reaction

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48
Q

what characterizes non-inflammatory edema

A

pitting: press into skin and pits form. has a variety of causes

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49
Q

what characterizes effusion

A

excess fluid enclosed in a space.
joint effusion = in capsule
pleural effusion = in pleural space

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50
Q

how can you describe edema

A

location, duration, inflammatory vs pitting, amount (girth/volume)

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51
Q

what is a typical prognosis of inflammation

A

1-2 weeks; if no change in signs/symptoms consider other factors such as repeated injury or other sources if inflammation

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52
Q

what is the goal in intervention for inflammation

A

to manage and promote healing

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53
Q

what is the main principle for inflammation intervention

A
POLICE
Protection
Optimal Loading
Ice
Compression
Elevation
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54
Q

what are the functional regions of a neuron

A

input, integrative, conductive, output

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55
Q

what is the major difference between a motor neuron and a sensory neuron in the PNS

A

sensory neurons have cell posies that lie just outside the spinal cord while motor neurons have sell bodies in the spinal cord

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56
Q

what is the job of the Endoplasmic reticulum

A

synthesis of lipids and vesicles

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57
Q

what is the job of the lysosome

A

digests glycogen to glucose; part of the axoplasmic transport system

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58
Q

what are the functions of an axon

A
  1. transmission of information: propagation of AP

2. transportation of metabolically important materials to and from the soma to the axonal end

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59
Q

Describe myelinated axons in the PNS

A

myelinated by Schwann cells that enveloping them with up to 300 concentric layers forming myelin sheath

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60
Q

how do neurons transmit information within the neuron

A

action potential

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61
Q

how do neurons transmit information between neurons

A

synapse

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62
Q

what are the cellular mechanisms for neural transmission of information

A

resting membrane potential, post synaptic potential, action potential

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63
Q

what are the synaptic mechanisms for neural transmission of information

A

convergence and divergence

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64
Q

what are the behavioral mechanisms for neural transmission of information

A

feed-forward and feedback

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65
Q

what is the importance of resting membrane potential

A

regulates activation so that neurons do not randomly fire

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66
Q

what is the role of the cell membrane in resting membrane potential

A

creates a physical barrier keeping ion charges separate due to selective permeability

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67
Q

what are the two types of forces that guide movement of ions

A

electrostatic force and diffusion force

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68
Q

what is electrostatic force

A

like charges repel eachother

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69
Q

what is diffusion force

A

ions tend to move from higher concentration to low concentration

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70
Q

what are the types of mechanisms for ion transport

A

ion channels and active mechanisms

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71
Q

what are the types of ion channels

A

ligand gated - had a receptor that must be bound to open
mechanically gated - mechanical stress applied at level of channel open them
voltage gated - opens & closes at specific voltage across a membrane
leakage - randomly open for shits and gigs

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72
Q

what is the active mechanism for ion transport

A

Sodium potassium pump! requires ATP, transports 3 Na+ out and 2 K+ in against diffusion gradient

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73
Q

what is resting membrane potential (value)

A

-70mV

74
Q

what is depolarization

A

the inside of the cell becomes less negative

75
Q

what is hyperpolarization

A

inside of the cell becomes more negative (over shoots RMP)

76
Q

what is a post-synaptic potential

A

graded potential, brief increase or decrease in membrane potential occurring in the post synaptic neuron; can cause action potential propagation if strong enough of via summation

77
Q

what is an EPSP

A

excitatory post-synaptic potential; inside becomes more positive than resting, membrane becomes depolarized

78
Q

what is a IPSP

A

inhibitory post-synaptic potential; inside becomes more negative than resting, membrane becomes hyperpolarized

79
Q

what happens when ESPS reaches threshold?

A

and action potential fires

80
Q

when do voltage gated sodium channels open and close

A

open at threshold (-55mV) and close at +30mV

81
Q

when do voltage gated potassium channels open and close

A

open at +30mV, close much slower than sodium channel

82
Q

when is the sodium potassium pump activated

A

around resting membrane potential

83
Q

how do axons conduct information

A

action potential propagation

84
Q

what is action potential propagation

A

diffusion of sodium atoms coming in moving down the axon creating a cyclic moving action potential

85
Q

what are the functions of the myelin sheath

A
  • acts as an electrical insulator for parts of the axon, thus preventing action potential form developing
  • allows for accumulation of charge at the nodes of Ranvier
  • speeds up conduction of action potential
86
Q

what happens in MS

A

myelin is degraded which leads to slow action potentials of formerly fast neurons

87
Q

what is the relationship between action potential speed and axon diameter

A

the greater the diameter the faster AP conduction

88
Q

what is the physical function of the spinal cord

A

two way link between the brain and the periphery

89
Q

how many pairs of spinal nerves are there

A

31

90
Q

are spinal nerves sensory or motor

A

neither! they’re mixed!

91
Q

what are the spinal cord enlargements

A

cervical and lumbar

92
Q

from what spinal nerves does the brachial plexus arise

A

C5-T1

93
Q

from what spinal nerves does the lumbar plexus arise

A

L1-S4

94
Q

from what spinal nerves does the sacral plexus arise

A

L5-S4

95
Q

what are the connective tissue layers in a nerve

A

epineurium - around entire nerve
perineurium - around a fascicle
endoneurium - around a single axon

96
Q

what is arthrology

A

the study of the classification, structure, and function of joints

97
Q

how does movement occur

A

through sequenced rotations around the joints

98
Q

what 2 ways can you classify joints

A

based on movement potential and based on mechanical analogy

99
Q

what are the two wats to describe/classify joints based on movement potential

A

synarthroses & diarthroses

100
Q

what is a synarthroses

A

joint that allows little to no movement

101
Q

what are the 3 types of synarthroses

A

fibrous - skull
cartilaginous - pubic symphysis & intervertebral discs
syndesmosis - ulna/radius & tibia/fibula

102
Q

what is the function of synathrodial joints

A

transfer forces between bones

103
Q

what is a diarthrosis

A

joint that allows moderate or extensive motion, AKA synovial

104
Q

what are the 7 elements of all synovial joints

A
  1. articular cartilage
  2. joint capsule
  3. synovial membrane
  4. synovial fluid
  5. ligaments
  6. blood vessels
  7. sensory nerves
105
Q

what is articular cartilage

A

cartilage that covers the articular surface of the bone

106
Q

what is a joint capsule

A

a connective tissue “envelope” that encloses the joint; has 2 histologically distinct layers

107
Q

what are the 2 layers of the joint capsule

A

outer layer = dense connective tissue

inner layer = synovial membrane

108
Q

describe the synovial membrane

A

inner layer of the capsule, ~3-10 cell layers thick, highly innervated. composed of specialized cells that produce synovial fluid

109
Q

describe synovial fluid

A

fluid secreted bu the synovial membrane, contains hyaluronan and glycoproteins; lubricates joint surfaces and provides nourishment to articular cartilage

110
Q

describe the structure and function of ligaments

A

connective tissue that joins two bones, prevents excessive movement.

111
Q

what are the 2 types of ligaments

A

capsular & extracapsular

112
Q

describe capsular ligaments

A

distinct thickening of a joint capsule, broad sheets of fibers, resist movement in multiple planes

113
Q

describe extracapsular ligaments

A

cord like structures, partially or completely separate from joint capsule; resists movement in 1 or 2 planes

114
Q

how do blood vessels play into synovial joints

A

blood vessels penetrate the capsule & extend to junction of fibrous and synovial layer

115
Q

how do sensory nerves participate in synovial joints

A

innervate external and internal capsular layer providing the ability for pain and proprioception

116
Q

what are accessory synovial joint structures

A
  • intra-articular discs or menisci
  • peripheral labrum
  • fat pads
  • bursae
  • synovial plica
117
Q

describe the structure and function of articular discs/menisci

A

made of fibrocartilage, increases joint congruency which increases stability, provides shock absorption

118
Q

describe the structure and function of peripheral labrum

A

fibrocartilage structures, extend around the periphery of the joint, deepens joints cavity and supports capsular attachment.(hip and shoulder)

119
Q

describe the structure and function of fat pads

A

reinforces capsule & fills in recesses in the joint, often interposed between fibrous layer and synovial membrane, cushions surfaces to reduce forces

120
Q

describe the structure and function of bursae

A

extension or outpouching of synovial membrane, filled with synovial fluid, cushions and prevents friction between moving tissue surfaces

121
Q

describe the structure and function of synovial plicae

A

redundancy or folds in synovial membrane; redundancy is necessary to prevent undue tension during motions

122
Q

what are the classifications of synovial joints based on movement potential

A

hinge joint, pivot joint, ellipsoid joint, ball and socket joint, plane joint, saddle joint, condylar joint,

123
Q

describe a hinge joint

A

single action of rotation; motion occurs perpendicular axis of rotation (ex: ulnar humeral joint)

124
Q

describe a pivot joint

A

single axis of rotation; rotation occurs parallel to the axis of rotation (ex: radial ulnar joint)

125
Q

describe an ellipsoid joint

A

two axes of rotation; one side elongated concave and other side elongated convex; bi-planar motion flexion/extension & abduction/adduction; limits spin motion at joint (ex: wrist)

126
Q

describe ball and socket joint

A

3 axes of rotation; spherical convex surface & cup like concave socket; allows 3 degrees of freedom for joint angular motion (ex: iliofemoral joint)

127
Q

describe a plane joint

A

lack a definitive axis of rotation; sliding and rotation of one surface on the other (ex: carpals on metacarpals)

128
Q

describe a saddle joint

A

2 axes of rotation; perpendicularly oriented convex and concave surfaces; allows ample bi-planer motion but limits spin (ex: thumb)

129
Q

what is an axis or rotation

A

fixed; all points experience equal rotation; instantaneous

130
Q

describe factors of mechanism of injury (MOI)

A

trauma or insidious onset; potential movements and forces which leads to tissues susceptible to damage

131
Q

what is a force

A

a push or pull that produces, arrests or modifies movement

132
Q

what is a torque

A

the product of a force and its moment arm (rotational force)

133
Q

what is a load

A

a force that acts on the body

134
Q

what are externally derived loads acting on the body

A

gravity, impact, friction, wind

135
Q

what caused internally derived load on the body

A

muscle activation & tissue deformation

136
Q

what is tissue deformation

A

tissues deform with load to match external forces

137
Q

how do healthy tissues respond to load?

A

healthy tissues deform to adjust to load but resist structure and shape change there for they return to homeostatic shape after load is removed

138
Q

what determines the load response

A

the type of tissue/ strength of tissue

139
Q

what is tissue stress

A

force/load generated within the tissue to resist deformation divided by its cross sectional area; measures stored energy of a tissue

aka pressure

140
Q

what is tissue strain

A

the amount a tissue deforms under a force/load; usually expressed as % or distance though it is truly unit-less

141
Q

what is the toe region of a stress strain curve

A

tissue is slack, the stress results in a removal of slack

142
Q

what is the linear region of the stress strain curve

A

period where the tissue is becoming loaded, slope = stiffness of the tissue

143
Q

what is young’s modulus

A

slope of the linear region of the stress strain curve; tissue stiffness

144
Q

what happens after tissue deformation in the elastic/linear region of the stress strain curve

A
  • the tissue returns to its original shape/length after loading
  • all stored energy is released with unloading
145
Q

what is the yield point on the stress strain curve

A

the transition point between elastic and plastic behavior, tissue permanently changed when you pass the yield point; not always a bad thing

146
Q

what is plastic deformation

A

overstrained tissue permanently damaged, plastic deformation energy cannot be recovered once load is released

147
Q

what is the ultimate failure point of the stress strain curve

A

the point at which the tissue fails and us unable to hold additional load

148
Q

what is tissue viscosity

A

the fluid like component of tissue behavior; it is time dependent

149
Q

what is tissue elasticity

A

the ability of a tissue to return to its original shape after loading

150
Q

how is the behavior of tissues discribed

A

viscoelastic; depends on the tissue and what makes it up

151
Q

what is creep

A

mechanical behavior of a tissue related to viscoelastic; continued deformation of a tissue over time as it is subject to a constant load

152
Q

what are the factors that impact musculoskeletal loads

A

magnitude, rate, and type

153
Q

how does a tissue react to loading rate

A

tissues are sensitive to rate; tissues behave differently under different loading rate conditions (ex: high vs low velocity ACL tear)

154
Q

what are the types of musculoskeletal loads

A

tension, compression, bending, shearing, torsion, combined loading

155
Q

describe tension loading & injury example

A

pull of two forces on a tissue in opposite directions; lateral ankle ligaments severely tensioned as the foot rotates inward

156
Q

describe compression loading & body example

A

forces that push or pull the surfaces of objects together or brings the end of an object closer; humerus is pulled against the glenoid by the deltoid muscle creating a compressive load between bones

157
Q

describe bending loading & body example

A

tissue deformation that occurs at right angles to its longitudinal axis; concave side undergoes compression load, convex side undergoes tension load; coxa vara results in increased bending load on the neck of femur

158
Q

describe shear loading & body example

A

unaligned parallel forces that move on part of a body in one direction and another part in opposite direction; femoroacetabular impingement creates abdormal shear load between the demur and acetabulum

159
Q

what is tissue deformation

A

tissues deform with load to match external forces

160
Q

how do healthy tissues respond to load?

A

healthy tissues deform to adjust to load but resist structure and shape change there for they return to homeostatic shape after load is removed

161
Q

what determines the load response

A

the type of tissue/ strength of tissue

162
Q

what is tissue stress

A

force/load generated within the tissue to resist deformation divided by its cross sectional area; measures stored energy of a tissue

aka pressure

163
Q

what is tissue strain

A

the amount a tissue deforms under a force/load; usually expressed as % or distance though it is truly unit-less

164
Q

what is the toe region of a stress strain curve

A

tissue is slack, the stress results in a removal of slack

165
Q

what is the linear region of the stress strain curve

A

period where the tissue is becoming loaded, slope = stiffness of the tissue

166
Q

what is young’s modulus

A

slope of the linear region of the stress strain curve; tissue stiffness

167
Q

what happens after tissue deformation in the elastic/linear region of the stress strain curve

A
  • the tissue returns to its original shape/length after loading
  • all stored energy is released with unloading
168
Q

what is the yield point on the stress strain curve

A

the transition point between elastic and plastic behavior, tissue permanently changed when you pass the yield point; not always a bad thing

169
Q

what is plastic deformation

A

overstrained tissue permanently damaged, plastic deformation energy cannot be recovered once load is released

170
Q

what is the ultimate failure point of the stress strain curve

A

the point at which the tissue fails and us unable to hold additional load

171
Q

what is tissue viscosity

A

the fluid like component of tissue behavior; it is time dependent

172
Q

what is tissue elasticity

A

the ability of a tissue to return to its original shape after loading

173
Q

how is the behavior of tissues discribed

A

viscoelastic; depends on the tissue and what makes it up

174
Q

what is creep

A

mechanical behavior of a tissue related to viscoelastic; continued deformation of a tissue over time as it is subject to a constant load

175
Q

what are the factors that impact musculoskeletal loads

A

magnitude, rate, and type

176
Q

how does a tissue react to loading rate

A

tissues are sensitive to rate; tissues behave differently under different loading rate conditions (ex: high vs low velocity ACL tear)

177
Q

what are the types of musculoskeletal loads

A

tension, compression, bending, shearing, torsion, combined loading

178
Q

describe tension loading & injury example

A

pull of two forces on a tissue in opposite directions; lateral ankle ligaments severely tensioned as the foot rotates inward

179
Q

describe compression loading & body example

A

forces that push or pull the surfaces of objects together or brings the end of an object closer; humerus is pulled against the glenoid by the deltoid muscle creating a compressive load between bones

180
Q

describe bending loading & body example

A

tissue deformation that occurs at right angles to its longitudinal axis; concave side undergoes compression load, convex side undergoes tension load; coxa vara results in increased bending load on the neck of femur

181
Q

describe shear loading & body example

A

unaligned parallel forces that move on part of a body in one direction and another part in opposite direction; femoroacetabular impingement creates abdormal shear load between the demur and acetabulum