Conditions

Question 1

Pain-Spasm Cycle

Answer 1

reflex muscle contraction > lack of movement > tissue ischemia > pain > muscle spasm > lack of movement > repeat

Question 1

Spasm

Answer 1

Involuntary muscle contraction

Question 2

Spasm Symptoms

Answer 2

-Pain from ischemia, spasm, HT, reduced ROM, possible TPs
-Caused by trauma, infection, stress, overstretch, pregnancy, medication, pathology

Question 3

Edema

Answer 3

Local or general accumulation of
fluid in interstitial tissue spaces

Question 4

Edema Symptoms

Answer 4

-varying temperature from hot if acute trauma to cool if chronic
- reduced ROM to limb
- possible painful adhesions

Question 5

Strain

Answer 5

An overstretch injury to musculotendinous (MCT) unit. Includes muscle, tendons, osseous attachment and MCT junction.

Question 6

Strain Grades

Answer 6

Grade 1: minor stretch or tear with minimal loss of strength, can continue activity with some discomfort

Grade 2: several to majority of MCT fibers tear, there is a snapping sound/sensation, a palpable gap and difficulty continuing activity

Grade 3: complete rupture/avulsion fracture (bony tendo attachment tears off and MCT unit remains intact), snapping sound/sensation, visible/palpable gap (muscle shortens), cannot continue activity

Question 7

Strain Symptoms

Answer 7

Grade 1: local edema, tender at lesion, little to no loss of strength and ROM

Grade 2: Moderate local edema, heat, hematoma, bruising, moderate tenderness, pain and loss of strength and ROM

Grade 3: Marked edema, heat, hematoma, bruising, severe pain at lesion, loss of strength and ROM

Question 8

Sprain

Answer 8

Over stretch injury to a ligament (join bones together and add stability to capsule)

Question 9

Sprain Grades

Answer 9

Grade 1: Minor stretch/tear, no instability with PRROM, can continue activity with some discomfort

Grade 2: several to majority of fibers tear, snapping sound/joint gives, joint hypermobile but stable with PROM, difficulty continuing with activity

Grade 3: Complete rupture or avulsion (bony attachment tears off, ligament remains in tact), snapping sound/joint gives, instability/no end range with PROM, cannot continue with activity

Question 10

Sprain Symptoms

Answer 10

Grade 1: Mild local pain at rest and with activity, local edema, heat and bruising, joint stable

Grade 2: Moderate pain at rest and with activity, moderate edema, heat, bruising, joint hypermobile yet stable

Grade 3: intense or mild pain at rest, marked edema, heat, bruising, possible hematoma, joint hypermobile and unstable

Question 11

Cruciate Ligament Injuries (ACL/PCL/MCL/LCL)

Answer 11

An injury to the ligaments that check motion at the knee. The ACL and PCL cross each other to form an ‘X’, the anterior ligament preventing extension and anterior movement at the knee, the posterior preventing posterior translation of tibia on femur and internal tibial rotation. The MCL and LCL prevent medial and lateral translation of the knee.

Question 12

Cruciate Ligament Injury Symptoms

Answer 12

Acute:
- Grade 1/2: pain, swelling, muscle guarding, bruising, redness, can continue with activity
- Grade 3: popping feeling, can’t continue activity due to pain, hemarthrosis, skin taut and hard

Chronic:
- unable to run/walk forward with ACL
- unable to squat, walk downstairs and run backwards with PCL

Question 13

Meniscus Injury

Answer 13

An injury to the structures that provide shock absorption and increase glide in the knee

Question 14

Meniscus Injury Symptoms

Answer 14

Acute: tearing, effusion, tenderness, pain, swelling

Chronic: clicking in joint, knee may lock, disuse atrophy, buckling with activity

Question 15

Whiplash

Answer 15

An acceleration-deceleration injury to the head and neck relative to the body (direction of impact effects the symptoms and structures involved)

Question 16

Grades of Whiplash

Answer 16

WAD0: no complaint about neck, no physical musculoskeletal or neuro signs)

WAD1: neck complaint of pain, stiffness, tenderness, no physical musculoskeletal or neurological signs, microscopic lesions not serious enough to cause muscle spasm

WAD2: neck complaint of pain, stiffness, tenderness, musculoskeletal signs of decreased ROM, point tenderness, injury to muscles/tendons/ligaments/joint capsule serious enough to cause spasm

WAD3: neck complaint of pain, stiffness or tenderness and neuro signs including decreased/absent DTR, weakness and sensory deficit, injury to neuro system due to mechanicla injury or inflammation/bleeding

WAD4: neck complaint and fracture or dislocation

Question 17

Whiplash Symptoms

Answer 17

Acute: heat, edema, spasm, headache, concussion, no pain or decreased ROM until 24-48hours after trauma

Subacute/Chronic: symptoms decrease with SOH and most pain/stiffness is resolved in 4 to 6 weeks