Lecture 4 (9-21) Flashcards
1
Q
What is the up down proprioception test called
A
Position test
2
Q
What is the mirror or follow test called
A
Passive motion sense
3
Q
What is kinesthesia
A
Dynamic, passive awareness of movement
4
Q
What does hyporeflexia signify
A
Lower motor neuron lesion
5
Q
What does hyperreflexia signify
A
Upper motor neuron lesion
6
Q
What make are the UMN
A
Brain and spinal cord
7
Q
What make are the LMN
A
Nerves and nerve roots
8
Q
What dermatome is the biceps biased towards
A
C5
9
Q
What dermatome is the brachioradialis biased towards
A
C6
10
Q
What is an athletic build
A
Mesomorphic
11
Q
What is a round or curvy build
A
Endomorphic
12
Q
What is a very skinny low body fat build
A
Ectomorphic
13
Q
What are special tests
A
Regional tests designed to confirm whether or not a specific condition is present
14
Q
True or False:
There are often many special tests per conditition
A
True
15
Q
True or False:
Special tests are not provocative and don’t require the PT to be sensible or judiciou
A
FALSE
16
Q
Are special tests used in conjunction with other examination data
A
Yes’m
17
Q
Are special tests the be all end all of DPT
A
NOOOOO
18
Q
Why is test validity questionable with special tests
A
Skill of examiner and presence of multiple conditions
19
Q
What are the uses of special tests (5)
A
- To confirm a tentative diagnosis
- To make a differential diagnosis
- To differentiate between structures
- To understand unusual signs
- To unravel difficult signs and symptoms
20
Q
What are the 2 types of injury
A
- Primary
2. Secondary
21
Q
What is a primary injury
A
Acute or chronic in nature
22
Q
What are the 2 types of primary injury
A
- Macrotrauma
2. Microtrauma
23
Q
What is a macrotrauma
A
Produces immediate pain and disability
24
Q
What are examples of macrotrauma
A
Fracture, dislocation, sprain, strain, and contusion
25
What is a microtrauma
An overuse injury that results from repetitive loading or incorrect mechanics from normal or abnormal loads
26
What are examples of microtrauma
Tendinitis, tenosynovitis, and bursitis
27
What is a secondary injury
A destructive and self-propogating biological change in cells and tissues that leads to their dysfunction or death over hours to weeks after the initial insult
28
What are the 5 signs of imflammtion
1. Heat
2. Pain
3. Swelling
4. Pain
5. Loss of function
29
What is the latin word for heat
Calor
30
What is the latin word for redness
Rubor
31
What is the latin word for swelling
Tumor
32
What is the latin word for pain
Dolor
33
What is the latin word for loss of function
Functio laesa
34
What causes heat
Increased vascularity to tissues
35
What causes redness
Increased vascularity to tissues
36
What causes swelling
Blockage of lymphatic drainage
37
What causes pain
Pressure or chemical irritation of pain sensitive structure
38
What causes loss of function
Occurs as a result of pain and swelling
39
What are the 3 main phases of healing
1. Imflammatory phase
2. Proliferation phase
3. Maturation phase
40
What is another name for the inflammatory phase
Acute or protective stage
41
What is another name for the proliferation phase
Subacute or controlled motion stage
42
What is another name for the maturation phase
Chronic or return to function stage
43
True or False:
| Without the hemostasis phase you would bleed out
True
44
What are the 3 phases of hemostasis
1. Body goes thru period of vasoconstriction
2. Platelets start to get sticky and form plug
3. Clotting of blood due to fibrin and erythyrocytes
45
When does hemostasis occur
Before inflammation
46
How long does the inflammatory phase last
0-6 days
47
True or False:
| Inflammation is critical to the entire healing process
True
48
True or False:
| Inflammation can only occur in areas with vascularity
True
49
What is the process of inflammation (6)
1. Disposal of injury by product
2. Localized to trauma area - local vascular changes
3. Protective response
4. Sets the stage for repair
5. Disturbed fluid exchange
6. Migration of leukocytes from blood to tissues
50
What is the clinical picture of inflammation (4)
1. Painful movement
2. Patient guarding
3. Increased tissue tension
4. Increased edema
51
How long does the proliferation phase last
3-20 days
52
What is the purpose of the proliferation phase
Cover the wound and impact strength to the injury site
53
True or False:
| The injured site does not have the most amount of collagen
False
54
How much lower can the tensile strength of the tissue be
15%
55
What is the process of proliferation (4)
1. Growth of capillary buds into wound is stimulated by lack or oxygen
2. Increased blood flow to the area delivering nutrients for regeneration
3. Collagen fibers deposit in random fashion scarring the tissues
4. As tensile strength increases and fibroblastic activity decreases
56
What does fibroblastic activity decreasing indicate
The beginning of the maturation phase
57
What is the clinical picture of the proliferation phase (3)
1. Signs and symptoms of inflammation subside
2. Patient may indicate tenderness to touch
3. Patient will typically complain of pain when movement stresses injured tissue
58
How long does the maturation phase last
20 days - 3 years
59
What is the purpose of the maturation phase
Realignment or remodeling of the collagen fibers that make up scar tissue
60
What are the clinical presentations of the maturation phase (4)
1. No signs of inflammation
2. Contractures or adhesions may limit motion
3. Pain felt well after tissue resistance, typically with passive exposure
4. Function is limited
61
What limits function in the maturation phase (3)
1. Weakness
2. Poor endurance
3. Poor neuromuscular control
62
what are the rehab considerations for the maturation phase
Wolff's law and aggressive AROM and strengthening key at the start of this phase
63
What is Wolff's Law
Tissues respond to the demands placed upon them causing remodeling or realignment of fibers along lines of tensile force
64
What are the 12 factors that impact the rate of healing
1. Extent of injury
2. Edema
3. Hemorrhage
4. Poor vascular supply
5. Separation of tissue
6. Muscle spasm
7. Atrophy
8. Corticosteroids
9. Keloids and hypertrophic scars
10. Infection
11. Humidity, climate, oxygen tension
12. Health, age, nutrition
65
What are the types of injury extent
Microtrauma and macrotrauma
66
If you increase pressure what happens to blood flow and secondary injury
Blood flow decreases and secondary injury increases
67
What is hemorrhaging do to
Chemical changes due to increased blood flow that causes cell death
68
What does poor vascular supply do
Leads to cell death because of the lack of nutrients
69
What happens if there is separation of the tissue
It takes a long time to heal
70
What does muscle spasms cause
The patient to be in the inflammatory stage longer
71
How many corticosteroid shots can be administered per year
3
72
Why only 3 corticosteroid shots per year
It reduces tensile strength of the tendon causing ruptures
73
What does infection cause
Slow healing
74
What scab color is good
Brown
75
What scab color is bad
Black
76
What is chronic inflammation
Acute inflammatory response does not sufficiently eliminate the injury agent and restore tissue to its normal state
77
What does chronic inflammation cause (4)
1. Damage to connective tissue
2. Tissue necrosis and fibrosis
3. Appears to be related to microtrauma
4. Resistant to physical and pharmocological treatment
78
What is pain
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
79
What do we know about pain (6)
1. Subjective
2. Past experience impacts perception of pain
3. Warning mechanism
4. Protects against injury
5. Prevents further injury
6. Can persist long after it is no longer useful
80
What are the types of pain (5)
1. Acute
2. Chronic
3. Referred
4. Radiating
5. Deep somatic
81
What is acute pain
Experienced after injury has taken place and tissue damage is occurring
82
What is chronic pain
Pain lasting longer than 6 months
83
What is referred pain
Pain perceived to be in an area that has little relation to the pathology
84
Why can referred pain be long lasting (4)
1. Altered reflex patterns
2. Continued mechanical stress on muscles
3. Learned habits of guarding
4. Development of trigger points
85
What is radiating pain
Caused irritation of nerves and nerve roots
86
What is deep somatic pain
Pain emanating from a sclerotome
87
True or False:
| There is often a discrepancy between the site of the pain and the location of pathology with deep somatic pain
True
