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NMSK1 - physio 1 > introduction to soft tissue injuries > Flashcards

introduction to soft tissue injuries Flashcards

1
Q

what are examples of radiology images that can be used to see soft tissue injuries?

A

X ray, ultrasound, MRI, CT scan

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2
Q

what processes does the inflammatory phase of healing involve after an acute/ traumatic injury?

A

vasodilatation, exudate of tissue fluids, oedema, stimulation of pain fibres

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3
Q

what does the proliferative phase of injury healing involve?

A

elimination of debris, revascularisation, fibroblast proliferation

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4
Q

what processes does the remodelling phase of soft tissue injury involve?

A

maturation of collagen fibres, contraction of wound .. can continue up to 6 months

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5
Q

what are the main aims of treatment during the inflammatory phase of injury?

A

to minimise pain and loss of function
minimise traumatic exudate
promote rapid acceleration to subsequent phases

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6
Q

what are examples of general factors that can delay healing?

A

Age
protein deficiency
vitamin deficiency
medication - eg NSAID’s
chronic disease

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7
Q

what are examples of local factors which can delay healing?

A

type and size of injury
poor blood supply to the area
infection
continued inflammation
excessive movement too early

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8
Q

what does the elastic limit represent on the stress strain curve?

A

it represents the maximum stress that is possible for the tissue in order for it to return to its original shape once the load is removed

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9
Q

why do bones, ligaments, tendons and cartilages all have different shapes to their stress stain curves?

A

because they are made from different materials - ie some might be more rigid or more elastic than others

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10
Q

what is the stress strain curve?

A

how the structure of the tissue changes in response to increasing stresses

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11
Q

what does the acronym POLICE stand for in acute injury management?

A

P= Protect
OL= Optimal Loading
I= Ice
C= Compression
E=Elevate

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12
Q

what structures do ligaments attach?

A

they attach bone to bone

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13
Q

what is the function of a ligament?

A

they provide passive stability to a joint - can allow movement to take place in certain planes but not others

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14
Q

what are ligaments made of?

A

70-80% collagen
3-5% elastic fibres

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15
Q

how would ligament injuries usually occur?

A

usually a force overload
can be due to trauma or a direct blow

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16
Q

what is a grade 1 ligament sprain?

A

microscopic or minimal tearing of a few fibres

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17
Q

is there loss of structural integrity with a grade 1 ligament sprain?

A

there is little or no loss of structural integrity

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18
Q

what are the signs/symptoms of a grade 1 ligament sprain?

A

little or no swelling
localised tenderness
minimal bruising

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19
Q

what is a grade II or moderate ligament tear?

A

moderate tearing of the ligaments collagenous fibres with some loss of structural integrity

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20
Q

what are the physical signs / symptoms of a grade II moderate ligament sprain?

A

structural weakness
some loss of ROM
more bruising and swelling

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21
Q

what does rehab for a grade II ligament injury normally involve?

A

modified rear and rehab, combined with careful introduction of increasing stress
may take 2-3 months before return to full physical activity
rehab must focus on proprioception
& balance to prevent reoccurrence

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22
Q

what is a grade III severe ligament tear?

A

a complete tear of ligament with loss of structural integrity

23
Q

what are the signs of a grade III ligament tear?

A

altered end feel, abnormal motion
significant bleeding and bruising
may require surgical repair

24
Q

describe the structure of the joint capsule

A

there are 2 layers
there is an outer fibrous later that is strong and flexible but inelastic which is supported by ligaments
then there is an inner synovial layer - where the synovial membrane is located

25
Q

what are the 3 main types of joint injuries?

A
  1. Dislocation
  2. subluxation
  3. Capsular tear
26
Q

Define dislocation

A

the separation of 2 bones where they meet at a joint

27
Q

Define subluxation

A

an incomplete or partial dislocation of a joint

28
Q

what is an example of a joint that are more vulnerable to injuries than others?

A

the shoulder

29
Q

what is a muscle strain / tear?

A

when some or all of the muscle fibres fail to cope with the demands placed upon them

30
Q

what is a contusion/ haematoma involving muscle?

A

bleeding into a muscle due to a direct blow eg kick, contact from sport

31
Q

what is a grade 1 muscle tear?

A

small number of muscle fibres torn, localised pain, no major loss of strength

32
Q

what is a grade II muscle tear?

A

the tearing of a significant number of muscle fibres with associated pain and swelling
note the pain is reproduced by muscle contraction

33
Q

is strength and movement reduced with a grade II muscle tear?

A

yes strength is reduced and movement is limited by pain

34
Q

what is a grade III muscle tear?

A

a complete tear of muscle, often at a musculotendinous junction.. the function is severely impaired

35
Q

what is a musclotendinous junction?

A

the junction in which force is transmitted between a muscle and tendon

36
Q

what are some examples of predisposing factors in the development of muscle strains?

A
  • inadequate warm up
  • insufficient ROM
    -fatigue or overuse of muscle
    -muscle imbalance
    -faulty technique - work, lifting, sport
    -previous injury
37
Q

what are contusions caused by?

A

a direct blow causing trauma and tearing of muscle fibre - can be intramuscular or intermuscular

38
Q

what is a tendon?

A

a strong rope like structure that attaches muscle to bone (note contains type 1 collagen and no elastic fibres)
its role is to transmit load

39
Q

what are tendons surrounded by?

A

all tendons are surrounded by fibroelastic paratenon to facilitate gliding and some tendons are surrounded by a synovial sheath

40
Q

what are 2 examples of tendon injury?

A

1- rupture/ tear- can be partial or complete
2- tendinopathy

41
Q

where does a tendon rupture?

A

occurs at the point of least blood supply eg in the achilles

42
Q

describe the assessment (what’s noted after contraction, stretch and palpation) of a partial tear of a tendon

A

contraction - painful and weak
stretch- painful
palpation- tender to touch

43
Q

describe the assessment (what’s noted after contraction, stretch and palpation) of a complete tear of a tendon?

A

contraction - no contraction, no pain
stretch- potential increase in ROM
palpation - a gap may be noticed

44
Q

what is tendinopathy?

A

an overuse condition/ injury in which the tendon is repeatedly strained and micro tears form

45
Q

what is neovascularisation?

A

the growth of new poor quality blood vessels

46
Q

what are the main aims of tendinopathy rehab treatment /progression?

A
  • to reduce pain
  • to improve strength
  • too build functional strength - ie more functional tasks
  • to increase power by introducing plyometrics
  • to develop stretch- shortening cycle SSC
47
Q

what is the stretch shortening cycle?

A

the process by which muscles undergo massive stretch and then rapid contraction

48
Q

what are examples of tendons in the body that are commonly affected by tendinopathy?

A
  • rotator cuff
    -patellar tendon
    -Achilles tendon
  • gluteal (medius and minimus) muscles
  • adductor longs muscle (muscle of the medial thigh)
49
Q

Describe the assessment (ie upon contraction, stretch and palpation) of tendinopathy

A
  1. CONTRACTION - pain on contraction, also may be weak due to pain of if degenerative tear
  2. STRETCH- often painful and may be limited flexibility due to pain
  3. PALPATION - tender and thickening over specific area of the tendon
50
Q

what is tenosynovitis?

A

some tendons are surrounded by synovial sheaths to reduce friction
tenosynovitis is inflammation of the synovial sheath surrounding the tendon

51
Q

what is an example of tenosynovitis?

A

De Quervain’s tenosynovitis in the wrist

52
Q

what is the plantar fascia?

A

a thick connective tissue that functions to support and protect the underlying vital structures of the foot

53
Q

what is a bursa?

A

they are small fluid filled sacs between bone and tendon
their role is to reduce friction

54
Q

what are DOMS?

A

delayed onset muscle soreness
-sore,aching, painful feeling in muscles after exercise

NMSK1 - physio 1 (36 decks)

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