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NMSKI > Intro to STIs > Flashcards

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
Q

signs of grade I ligament sprain

A

Solid end-feel on stress testing
Little or no swelling
Localised tenderness
Minimal bruising

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25
Q

implications of grade I ligament sprain

A

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.

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26
Q

signs of grade II ligament sprains

A

Significant structural weakness
Some loss of ROM 2 to pain
Solid end-feel to stress testing.
More bruising and swelling.

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27
Q

Implications of Grade II ligament sprain

A

Increased tendency for healed ligaments to stretch out with time leading to functional instability.
Tendency for recurrence

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28
Q

treatment and timeframe of Grade II ligament sprains

A

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

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29
Q

signs of grade III ligament sprain

A

Altered end feel/stress tests/abnormal motion

Significant bleeding +/-bruising

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30
Q

treatment of grade III and possible time frame

A

May require complete or modified immobilisation of the ligament for between 3-6 weeks.
Or may require surgical repair
Prolonged rehabilitation

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31
Q

aims of treatment for ligament sprain

A 
Treat pain/ swelling 
POLICE
Promote healing
Restoration of function
ROM/Strengthening
Prevention of recurrence
Balance/Proprioceptive rehab 
Sports/Activity specific rehan
32
Q

2 layers of joint capsule

A

Outer fibrous layer-strong, flexible but relatively inelastic. Supported by ligaments
Inner synovial layer: synovial membrane

33
Q

POLICE

A

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
Q

injuries of join capsule

A

dislocation

35
Q

dislocation

A

complete dissociation of the articulating surfaces

36
Q

subluxation

A

where the articulating surfaces remain partially in contact with each other.

37
Q

causes of dislocation

A

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
Q

injuries in muscle

A

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
Q

Grade I muscle sprain

A

Small number of muscle fibres
Localised pain
No major loss of strength/Endurance may be reduced

40
Q

grade II muscle sprain

A 
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
Q

Grade III muscle sprain

A

complete tear of muscle, often at musculotendinous junction. Function severely impaired. Greater bleeding with tracking

42
Q

predisposing factors in development of muscle strains

A 
Inadequate warm up before activity, sport
Insufficient ROM
Excessive muscle tightness
Fatigue/Overuse
Muscle imbalance
42
Q

most common muscle injuries

A

contusions

43
Q

common areas of contusions

A

quads, gastracs, hams

44
Q

causes of haematoma

A

direct blow causing trauma and tearing of muscle fibre proportionate to the severity

45
Q

types of haematoma

A

intramuscular and intermuscular

46
Q

signs of haematoma

A

Bleeding within the tissues
Formation of inflammatory exudate
Tissue death/ phagocytosis/ proliferation/healing
Rare complication – myositis ossificans

47
Q

main function of tendon

A

to transmit load

48
Q

all tendons are surrounded by

A

fibroelastic paratenon to facilitate gliding

49
Q

what connective tissue can withstand greater tensile strength tendon or ligament?

A

tendon

50
Q

what are SOME tendons surrounded by

A

synovial sheath

51
Q

tendon injuries

A

rupture - partial or complete

tendinopathy

52
Q

where does tendon rupture occur

A

Occurs at the point of least blood supply

53
Q

examples of tendon rupture

A

Achilles (lower limb)
Supraspinatus (upr limb)
Long Head of Biceps (upr limb)

54
Q

contraction of partial tendon rupture

A

weakness, pain

55
Q

stretch of partial tendon rupture

A

pain

56
Q

palpation of partial tendon tear

A

tender

57
Q

contraction of complete tear of tendon

A 
no contraction (0/5 Oxford)
no pain
58
Q

stretch of complete tendeon tear

A

increase in ROM

no pain

59
Q

palpation of complete tear of tendon rupture

A

gap

60
Q

tendinopathy

A

Overuse condition which can become chronic
Collagen disarray & separation
↑ ground substance
Neovascularisation (↑ poor quality blood vessels)

61
Q

common areas of tendinopathy

A 
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
Q

stages of tendinopathy

A 
underloaded
normal
reactive tendinopathy
tendon disrepair
degenerative tear
63
Q

cause and signs of underloaded tendinopathy

A

cause -Insufficient stress

sign - asymptomatic

64
Q

cause and sign of normal tendinopathy

A

cause - Can cope with normal loading

sign -Asymptomatic

65
Q

cause and sign tendinopathy

A

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
Q

cause and signs of tendon disrepair

A

cause - Changes in quality of tendon

sign -Similar clinical signs +/- changes on US/MRI. Pain may be more persistent

67
Q

cause and sign of degenerative tear

A

cause -Structural failure with partial or full thickness tears
signs -Significant impact on function and strength. Positive signs on examination including significant weakness

68
Q

clinical presentation of tendinopathy

A

localised pain
sharp, dull, chronic ache
pain disappears with warm up, returns after exercise
local tenderness

69
Q

tendinopathy contraction

A

Pain on contraction

May be weak due to pain or if degenerative tear

70
Q

tendinopathy stretch

A

May or may not be painful

May limited flexibility due to pain

71
Q

tendinopathy palpation

A

Tender /thickening over specific area of tendon

72
Q

tenosynovitis

A

inflammation of synovial sheath surrounding a tendon

73
Q

example of tenosynovitis

A

is De Quervain’s tenosynovitis at wrist

73
Q

purpose of MRI/US for tendon injury

A

Can distinguish partial vs complete tear vs tendinopathy

74
Q

bursitis

A

inflammation of bursa

75
Q

bursa

A

small fluid filled sacs between bone and tendon

76
Q

cause of bursitis

A

overuse

direct trauma

NMSKI (38 decks)

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