Exam II Flashcards
how would you describe a grade 1 tissue injury?
mild pain, swelling, tenderness with stress
how would you describe a grade 2 tissue injury?
mdoerate pain, activity must stop, stress and palpation increases pain, torn fibers, increased mobility
how would you describe a grade 3 tissue injury?
near or complete avulsion, stress is painless, marked joint instability
when muscle tissue is healing, how do collagen fibers mature?
according to the stress placed on it
what are 4 types of injuries that can result in nerve damage?
(1) contusions
(2) inflammation
(3) crushing / compression
(4) severing
when can a nerve cell not regenerate?
after the nerve cell dies
how long does it take for nerves to heal?
depends on how close the injury is to the cell body
how long does the acute (inflammatory) stage of healing last?
4-6 days
what are the goals for the acute phase of healing? (2)
(1) control pain, edema, and spasm
(2) maintain joint integrity / mobility
what treatment can be provided to a patient in the acute phase of healing? (4)
(1) PRICE
(2) pain free passive ROM
(3) active movement of associated areas
(4) grade I and II mobs; soft tissue
what are precautions in the acute phase of healing? (2)
(1) increased pain
(2) increased inflammation
what are contraindications in the acute phase of healing?
(1) no active ROM
(2) no stretching
(3) no resistance exercise
how long does the subacute (proliferation) stage of healing last?
up to 6 weeks
what is the main difference observed between the acute and subacute phases of healing?
the injury is starting to improve in subacute; increased fibroblastic activity with decreased inflammation
what are the goals for the subacute phase of healing? (3)
(1) promote healing
(2) restore joint / soft tissue mobility
(3) progressively strengthen
what treatment can be provided to a patient in the subacute phase of healing? (4)
(1) transition to AROM
(2) watch for signs of inflammation and decreased ROM
(3) grade I and II mobs
(4) no eccentrics early in this phase
how is the subacute phase of healing managed?
carefully balancing an appropriate amount of stress to facilitate healing but not over stressing to cause a regression
how long does connective tissue respond well to remodeling stress?
8-10 weeks
what are the goals for the chronic phase of healing? (4)
(1) decrease pain from stress on contractures / adhesions
(2) increase muscle strength
(3) increase mobility
(4) progress functional independence
how long can chronic management last?
12-18 months
what is osteoporosis?
a systematic skeletal disorder characterized by decreased bone strength than increases a person’s risk of fracture
what is osteopenia?
low bone mass (start of osteoporosis)
how long are bones immobilized after a fracture?
few as 3 weeks for small bones; 8 weeks for larger bones
how long does osteoblastic and osteoclastic activity last after a bone has been fractured?
up to 2-3 years
what can be said about the healing of cartilage?
(1) healing is limited and variable
(2) healing depends upon severity and involvement of subchondral bone
what are the reps for holten’s curve?
50% - 31+ reps 60% - 25-30 reps 75% - 15-20 reps 80% - 8-12 reps 90% - 4-6 reps
what are you targeting for different ranges in holten’s curve?
50% - vascularity, tissue healing, mobilization 60% - coordination / endurance 75% - strength / endurance 80% - strength 90% - strength / power
what are 3 ways stress can be manipulated?
(1) intensity
(2) time
(3) direction
what does stress that is less than maintenance result in? what about stress applied greater than maintenance?
(1) less than maintenance = atrophy (decreased tolerance)
(2) at maintenance = no change
(3) more than maintenance = hypertrophy (increased tolerance)
what can excess stress to tissues lead to?
tissue injury, or tissue death with extremely excessive stress
what are 4 factors that affect physical stress and adaptations of tissues?
(1) movement / alignment
(2) extrinsic
(3) psychosocial
(4) physiological
what muscle is considered the agonist muscle when using PNF stretching?
the muscle opposite of the range limiting muscle
what muscle is considered the antagonist muscle when using PNF stretching?
the range limiting muscle
what is the SAID principle?
specific adaptation to imposed demands
how much mobility does the median nerve have?
10mm
how much mobility does the ulnar nerve have?
8mm
how much does a nerve regenerate per day?
1mm
what is convergence?
when tension is placed on a nerve bed; nerve gliding is towards the moving joint
what is divergence?
when tension is relieved; nerve gliding is away from the moving joint
how do you maximally stretch the median nerve?
-shoulder girdle depression
-shoulder abduction
-elbow extension
-shoulder external rotation
-supination of the forearm
-wrist, finger, and thumb extension
-contralateral cervical
side flexion
how do you maximally stretch the radial nerve?
-shoulder girdle depression
-shoulder abduction
-elbow extension
-shoulder internal rotation
-pronation of forearm
-wrist, finger, and thumb flexion
-wrist ulnar deviation
-contralateral cervical
side flexion
how do you maximally stretch the ulnar nerve?
-shoulder girdle depression
-shoulder abduction
-shoulder external rotation
-elbow flexion
-supination of forearm
-wrist extension
-contralateral cervical
side flexion
