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CATA 263 > lecture 6: injury classification > Flashcards

lecture 6: injury classification Flashcards

1
Q

explain macrotrauma and give exmples

A

large maginited

ex: sprains, strains, contusions

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2
Q

explain microtrauma and examples

A

small magnitutde

ex: stress fractures, overuse injuries

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3
Q

what are the forms of muscuoloskeletal trauma

A

physical, chemical, thermal, metabolic and biological

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4
Q

what are the 5 directions of force

A 
Tensile
Compression
Shear
Torsion
Bending (combination)
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5
Q

what are the2 types of dirextion of force that are longitudinal

and give example

A

tensile and compression

muscle elong.

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6
Q

true or false: direction of focre only applied ot bone

A

false, bone,l igs, capsules and msucles

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7
Q

be able to explain the different forces

A

.

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8
Q

what are the 3 responses to force

A

1) elstic response
2) yield load
3) failiurre

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9
Q

explain elastic repsonse

A

period of time where normal structire function

Load is removed and tissue goes back to original shape

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10
Q

explain yield load

A

max amount of load before deformation occurs

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11
Q

explain failure

A

Does not return to normal shape

Fractures, strains, sprains

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12
Q

in what region do injuries happen

A

failure/plastic region

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13
Q

turue or false : the deformation in the elastic region is tolerable

A

true

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14
Q

whats the general response to force

A

elongation (strecth/deformation) >miccrotauma > failure/macro

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15
Q

what is stress

A

Force divided by the area over which the force acts

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16
Q

true or false and explain: Force over a large area versus over a small concentrated area can have very different results

A

ex: Increased SA= decraed foce

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17
Q

what is the accpetable strain tolerance

A

Load before failing
Deformation before failing
Energy stored before failing

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18
Q

in terms of stiffness of tissue, a steeper slope mean

A

greatter stifness

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19
Q

if a tissue has a greater stiffness, it has more or less deformation

A

less

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20
Q

know the straing and stress grpah

A

.

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21
Q

deformation that is accetepable occurs in what region

A

elastaic

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22
Q

what affects the load distrubion ,force absorption and stabilityo of a joint

A

joint types

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23
Q

what are the fibrous joints

A

Fibrous joints: synarthrosis, sutures, syndesmoses and gomphosis joints

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24
Q

what are the cartilaginous joints

A

Cartilaginous joints: synchondrosis & symphyses

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25
Q

what are the sunovial joints

A

Synovial joints: plane, hinge, pivot, condyloid, saddle & ball-and-socket.

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26
Q

Synovial joints incl. what structures

A

articular cartilage, synovial cavity, articular capsule, synovial fluid and ligaments.

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27
Q

what tis the function of connective tissue

A

joins strtuctures toghther

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28
Q

connecttve tissue can be …

A

dense or loss

and regular vs irrengular

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29
Q

what are the 3 main componenets of connectiev tissue

A

collagen, elasttin, reticulum

=and ground substance

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30
Q

whatt is the function of collagen

A

give stregnth to tissue

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31
Q

what is the most numerous protein in the body

A

collagen

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32
Q

whatt makes up 95% of bones sexttracellular matrix

A

collagen

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33
Q

what did collagen develep from

A

fibroblasts

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34
Q

collagen forms what and why is that imporant

A

crosslinks and it increases soliditty

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35
Q

what is elastic

A

has a stretch property,

ability to retturn to origional shape

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36
Q

where is elastin scarce

A

tendon and ligaments

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37
Q

why can tendons and ligamentts only be strecthed limited amounts

A

because scarce amount of elastin

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38
Q

what is ground substance

A

Protein chains that give substance to structure
Provide cement like foundation (provide strength for collagen)
Hold water

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39
Q

what is the cause of injuries in terms of proteins

A

collagen and elastin becaome distubed

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40
Q

what is the cause of injury

A

event altering the tissue structure

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41
Q

what does injury affect

A

the ability of tissues to carry out normal function/ load

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42
Q

why do we care about cause of injury

A

1) helps with injury prevention again
2) helps with injury rehab

= allows to assess in a more specific mannerr

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43
Q

what are the closed soft tissue injuries of muscle/

A

strains
tendinopathy
contusions

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44
Q

what are the closed soft tissue injuries of joints

A

Sprains
Dislocations/subluxations
Articular cartilage damage
Bursitis

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45
Q

what is the main 2 symptoms of closed soft tissue injuries

A

sweeling and discolouratiton

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46
Q

true or fasle: in a closed soft tissue injury there is leakage

A

false, swelling is all contained

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47
Q

what is tthe cause of contusion

A

Direct compressive force created by external blow

or falling

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48
Q

what is an ecchymosis

A

Ecchymosis- tissue discoloration if hemorrhage is superficial

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49
Q

what is hematoma

A

Hematoma- swelling of clotted blood

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50
Q

what are some expamples of complicates of contunsions

A

Complications of contusions can be acute compartment syndrome, active bleeding and large hematomas

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51
Q

wgat is acute compartmentt syndrome

A

if fluid gets in comparment and sweels it can compress on nerves, veins ettc and cause problems

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52
Q

explain first degree cnotusions

A

superficial strecutures crushed
mild weaknes and loss of function
no restriction in ROM

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53
Q

explain second deree contusions

A

superficial and some deep are crushed
mild weakness and mod loss of function
decreased ROM

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54
Q

explain third degree contusions

A

deeoer tissues are crushed (fasicia can be raptured and swollen tissues protrude)
mod to severe weakness nd loss of function
ROM is significantly decreased because of swelling

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55
Q

what are muscle strains

A

Injuries to the muscle that cause varying degrees of tears to a muscle

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56
Q

ttrue or false: grading if very different for diff structures that are injuried

A

trtue

57
Q

what is the typical cause of muscle strain

A

Typically caused by a stretch induced by a large contraction
Eccentric contractions**

ex: decceleration

58
Q

what are some signs and symptoms of muscle strain

A

Acute MOI- overstretch or overload
Pain located over injury site (commonly musculotendinous junction)
Discolorations (severe cases)
Muscle weakness and/or ROM limitations

59
Q

explain first degree strain

A 
few fibers are ttorn and there is mild weakness, loss of function, swelling
=no  pap. defect
=mild contrtction pain
=pain with strtecth 
decrased ROM
60
Q

exlain 2nd degree strain of muscle

A 
nearly half fibers are torn and there is mod to sevsere weakness, loss of function, swelling
=no  pap. defect
=mod-severe contrtction pain
=pain with strtecth 
decrased ROM
61
Q

explain 3rd degree strains of muscle

A 
all muscle fibers torn (ruptture) and there is mod to sevsere weakness, loss of function, swelling
=yes pap. defect
=none to mild contract. pain
=no  pain with sttretcth  
decrased/increase ROM
62
Q

true or false: in a muscle strain 3rd degree there is pain with strtecthing

A

false, no ligaments left to stretcth

63
Q

what is the cause of ligament sprains

A

Acute traumatic injuries to ligaments
Placed in extreme ROM in which ligament supports
(extreme force on log at ROM or combined force directions)

64
Q

signs and symptoms of ligament sprains

A

Discomfort over ligament (point tenderness)
Swelling
Loss of function
Increased laxity (no passive stability)
Pain with stretching
Muscle weakness (usually pain/apprehension)
No contraction pain*** theory no, real life yes!

65
Q

explain why in lgament sprains there should technically be no contraction pain

A

because no affecting muscles just ligamnets (so only passive should hurt)

66
Q

treu or false: ligamentts will tear before joint stability is compormised

A

true

67
Q

does pain dictate grade

A

no

68
Q

explain first degree sprain

A

check slides

69
Q

what is discolation and what are tthe 2 types

A

Bones are forced beyond normal limits

Partial or incomplete dislocation is called a subluxation

70
Q

true or false: subluxation is a complete dislocation

A

falsse, that is subluxation

71
Q

what is discolation/sub usually assocaitted with

A

Associated with damage to surrounding ligaments and capsules, as well as possible muscle-tendon units

72
Q

what is bursitis

A

irritation to bursa

73
Q

true or false and explain: bursitis can be both acutte and chronic

A

true

it can be from single traumatic compression or repeated compressions

74
Q

what ar the signs and symptoms of bursitis

A 
Localized swelling (obvious in olecranon, prepatellar)
Point tender
Warm to touch
75
Q

which type of bursitis causes warm to tocu h

A

acutet

chronic is not warm

76
Q

what is tendinopathy

A

common term for tendon pattholgy

77
Q

what is tendinitis

A

Tendons lack good blood supply, many have lack of direct inflammatory response (tendinitis)

78
Q

what causes tendinosis

A

degenative changes in the tendon

79
Q

how can you confirm either tendinitus/tendinosis

A

both need to be confirmed witth histopatthological examinaiton

80
Q

how can you go from tendinitus to tendinosus

A

through degenerative changes

aftter time and consttant imflamtion

81
Q

what are the signs and symtpoms of tendiopathy

A

Chronic onset- MOI overuse or by repetitive overstretching or overload
Pain, swelling
Crepitus
Pain at extremes of motions (passive and active)
Pain increases during stretching and RROM
Strength decreases with pain

82
Q

whatt is tenosynovitis and where is it common

A

Inflammation of the synovial sheath surrounding a tendon

Common in hands and feet

83
Q

explain acute tenosynovitis

A

Acute- grating sound (crepitus) with movement, inflammation and swelling

84
Q

explain chronic ttenosynovitus

A

Chronic- nodule formation in the tendon sheath

85
Q

what can long term tendinopathy lead to

A

Long term tendinopathy can lead to accumulation of mineral deposits in the bone (myositis ossificans)

86
Q

what are the 4 sttages of overuse injuries

A

Stage 1: pain after activity only

Stage 2: pain during activity that does not restrict performance

Stage 3: pain during activity that restricts performance

Stage 4: chronic, unremitting pain even at rest

87
Q

at what stage do athletets usually come see hte doctor

A

stage 3

88
Q

whatt are the two factors of overuse injuries

A

intrinsic and extrinsic

89
Q

explain the intrinsic factors causing overuse injures

A 
Malalignment of limbs
Muscle imbalances (weaknesses, tightness)
90
Q

explain the extrinsic factors causing overuse injures

A

Training errors- to fast to soon
Faulty technique
Incorrect surfaces and equipment
Poor environmental conditions

91
Q

what is osteoarthritis

A

Degeneration of articular cartilage in a joint

92
Q

whatt is osteoarthritis caused by

A

Caused by a combination of factors

Stresses obtained during physical activity, joint trauma, aging process

93
Q

what are teh signs and symtoms in osteoarthrisu

A

pain

limited movement

94
Q

where is osteoartthritis common

A

knees

95
Q

wha tis msucle cramps

A

Painful involuntary contractions of muscles

96
Q

what are the 2 types of muscle cramps and explain

A

Clonic- alternating contraction and relaxation

Tonic- continued contraction

97
Q

which type of muscle cramp is pumping

A

clonic

98
Q

which type of muscle type is contatnt

A

totnic

99
Q

true or fa;se Muscle cramps are usually exercis induced

A

yes

100
Q

whatt are the exact causes of muscle crramps

A

Exact causes unknown
Biochemical imbalances
Neuromuscular fatigue

101
Q

what are the 2 injury types

A

primary and secondary

102
Q

explain primary injuries

A

Caused by a particular event

External causes vs internal causes

103
Q

explain secondary injury

A

Caused by complications after the primary injury occurs
Hypoxia and ischemia
(accumulation of calcium)

104
Q

whatt are the 3 phases of soft tissue healing

A

inflamatory
proliferation
matturation

105
Q

in general, how long is the soft tissue healing

A

3 days -1 year

106
Q

how long is the inflam period

A

0-6 days

107
Q

when is inflammatory greates f

A

firstt 24-72 hours

108
Q

is inflammatory response good or bad

A

good for healing but needs to be controlled (use compression, evelattion, movementt)

109
Q

what is common to see in inflammatory phase

A

Rubor (redness), calor (local heat), tumor (swelling), dolor (pain) and function laesa (loss of function)

SHARP

110
Q

what is the first goal in inflammatory phase

A

stop blood loss to the wound

111
Q

explain part 1 of stopping blood in inflmattory phase

A 
Local vasoconstriction (few seconds-10 minutes)
Large vessels constrict from signals from neurotransmitters

reduction of blood volume = increased blood viscosity/ resistance to the flow (further reducing loss of blood at site)
=first clot

Platelet reaction then promotes clotting as cells combine together with fibrin to form a mechanical plug
=second clott

112
Q

what comes firstt vasoconsttriction or dilation

A

vasodilation

113
Q

what is vasodilation due to

A

histamine and bradykinin (neurotransmitters)

114
Q

why are proteins activiated in inflmatory phase

A

to promote a variety of activities essential for healing

ex: phagocytosis

115
Q

explain phagocytosis

A

Phagocytosis- attraction of macrophages and neutrophils

116
Q

what does the release of chemical mediators cause

A

Increase blood vessel wall permeability
Promotes vasodilation
Pain!

117
Q

explain vascular events

A

Vascular- first a quite vasoconstriction followed by a vasodilation. Increase pressure in the capillaries causes fluid to move into the tissue and produce swelling, pain and impaired function

118
Q

explain cellular events

A

Cellular- mast cells released which mobilize leukocytes (neutrophils and monocytes). Neutrophils first line of defense, can cause damage to healthy tissue

119
Q

what is the duratiton of the proliferative pahse

A

fays 3-21

120
Q

what is the prolif. phase

A

repair and regen of the injured tissue

121
Q

during the proliferattive phase, what is tthere tthe develipment of

A

new blood vessels
fibrous tissue formation
generation of new epithetical tissue
wound contractions/scarring

122
Q

in prolif phase, what do fibroblats synthesize

A

new type III collagen fibesr

123
Q

true or false: in thte prolif phase we get new vessel formation

A

ttrue

angiogenesis

124
Q

how long can thte maturation phase be

A

up to 1 year

125
Q

what is scar tissue

A

Scar tissue is fibrous, inelastic and nonvascular- less strong and less functional than original tissue

126
Q

new scar tissue has more or less flexibility

A

less and decreased size of involved tissues

127
Q

what is execssive scar tissue called

A

keloid tissue

128
Q

during the maturattion phase, what does type 3 collagem become

A

type 1= it is stronger

129
Q

whatt happens to the fibers in the matturation phase

A

alighment of fibers along muscle fibers to regain mobility and strength

130
Q

how long can tensile strtength take to increase

A

up ot 2 uyears postt injurt

131
Q

Bad rehabilitation that doesn’t reorient collagen fibers could lead to what

A

permanent decrease of 30% compared to pre-injury strength.

132
Q

true or false: ,muscle fibres can reproduce

A

false, do no t

=thats why we need to prvent necrosis

133
Q

what do ligaments and tendons need to have for a chance of healing

A

they need to be in very close proximity. If a ligament is isolated (ex: ACL), it has a poor chance of healing conservatively.

134
Q

what does tissue immbolization cause

A

leads to atrophy, loss of strength and decreased healing of the tissues. ↑Immobilization time = ↑atrophy

135
Q

explain immolixation vs atrphy

A

if you are immbolized longer than you will increase atrphy which delays rehab

try to stay moving asap after injury when possibble
(frcature must be immoblized longer)

136
Q

which heals the slowest, soft tissue, bone or nerve injuries

A

nerve injries

137
Q

what is the healing rate of nerve injuries

A

rate <1mm per day or 2.5mm per month

138
Q

most common nerve injuries are what tyoe of injuries

A

tension and compression injuries

or severed

CATA 263 (17 decks)

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