Chapter 9 - Mechanisms and Characteristics of Sports Trauma Flashcards
Load
outside force or forces acting on tissue
stress
internal reaction or resistance to an external load
strain
extent of deformation of tissue under loading
viscoelastic
both viscous and elastic properties, allowing for deformation
anisotropic
tissue responds with greater or lesser strength depending on load direction
yield point
elastic limit of tissue
mechanical failure
elastic limit of tissue is exceeded, causing tissue to break
tension
pulls or stretches tissue ( strains and sprains)
stretching
beyond yield point (rupture or fx also sprains, strains, or avulsions)
compression
fractures and contusions - crushing
shearing
moves across the parallel organization of tissue
blisters, abrasions, vertebral disk injury
bending
force on a horizontal beam/bone that places stress within structure, causing it to bend or strain
3 point bending
compression if force on concave side, tension if force on convex side
soft tissue trauma categorized as
innert (noncontractile) - skin, joints, ligament, fascia, cartilage, dura mater, nerve roots
or
contractile - muscle, tendon, bony insertion
characteristics of muscle fibers
contractility, irritability, conductivity, elasticity
types of muscle fibers
cardiac, smooth, striated
muscle encasing
endocysium - inner
perimysium
epimysium - outer
mysiums conform into..
aponeurosis and or tendons
tendons and aponeurosis are
resilient fascia
what are spread into the perimysium?
arteries, veins, lymph vessels and nerve fibers
capillaries run through
endomysium
strains
stretch, tear, rip in muscle fascia or tendon
caused by abnormal cmuscle contraction
Grade 1 strain
fibers stretched, some pain with AROM,
painful ROM but still WNL
Grade 2 strain
several fibers torn
AROM painful
palpable divot
swelling and possible discoloration
Grade 3 strain
complete rupture, impairment, pain that quickly subsides
Tendon
wavy parallel collagenous fibers organized in bundles surrounded by gelatinous material
double the strength of the muscle it is connected to
tendon breaking point
> 6-8% increase in length
Muscle spasm
reflex caused by trauma of the musculoskeletal system
tonic spasm
rigid muscle contraction that lasts a period of time
clonic spasm
alternating involuntary muscular contracion and relaxation in quick succession
Muscle soreness
acute and DOMS
Muscle stiffness
fluids that collect in muscles during and after exercise are absorbed into blood stream at a slow rate
muscle cramps
painful involuntary skeletal contractions;
occurs in when developed people
more likely when the muscle is in shortened position
spasiticity
associated with increased tone/contraction because of an upper motor neuron lesion in the brain
Myofascial Trigger points
hypersensitive nodule found within a taut band of skeletal muscle and or fascia
latent - no pain unless pressed, may restrict movement
active - pain at rest
tender point - pain only at site of palpation
Myositis
inflammation of muscle tissue
fascitis
chronic inflammation of fascia that supports and separates muscle
tendinitis
graduate onset, diffuse tenderness because of repeated micro traumas, and degenerative changes (swelling, pain)
tenosynovitis
inflammation of synovial sheath surrounding a tendon
can be acute or chronic
difference between acute vs. chronic tenosynovitis
acute: rapid onset, articular creptitus, diffuse swelling
chronic: tendons become locally thickened, with pain and articular crepitus present during movement
ectopic calcification
myositis ossificans
osteoid material that resembles bone accumulating in the muscle
growth may mature into calcified area
synarthrotic
immovable
ampiarthrotic
slightly movable
diarthrotic
freely movable
characteristics of diarthrodial or synovial joints
capsule ligaments synovial membrane hyaline or articular cartilage joint space and synovial fluid
primary factor in ligamentous injuries
viscoelastic tissue properties
constant compression causes deterioration
intermittent compression strengthens
chronic inflammation causes shrinkage of collagen fibers
primary protection of joint
dynamic aspect of muscles and tendons
Roux’s law of function adaptation
an organ will adapt itself structurally to an alternation, quantitative or qualitative, or function
hyaluronic acid viscosity tendencies
thickens during slow movement, thins during fast movment
hyaline cartilage
articular
nasal septum, larynx, trachea, bronchi, ends of bones
provides static and dynamic stability
no direct blood supply
provides motion control, stability, load transmission
fibrous cartilage
vertebral disks, pubic symphysis, menisci of knee
elastic cartilage
external ear, eustachian tube
ball and socket
all movements
glenohumeral and hip
hinge joint
flexion and ext
elbow
ellipsoidal
elliptical convex head, in a concave socket
wrist
saddle
concave head in a convex socket (CMC joint of thumb)
pivot joint
rotation about an axix
cervical atlas and axis
end of radius and ulna
gliding
slight gliding back and forth and sideways
joints between carpals/tarsals
intervertebral jts
what limits joint motion
end points and muscle tension
Hilton’s law
the joint capsule, the muscles moving in that joint, and the skin overlying the insertion of the muscles have the same nerve supply
joint sprain
traumatic joint twist that results in stretching or total tearing of stabilizing connective tissues
Grade 1 sprain
some pain, minimum loss of function, little or no swelling, no laxity
Grade 2 sprain
pain, moderate loss of function, swelling, slight to moderate instability
Grade 3 sprain
extremely painful, loss of function, severe instability, tenderness and swelling
S/S of joint sprains
effusion of blood or synovial fluid into cavity, swelling, increase temp and pain, ecchymosis
acute synovitis
increase in fluid production and swelling after injury
resolves in a few days
subluxation
partial dislocation
luxation
complete dislocations, presenting a total disunion of bone apposition
diastasis
disjointing of 2 bones parallel to one another
or
rupture of a solid joint (pubic)
osteochondrosis
degenerative changes in the ossification centers of the epiphyses of bones
OCDs or apophysistis
Osteochondritis dissecans
located in the knee
apophysistis
located at tubercle/tuberosity
osteoarthritis
degeneration of articular or hyaline cartilage
-repeated trauma
can affect whole body joints
s/s localized pain, pain relieved with rest, stiffness that loosens up with activity, creaky joints
Bursitis
overuse of muscles or tendons or external compression
can lead to calcific deposits
capsulitis/synovitis
repeated joint injury or with improperly managed joint injury
chronic edema, thickened edema, exudation, crepitus
osteocytes
bone cells
cancellous bone
porous bone
periosteum
outside of bone that contains blood supply
flat bones
skull, ribs, scapulae
irregular bones
vertebral column and skull
short bones
wrist and ankle
long bones
humerus, ulna, femur, tibia, fibula, phalanges
diaphysis
main shaft of long bone
epiphysis
located at the ends of long bones
medullary cavity
hollow tube in the long bone diaphysis; contains a yellow, fatty marrow
endosteum
lines the medullary cavity
calcium salts
make bone hard
Volkmann’s canal
blood circulation connects periosteum with haversian canal
periostitis
inflammation of the periosteum (contusion) - skin rigidity over underlying muscles
depressed fracture
usually in flat bones,
greenstick fracture
incomplete break in bones that have not completely ossified;
impacted fracture
fall from a height, force goes up the long axis, immediate splinting
longitudinal fracture
bone splits along its length, often result of jumping and stress directs up long axis
spiral fracture
S-shaped separation; common in football and skiing
sudden rotation of body with planted foot
oblique fracture
occur when one end of the bone receives sudden torsion while other is fixed or stabilized
serrated fracture
2 bony fragments have a saw-tooth, sharp-edged fx line;
transverse fracture
occur in a straight line at right angles to the bone shaft, caused by direct blow
comminuted fracture
more than 3 fragments, hard blow, difficult healing process
contrecoup fracture
occur on side opposite to the point at which trauma was initiated; fx of skull
blowout fracture
occur to the wall of a bone fragment at an attachment of ligament or tendon. Usually occurs as a result of a sudden, powerful twist or stretch of a body part
avulsion fracture
separation of a bone fragment at an attachment of ligament or tendon.
sudden powerful twist or stretch of body part
causes of stress fractures
overload
altered stress distribution
change in movement environment
repetitive stress
physiology of stress fractures
weight bearing bones undergo bone resorption and become weaker before they become stronger
s/s for stress fractures
swelling, focal tenderness, pain,
salter haris classificiation
type 1: separation of physis
type 2: separation of growth plate and small part of metaphysics
type 3: fracture of physics
type 4: fx of portion of physics and metaphysis
type 5: crushing force (growth deformity)
apolphyses injuries
Sever’s disease and Osgood-Schlatter’s
Neuritis
inflammation of a nerve
referred pain
pain that is felt at point of the body other than its origin
pathomechanics
poor mechanics of movement
