Intro to STIs Flashcards

1
Q

Types of injury

A

Traumatic Injury
‘Overuse’ Injury (cumulative ‘load)
Not just Sports Injuries!

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2
Q

Types of Soft Tissue Injury

A

ligament - sprain/tear
Bursa -bursitis
Joint capsule - joint dislocation/subluxation
Muscle - strain/tear, contusion
Tendon - partial/complete rupture, tendinopathy, tensosynovitis

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3
Q

soft tissue injury of synovium

A

synovitis

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4
Q

soft tissue injury of fascia

A

fasciitis

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5
Q

soft tissue injury of menisci

A

menisci tear

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6
Q

fat pad soft tissue injury

A

inflammation

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7
Q

soft tissue injury labrum

A

tear

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8
Q

soft tissue injury of nerve

A

compression, irritation,sensitisation

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9
Q

inflammatory phase of acute/traumatic injury

A

Vasodilation
Plasma proteins/exudate of tissue fluid/ oedema
Stimulation of pain fibres
Cellular response

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10
Q

proliferative phase of acute/traumatic injury

A

Elimination of debris
Revascularisation
Fibroblast proliferation

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10
Q

remodelling phase of acute/traumatic injury

A

Contraction of wound
Maturation of collagen fibres
Continues up to 6 months

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11
Q

aims of treatment of injury in the inflammatory phase

A

Minimise traumatic exudate,
Minimise pain, loss of function,
Promote rapid acceleration to subsequent phases

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12
Q

aims of treatment in the proliferation phase

A

Facilitate removal of debris
Optimise fibroblast production
promote revascularisation

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13
Q

aims of treatment in remodelling phase

A

Ensure mobile and well conditioned scar

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14
Q

general factors that delay healing

A
Age
Protein deficiency
Vitamin deficiency 
Steroids (inhibitory effect)
Colder Temperature
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15
Q

local factors which delay healing

A
Type and size of injury
Poor blood supply to the area
Continued inflammation
Infection
Excessive movement too early
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16
Q

function of ligaments

A

reinforces a joint capsule
attaches bone to bone
provides passive stability to joint - allow movement to take place in certain planes
restrain too much movement

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17
Q

what kind of impulses are sent from the ligaments what is its purpose

A

Proprioceptive impulses are transmitted from the ligament to Central Nervous System (CNS), where muscles are recruited to provide dynamic support

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18
Q

mechanism of injury in ligament injury

A
force beyond its tensile strength is applied due to 
Trauma
Collision
Direct blow
Sport
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19
Q

what characteristics does connective tissue have to have

A

pliable and strong

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20
Q

when longitudinal stress is applied to connective tissue

A

Elongation: straightening out of crimping
Microfailure: e.g. in cumulative overload
Failure (tearing): e.g. macrofailure or clinical strain.

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21
Q

grade I ligament sprain

A

stretching small tear

little to no loss of structural integrity

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22
Q

Grade II ligament sprain

A

moderate but incomplete tear of ligament collagenous fibres

less structural integrity

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23
Q

Grade III ligament sprain

A

complete tear

loss of structural integrity

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24
signs of grade I ligament sprain
Solid end-feel on stress testing Little or no swelling Localised tenderness Minimal bruising
25
implications of grade I ligament sprain
Minimal functional loss Treatment progress guided by pain Return to full activity within 10 days to 2 weeks. Early return to activity/training- some protection may be necessary.
26
signs of grade II ligament sprains
Significant structural weakness Some loss of ROM 2 to pain Solid end-feel to stress testing. More bruising and swelling.
27
Implications of Grade II ligament sprain
Increased tendency for healed ligaments to stretch out with time leading to functional instability. Tendency for recurrence
28
treatment and timeframe of Grade II ligament sprains
modified rest and rehabilitation - careful intro to increasing stress 6-8 weeks may take 2-3 months before full physical activity rehab focus on proprioception/balance toprevent recurrence
29
signs of grade III ligament sprain
Altered end feel/stress tests/abnormal motion | Significant bleeding +/-bruising
30
treatment of grade III and possible time frame
May require complete or modified immobilisation of the ligament for between 3-6 weeks. Or may require surgical repair Prolonged rehabilitation
31
aims of treatment for ligament sprain
``` Treat pain/ swelling POLICE Promote healing Restoration of function ROM/Strengthening Prevention of recurrence Balance/Proprioceptive rehab Sports/Activity specific rehan ```
32
2 layers of joint capsule
Outer fibrous layer-strong, flexible but relatively inelastic. Supported by ligaments Inner synovial layer: synovial membrane
33
POLICE
Protect - prevent further tissue damage, use crutches Optimally Load - load, mobilise and use area as pain is tolerated Ice - apply ice 15-20 mins every 2-3 hours Compress - area with elastic or tubular bandage to reduce swelling Elevate - injured area to reduce swelling
34
injuries of join capsule
dislocation
35
dislocation
complete dissociation of the articulating surfaces
36
subluxation
where the articulating surfaces remain partially in contact with each other.
37
causes of dislocation
Can be caused by a fall, blow or other trauma Some joints more vulnerable than others Results in injury to capsule and associated ligaments
38
injuries in muscle
muscle strain/tear - some or all of the fibres fail to cope w/ demands place on them contusion/haematoma - bleeding a muscle from direct blow
39
Grade I muscle sprain
Small number of muscle fibres Localised pain No major loss of strength/Endurance may be reduced
40
grade II muscle sprain
``` Tear of significant number of fibres with associated pain and swelling. Pain is reproduced by muscle contraction Strength is reduced Movement is limited by pain. Contained bleeding ```
41
Grade III muscle sprain
complete tear of muscle, often at musculotendinous junction. Function severely impaired. Greater bleeding with tracking
42
predisposing factors in development of muscle strains
``` Inadequate warm up before activity, sport Insufficient ROM Excessive muscle tightness Fatigue/Overuse Muscle imbalance ```
42
most common muscle injuries
contusions
43
common areas of contusions
quads, gastracs, hams
44
causes of haematoma
direct blow causing trauma and tearing of muscle fibre proportionate to the severity
45
types of haematoma
intramuscular and intermuscular
46
signs of haematoma
Bleeding within the tissues Formation of inflammatory exudate Tissue death/ phagocytosis/ proliferation/healing Rare complication – myositis ossificans
47
main function of tendon
to transmit load
48
all tendons are surrounded by
fibroelastic paratenon to facilitate gliding
49
what connective tissue can withstand greater tensile strength tendon or ligament?
tendon
50
what are SOME tendons surrounded by
synovial sheath
51
tendon injuries
rupture - partial or complete | tendinopathy
52
where does tendon rupture occur
Occurs at the point of least blood supply
53
examples of tendon rupture
Achilles (lower limb) Supraspinatus (upr limb) Long Head of Biceps (upr limb)
54
contraction of partial tendon rupture
weakness, pain
55
stretch of partial tendon rupture
pain
56
palpation of partial tendon tear
tender
57
contraction of complete tear of tendon
``` no contraction (0/5 Oxford) no pain ```
58
stretch of complete tendeon tear
increase in ROM | no pain
59
palpation of complete tear of tendon rupture
gap
60
tendinopathy
Overuse condition which can become chronic Collagen disarray & separation ↑ ground substance Neovascularisation (↑ poor quality blood vessels)
61
common areas of tendinopathy
``` Rotator cuff Extensor Carpi Radialis Brevis (ERCB) ‘Tennis Elbow’ Patellar tendon (NMSK II) Achilles tendon (NMSK II) Adductor longus Biceps (upper and lower limb-NMSK II Tibialis posterior Gluteal (Med/Min) Muscles (NMSK II) ```
62
stages of tendinopathy
``` underloaded normal reactive tendinopathy tendon disrepair degenerative tear ```
63
cause and signs of underloaded tendinopathy
cause -Insufficient stress | sign - asymptomatic
64
cause and sign of normal tendinopathy
cause - Can cope with normal loading | sign -Asymptomatic
65
cause and sign tendinopathy
cause - Applied load> physiological capability. Has potential to revert back to normal structure applied - pain: constant or activity dependant. Positive signs on clinical examination
66
cause and signs of tendon disrepair
cause - Changes in quality of tendon | sign -Similar clinical signs +/- changes on US/MRI. Pain may be more persistent
67
cause and sign of degenerative tear
cause -Structural failure with partial or full thickness tears signs -Significant impact on function and strength. Positive signs on examination including significant weakness
68
clinical presentation of tendinopathy
localised pain sharp, dull, chronic ache pain disappears with warm up, returns after exercise local tenderness
69
tendinopathy contraction
Pain on contraction | May be weak due to pain or if degenerative tear
70
tendinopathy stretch
May or may not be painful | May limited flexibility due to pain
71
tendinopathy palpation
Tender /thickening over specific area of tendon
72
tenosynovitis
inflammation of synovial sheath surrounding a tendon
73
example of tenosynovitis
is De Quervain’s tenosynovitis at wrist
73
purpose of MRI/US for tendon injury
Can distinguish partial vs complete tear vs tendinopathy
74
bursitis
inflammation of bursa
75
bursa
small fluid filled sacs between bone and tendon
76
cause of bursitis
overuse | direct trauma