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FM1 > Intro > Flashcards

Intro Flashcards

1
Q

Loss cylce

A
  1. Shock
  2. Distress
  3. Disorganization
  4. Acceptance
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2
Q

Shock

A

Physical effects (sleep, numbness, irritable)
poor awareness of physical limitations
Goal: pt safety
Intervention: normalize breathing, decrease tension, pt ed on loss cycle

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3
Q

Distress

A 
Emotional effects (angry, sad, helpless)
Goal: Support and understanding for pt's emotional hurt
Intervention: express feelings into words, pain diary
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4
Q

Disorganization

A

Mental Effects (depression, suicidal, hopeless)
decreased focus and cognitive ability
Goal: assist pt to be active within limits - provide structure
Intervention: set clear limits, engage support systems

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5
Q

Acceptance

A

Integration - ready to learn/maximize recovery
-Positive feelings, lessons learned, future planning
Goal: guide the rehab process

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6
Q

Stress is

A

Stress is a state of disharmony, and is a state of threatened homeostasis

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7
Q

Autonomic NS compensation

A

increased adrenaline production

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8
Q

CNS compensation

A

increased nociceptive representation

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9
Q

Immune system compensation

A

chronic inflammation

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10
Q

Peripheral NS compensation

A

increased number of nociceptors

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11
Q

Wolf’s Law

A

Arrangement of connective tissue structures and specialization of their fibers are directly related to stresses placed on them.
Forms structures of varying densities and functions which include bone, cartilage, blood cells and blood forming tissue, adipose tissue, tendons, ligaments.

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12
Q

What are the regular connective tissues?

A

tendons and ligaments

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13
Q

Regular connective tissue: Tendon

A

Arranged in parallel fibers of collagen
Continuum of muscle
Held together by cross fibers and bound by a layer of loose connective tissues

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14
Q

Regular connective tissue: ligaments

A

Tough, pliant, flexible without resisting movement.
Unyielding
Less regular vs tendons: spiral and oblique arrangement

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15
Q

What is irregular connective tissue?

A

Fascia - dense and loose connective tissue

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16
Q

Composition of fascia

A

Irregular sheaths of collagen and elastin that are continuous with each other.
-include all structures from basement membrane of dermis to periosteum of bone.

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17
Q

Characteristics of fascia

A
  • superficial thinner/delicate to allow for skin movement

- deeper thicker/stronger, separating surrounding structures

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18
Q

Organization of fascia fibers

A

Sheaths and fibers lay at angles to each other: provide greater strength and extensibility/flexibility

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19
Q

Functional joint

A

space between structures created by fascia - a space built for motion

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20
Q

6 Functions of fascia

A
  1. Separate structures
  2. Absorbs shock
  3. Exchange of metabolites
  4. Energy storage
  5. Protect against spread of infection
  6. Allows for normal muscle play
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21
Q

3 Components of Fascia

A
  1. collagen
  2. elastin
  3. reticulin (anchors structures)
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22
Q

Most common/prolific fiber of loose connective tissue

A

Collagen

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23
Q

Tensile strength of collagen

A

High tensile strength

Withstands 50% that of bone

24
Q

Where is collagen found?

A

Tendon, ligament, fascia, and capsules

25
Q

What is needed for efficient production of collagen?

A
  • Vitamin C (hydroxylation of proline)

- Regular stress

26
Q

What can impair collagen production?

A
  • Steroids

- Impaired within distribution of nerve impingements

27
Q

What type of collagen is treated with STM?

A

Type 1 collagen

28
Q

2 elements responsible for formation and health of connective tissues

A
  1. Fibroblasts

2. Ground substance

29
Q

Fibroblasts

A

most prolific of cellular elements, responsible for collagen synthesis

30
Q

Make up of collagen

A

proline + lysine + glysine = tropocollagen
Tropocollagen aligns and forms collagen
-Hydrostatic covalent bond

31
Q

Ground Substance

A

Non-fibrous element of connective tissue matrix

32
Q

Extracellular matrix of ground substance made by

A

fibroblasts

33
Q

Ground substance made of

A
  • Long changes of water and carbohydrates

- Carbs made of GAGs, proteoglycans, and collagen

34
Q

Glycosaminoglycans (GAGs) importance

A
  • important for STM
  • Composed of:
  • -non-sulfated hyaluronic acid (holds water/lubricates and prevents abnormal cross-links)
  • -chondroitin sulfates (determines cohesiveness, viscosity, and rigidity of tissues)
35
Q

Water component of ground substance

A

-Facilitates diffusion of metabolites, electrolytes, and gasses between cells and vascular/lymphatic systems

36
Q

How to keep connective tissues healthy

A

Frequent mobility of tissues to maintain normal lubrication and critical fiber distance

37
Q

Decreased mobility of ground substance related to

A
  • dehydration

- decreases with age, immobility, atrophy, trauma

38
Q

Macrophage

A

phagocytic action on bacteria, foreign bodies, damaged tissues, 2nd most numerous cell

39
Q

Lymphocytes and plasma cells

A

make antibodies

40
Q

Mast Cells

A

release histamine and serotonin - agents in inflammatory changes and heparine - anticoagulant

41
Q

Types of connective tissue

A

1 macrophage
2 lymphocytes and plasma cells
3 mast cells
4 fat cells

42
Q

Intermolecular cross-linking: immobilization

A

30-40% reduction in GAGs in ground substance leading to dehydration

43
Q

Effect of dehydration on critical fiber distance

A

Decreases critical fiber distance and lubrication between fibrous elements increasing resistance to movement

44
Q

Intermolecular cross linking may occur

A

Between fibers of functional intercept points, further limiting extensibility of tissues

45
Q

Body’s response to trauma, infection, or immobilization

A

Increased crosslinks, decreased tissue extensibility

46
Q

Inflammatory stages

A

-Leukocytes and macrophages begin phagocytic action against bacteria

47
Q

Fibrogenesis stage

A

Fibroblasts proliferate and begin this stage, begins process of scar tissue formation and healing

48
Q

No motion in reparative process may produce…

A

Non-neoplastic fibrous tissue that is immobile and restrictive

49
Q

Days 3-21

A

High scar tissue production

50
Q

Weeks 6-8

A

poor tensile strength

51
Q

Week 14

A

poor scar elongation

52
Q

6mo-1yr

A

90-100% of tensile strength returns

53
Q

Possible reasons for pain/injury/inflammation related to soft tissue mobility

A
  • Intermolecular cross linking
  • Scar tissue adhesions
  • Ground substance dehydration
  • Lymphatic stasis
  • Neuroreflexive causes
  • Electrochemical causes
54
Q

Possible causes for improved mobility following STM

A
  • Mechanical: breaking of cross links
  • Mechanical: alteration of scar tissue matrix
  • Viscoelastic: mechanical elongation of collagen tissue
  • Hydration: redistribution of interstitial fluids
  • Stimulation of GAG synthesis, reinstatement of normal lubrication and hydration, neuroreflexive changes, electrochemical changes
55
Q

Precautions and contraindications to STM

A

New scar, fragile skin, active inflammatory response, open wound, malignancy, active infection, obstructive edema, aneurysm, acute RA, osteomyelitis, advanced osteoporosis, advanced diabetes, fibromyalgia during exacerbation, fracture

56
Q

Degenerative cascade

A

Kolby

FM1 (2 decks)

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