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Manual Therapy Exam 1 > Connective Tissue Part 3 Injury and Repair > Flashcards

Connective Tissue Part 3 Injury and Repair Flashcards

1
Q

What are five types of tendon injuries?

A
  • peritendinitis
  • tendinitis
  • tendinosis
  • chronic tendinitis
  • Rupture
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2
Q

Three phases of tendon healing?

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

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

A

perpendicular, remodeling is dependent on stress

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4
Q

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

A

-reparative and reabsorptive

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5
Q

what happens if you have excessive collagen synthesis?

A

excessive scar tissue and adhesions that can restrict mobility

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6
Q

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

A

4-5 weeks

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7
Q

in regards to tendon healing, what does immobilization do?

A
  • reduces collagen synthesis (weaker tendon)
  • decreased nutrition to tissue form synovial fluid
  • adhesion formation
  • essential to prevent rupture in early stages
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8
Q

when letting a tendon heal you should immobilize and then?

A

gradually increase controlled mobilization

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9
Q

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

A

ligaments

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10
Q

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

A

Sharpeys Fibers

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11
Q

what is the main structural support for joint stability?

A

ligaments

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12
Q

where do ligaments get their blood?

A

arterial plexuses

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13
Q

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

A

proprioceptive feedback and kinesthetic awareness

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14
Q

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

A

Ligament

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15
Q

How many grades of ligaments sprains are there?

A

3

  1. mild
  2. moderate
  3. severe
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16
Q

Grade 1 ligament sprain

A

mild, no increased laxity/instability, painful

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17
Q

Grade 2 ligament sprain

A

moderate, slight laxity/instability, marked swelling/pain

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18
Q

Grade 3 ligament sprain

A

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

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19
Q

What is the most common tear of a ligament?

A

mid substance tear during fast loading

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20
Q

What is the least common tear of ligament?

A

insertion point

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21
Q

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

A

avulsion of bone

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22
Q

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

A

48-6wks

23
Q

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?

A

proliferation/repair

24
Q

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

A

6 wks to 24+ months

25
Q

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

A

Remodeling/Maturation

26
Q

two types of injury to cartilage?

A
  • loss of matrix macromolecules with out damage to cells or matrix
  • mechanical injury
27
Q

three types of mechanical injury in cartilage?

A
  • trauma
  • penetrating injuries
  • frictional abrasion
28
Q

how soon is the fibrin clot in cartilage repair?

A

wishing 48 hours

29
Q

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

A

+5 days

30
Q

When is matrix formation in cartilage repair?

A

2 weeks

31
Q

After 2 months repair is complete but

A

the matrix is lacking

32
Q

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

A

Fracture Healing, Bone Repair

33
Q

Describe the repair process of bone healing?

A
  • localized hematoma (impaction, induction, inflammation)
  • internal callus formation (set callus-proliferative)
  • cementing bone, cartilage layer, proliferative osteogenic surface layer
  • external callus (hard)
  • remodling
34
Q

what is wolfs law

A

stresses applied to bone will alter the structure of the bone

35
Q

what is the force per cross sectional area

A

stress

36
Q

what type stress is stretched perpendicular to cross section

A

tensile stress

37
Q

stress of squeezing force perpendicular to cross section

A

compressive stress

38
Q

force parallel to cross section

A

shear stress

39
Q

what is the percent change in length

A

strain

40
Q

What are two time dependent propteries of joints?

A

Force Relaxation and Creep

41
Q

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

A

Force Relaxation

42
Q

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

A

Creep

43
Q

Factos affecting biomechanics propteries

A 
age
pregnancy
non-steriodal drugs
steroids
exercise
immobilization
stiffness
viscoelasticity
44
Q

Matrix changes when you immobilize a tendon or ligament?

A
  • decreased water
  • decreased GAGs
  • increased tissue metabolism
  • increased collagen turnover
  • increased immature collagen
  • increased cross linkages
45
Q

What happens when cartilage is immobilized

A
  • adherence to fatty CT
  • atrophy
  • pressure necrosis and cartilage
  • softening of articular cartilage
  • loss of ECM proteoglycans
46
Q

What happens when immobilizing a muscle in lengthened position?

A
  • fibers lengthen
  • more sarcomeres
  • shorter sarcomeres
  • increased actin/myosin
  • lengthened tendon
  • length/tension curves right
47
Q

what happens when you immobilize a muscle in shortened position?

A
  • fibers shorten
  • less sarcomeres
  • longer sarcomeres
  • decreased actin/myosin
  • shortened tendon
  • length tension curves left
48
Q

Types of stretch?

A
  • stretch
  • elastic stretch
  • plastic stretch
  • viscoelastic
49
Q

linear deformation that increases length

A

stretch

50
Q

tissues return to pervious length, short term deformation

A

elastic stretch

51
Q

increased length maintained without sustaining force-permanent deformation

A

plastic stretch

52
Q

substance with bother plastic and elastic stretch

A

viscoelastic

53
Q

Stretching implications

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

Manual Therapy Exam 1 (8 decks)

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