Med Surg-Quiz 8 Flashcards
Overstretching, overexertion, overuse of soft tissue: tends to be less severe than a sprain, occurs from slight trauma or unaccustomed repeated trauma of a minor degree. This term is frequently used to refer specifically to some degree of disruption of the musculotendinous unit.
Strain
Sever stress, stretch, or tear of soft tissues, such as joint capsule, ligament tendon, or muscle. This term is frequently used to refer specifically to injury of a ligament and is graded as first- (mild), second- (moderate), third- (severe) degree pain.
Sprain
Displacement of a part, usually the boney partners in a joint, resulting in loss of the anatomical relationship and leading to soft tissue damage, inflammation, pain, and muscle spasm.
Dislocation
An incomplete or partial dislocation of the boney partners in a joint that often involves secondary trauma to surrounding soft tissue.
Subluxation
If a rupture or tear is partial, pain is experienced in the region of the breach when the muscle is stretched or when it contracts against resistance. If a rupture or tear is complete, the muscle does not pull against the injury, so stretching or contraction of the muscle does not cause pain.
Tendon rupture/Muscle tear
The general term that refers to chronic tendon patholgy
Tendinopathy
The inflammation of a tendon; there may be resulting scarring or calcium deposits.
Tendinitis
Inflammation of a synovial membrane; an excess of normal synovial fluid in a joint or tendon sheath caused by trauma or disease.
Synovitis
Inflammation of the synovial membrane covering a tendon.
Tenosynovitis
Inflammation with thickening of a tendon sheath.
Tenovaginitis
Degeneration of the tendon due to repetitive microtrauma.
Tendinosis
Bleeding into a joint, usually due to severe trauma.
Hemarthrosis
Ballooning of the wall of a joint capsule or tendon sheath. Ganglia may arise after trauma, and they sometimes occur with rheumatoid arthritis.
Ganglion
Inflammation of a bursa.
Bursitis
Bruising from a direct blow, resulting in capillary rupture, bleeding, edema, and an inflammatory response.
Contusion
protect the integrity of the post-op or damaged tissues. Manage inflammation and pain. Begin PROM exercises as allowed by protocol. Mobilize or immobilize as necessary. Isometric exercise. Gentle manual therapy.
See K/C pg. 319 Box 10.1
*See precautions and contraindications!
ACUTE STAGE- Protection phase
*proliferation beginning- tissues starting to organize, yet still fragile; too much stress can cause re-injury; too little stress can cause unorganized healing of tissues. inflammation and healing have become controlled and mobility is increasing. Will have lack or decreased pain at rest and some pain-free ROM. Focus on correct body mechanics to optimize return to function. Initiate low resistance strengthening activities. See K/C pg. 321 Box 10.2
SUBACUTE STAGE- Moderate protection phase
*RETURN TO FUNCTION stage; full or WFL AROM of affected areas. Return to prior functional activities by gradually increasing strength. Achieve equal strength and flexibility of bilateral extremities, or equal strength and flexibility throughout all of trunk
See K/C pg. 324 Box 10.4
CHRONIC STAGE-Minimal protection phase
Surgical Procedure: invasive. Lengthy incision, extensive disruption of soft tissues to enable surgeon to see the underlying structures.
Open procedures
Surgical Procedure: less invasive. Smaller incisions, multiple incisions, minimal disruption of soft tissues. Surgeon visualizes underlying structures through a scope. Fluid is injected during procedure to allow an enlarged joint space and clear view.
Arthroscopic procedures
after a complete tear or rupture of a muscle. Best to wait 48-72 hours prior to surgery to let inflammation go down and acute symptoms calm down. Will be immobilized in a shortened position.
Muscle repair
Complete tear results in little pain and no movement. Incomplete tear will allow some movement with extreme pain.Best to have done immediately to avoid tendon contraction. Will be immobilized in a shortened position. Heals slowly due to low vascular supply.
Tendon repair
Surgical Procedure: approximating and suturing the torn ligament. Then allowing appropriate WB and ROM.
Ligament repair
Reconstruction: tissue graft taken from a donor site and re-attached to new joint.
Ligament reconstruction
Reconstruction: Reduce capsular laxity. Can be open or arthroscopic procedure.
Capsule reconstruction
Realignment: alters the line of pull for a muscle. Does not always change the action of the muscle unless the tendon is reattached to a new bone. Can be reattached on same bone in a new spot or can be reattached to a different bone. Will be immobilized in a shortened position.
Tendon transfer
cut through muscle
Myotomy
cut through tendon
Tenotomy
cut through fascia
Fasciotomy
removal of the synovium. Occurs with excessive joint inflammation. May have immobilization post-op? Definite need to monitor exercise levels and avoid excessive stress. Will cause a recurrence.
Synovectomy
arthro-scopically remove loose and jagged cartilage
Articular cartilage debridement