Connective Tissue Part 3 Injury and Repair

Question 1

What are five types of tendon injuries?

Answer 1

• peritendinitis
• tendinitis
• tendinosis
• chronic tendinitis
• Rupture

Question 2

Three phases of tendon healing?

Answer 2

1. inflammatory phase
2. reparative or collagen producing phase
3. remodeling phase/maturation phase

Question 3

How does scar tissue lay in comparison to previous collagen fibers?

Answer 3

perpendicular, remodeling is dependent on stress

Question 4

What are the two roles of fibroblasts as they migrate to the wound?

Answer 4

-reparative and reabsorptive

Question 5

what happens if you have excessive collagen synthesis?

Answer 5

excessive scar tissue and adhesions that can restrict mobility

Question 6

when is tensile strength of a healing tendon sufficient for strong contraction with out disruption of healing?

Answer 6

4-5 weeks

Question 7

in regards to tendon healing, what does immobilization do?

Answer 7

• reduces collagen synthesis (weaker tendon)
• decreased nutrition to tissue form synovial fluid
• adhesion formation
• essential to prevent rupture in early stages

Question 8

when letting a tendon heal you should immobilize and then?

Answer 8

gradually increase controlled mobilization

Question 9

what is collagen fibers surrounded by CT, connects bone to bone

Answer 9

ligaments

Question 10

what fibers are collagen fibers that penetrate bone matrix, bind to periosteum to bone and reinforce tendinous/ligamentous insertions?

Answer 10

Sharpeys Fibers

Question 11

what is the main structural support for joint stability?

Answer 11

ligaments

Question 12

where do ligaments get their blood?

Answer 12

arterial plexuses

Question 13

what is the benefit of sensory receptors in ligaments/joints?

Answer 13

proprioceptive feedback and kinesthetic awareness

Question 14

history of trauma, point tenderness, and joint effusion are characteristics of what type of injury?

Answer 14

Ligament

Question 15

How many grades of ligaments sprains are there?

Answer 15

3

1. mild
2. moderate
3. severe

Question 16

Grade 1 ligament sprain

Answer 16

mild, no increased laxity/instability, painful

Question 17

Grade 2 ligament sprain

Answer 17

moderate, slight laxity/instability, marked swelling/pain

Question 18

Grade 3 ligament sprain

Answer 18

severe, disruption of ligament with gross instability, marked swelling, significant pain

Question 19

What is the most common tear of a ligament?

Answer 19

mid substance tear during fast loading

Question 20

What is the least common tear of ligament?

Answer 20

insertion point

Question 21

What type of ligament tear occurs with slow loading mostly in people over 50 years old?

Answer 21

avulsion of bone

Question 22

How long is the proliferation/repair stage of ligament healing?

Answer 22

48-6wks

Question 23

New capillary growth, fibroblastic activity, formation of fibrin close, production of collagen/ECM, fibrin clot, and collagen randomly arranged is what stage of healing in a ligament?

Answer 23

proliferation/repair

Question 24

how long is the remodeling/maturation stage of ligament healing??

Answer 24

6 wks to 24+ months

Question 25

collagen organizes along lines of stress, increases strength of ligament, and collagen shifts from type III to type I

Answer 25

Remodeling/Maturation

Question 26

two types of injury to cartilage?

Answer 26

- loss of matrix macromolecules with out damage to cells or matrix - mechanical injury

Question 27

three types of mechanical injury in cartilage?

Answer 27

- trauma - penetrating injuries - frictional abrasion

Question 28

how soon is the fibrin clot in cartilage repair?

Answer 28

wishing 48 hours

Question 29

When do fibroblasts and collagen type I replace the fibrin clot in cartilage repair?

Answer 29

+5 days

Question 30

When is matrix formation in cartilage repair?

Answer 30

2 weeks

Question 31

After 2 months repair is complete but

Answer 31

the matrix is lacking

Question 32

what type of injury is it when there is death of matrix and cells, tearing of periosteum, endosteum and capillaries, and fragments?

Answer 32

Fracture Healing, Bone Repair

Question 33

Describe the repair process of bone healing?

Answer 33

- localized hematoma (impaction, induction, inflammation) - internal callus formation (set callus-proliferative) - cementing bone, cartilage layer, proliferative osteogenic surface layer - external callus (hard) - remodling

Question 34

what is wolfs law

Answer 34

stresses applied to bone will alter the structure of the bone

Question 35

what is the force per cross sectional area

Answer 35

stress

Question 36

what type stress is stretched perpendicular to cross section

Answer 36

tensile stress

Question 37

stress of squeezing force perpendicular to cross section

Answer 37

compressive stress

Question 38

force parallel to cross section

Answer 38

shear stress

Question 39

what is the percent change in length

Answer 39

strain

Question 40

What are two time dependent propteries of joints?

Answer 40

Force Relaxation and Creep

Question 41

at a fixed length, the drop in force measured over time

Answer 41

Force Relaxation

Question 42

constant foce, tissue gradually lengthens-due to rearrangement of structures in ECM

Answer 42

Creep

Question 43

Factos affecting biomechanics propteries

Answer 43

``` age pregnancy non-steriodal drugs steroids exercise immobilization stiffness viscoelasticity ```

Question 44

Matrix changes when you immobilize a tendon or ligament?

Answer 44

- decreased water - decreased GAGs - increased tissue metabolism - increased collagen turnover - increased immature collagen - increased cross linkages

Question 45

What happens when cartilage is immobilized

Answer 45

- adherence to fatty CT - atrophy - pressure necrosis and cartilage - softening of articular cartilage - loss of ECM proteoglycans

Question 46

What happens when immobilizing a muscle in lengthened position?

Answer 46

- fibers lengthen - more sarcomeres - shorter sarcomeres - increased actin/myosin - lengthened tendon - length/tension curves right

Question 47

what happens when you immobilize a muscle in shortened position?

Answer 47

- fibers shorten - less sarcomeres - longer sarcomeres - decreased actin/myosin - shortened tendon - length tension curves left

Question 48

Types of stretch?

Answer 48

- stretch - elastic stretch - plastic stretch - viscoelastic

Question 49

linear deformation that increases length

Answer 49

stretch

Question 50

tissues return to pervious length, short term deformation

Answer 50

elastic stretch

Question 51

increased length maintained without sustaining force-permanent deformation

Answer 51

plastic stretch

Question 52

substance with bother plastic and elastic stretch

Answer 52

viscoelastic

Question 53

Stretching implications

Answer 53

- activation of muscle spindle-stretch reflex - use of GTO to facilitate relaxation and increase stretch - stretch plastic not elastic