Module 2 ch 10

Question 1

Overstretching, overexertion, or overuse of soft tissue: tends to be less severe than a sprain, occurs from slight trauma or unaccustomed repeated trauma of a minor degree.4 This term is frequently used to refer specifically to some degree of disruption of the musculotendinous unit

Answer 1

Strain

Question 2

Severe 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 a first (mild), second (moderate), or third (severe) degree ______

Answer 2

Sprain

Question 3

Displacement of a part, usually the bony partners in a joint, resulting in loss of the anatomical relationship and leading to soft tissue damage, inflammation, pain, and muscle spasm.

Answer 3

Dislocation

Question 4

An incomplete or partial dislocation of the bony partners in a joint that often involves secondary trauma to surrounding soft tissue.

Answer 4

subluxation

Question 5

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

Answer 5

Muscle/tendon rupture or tear

Question 6

general term that refers to tendon injury affected by mechanical loading

Answer 6

Tendinopathy

Question 7

inflammation of the synovial membrane covering a tendon

Answer 7

tenosynovitis

Question 8

inflammation of a tendon, there may be resulting scarring or calcium deposits

Answer 8

Tendinitis

Question 9

inflammation with thickening of a tendon sheath

Answer 9

tenovaginitis

Question 10

degeneration of the tendon due to repetitive microtrauma

Answer 10

tendinosis

Question 11

Inflammation of a synovial membrane; an excess of normal synovial fluid in a joint or tendon sheath caused by trauma or disease.

Answer 11

Synovitis

Question 12

Bleeding into a joint, usually due to severe trauma

Answer 12

hemarthrosis

Question 13

Ballooning of the wall of a joint capsule or tendon sheath. Ganglia may arise after trauma, and they sometimes occur with rheumatoid arthritis

Answer 13

Ganglion

Question 14

Inflammation of a bursa.

Answer 14

Bursitis

Question 15

Bruising from a direct blow, resulting in capillary rupture, bleeding, edema, and an inflammatory response.

Answer 15

Contusion

Question 16

Repeated, submaximal overload and/or frictional wear to a muscle or tendon resulting in inflammation and pain.

Answer 16

Overuse syndromes, cumulative trauma disorders, and repetitive strain injury

Question 17

Loss of normal function of a tissue or region. The dysfunction may be caused by adaptive shortening of the soft tissues, adhesions, muscle weakness, or any condition resulting in loss of normal mobility.

Answer 17

Dysfunction

Question 18

Mechanical loss of normal joint play in synovial joints; commonly causes loss of function and pain. Precipitating factors may be trauma, immobilization, disuse, aging, or a pathological condition such as rheumatoid arthritis

Answer 18

Joint dysfunction

Question 19

adaptive shortening of skin, fascia, muscle, or a joint capsule that prevents normal mobility or flexibility of that structure

Answer 19

contracture

Question 20

Abnormal adherence of collagen fibers to surrounding structures during immobilization, after trauma, or as a complication of surgery, which restricts normal elasticity and gliding of the structures involved

Answer 20

Adhesion

Question 21

Prolonged contraction of a muscle in response to a painful stimulus. The primary pain-causing lesion may be in nearby or underlying tissue, or it may be a referred pain source. When not referred, the contracting muscle functionally splints the injured tissue against movement. Guarding ceases when the painful stimulus is relieved.

Answer 21

Reflex muscle guarding

Question 22

Prolonged contraction of a muscle in response to the local circulatory and metabolic changes that occur when a muscle is in a continued state of contraction. Pain is a result of the altered circulatory and metabolic environment, so the muscle contraction becomes self-perpetuating regardless of whether the primary lesion that caused the initial guarding is still irritable (Fig. 10.1). Spasm may also be a response of muscle to viral infection, cold, prolonged periods of immobilization, emotional tension, or direct trauma to muscle

Answer 22

Intrinsic muscle spasm

Question 23

A decrease in the strength of muscle contraction. Muscle weakness may be the result of a systemic, chemical, or local lesion of a nerve of the central or peripheral nervous system or the myoneural junction. It may also be the result of a direct insult to the muscle or simply due to inactivity

Answer 23

muscle weakness

Question 24

Increased interstitial pressure in a closed, nonexpanding, myofascial compartment that compromises the function of the blood vessels, muscles, and nerves. It results in ischemia and irreversible muscle loss if there is no intervention.11 Causes include, but are not limited to, fractures, repetitive trauma, crush injuries, skeletal traction, and restrictive clothing, wraps, or casts.

Answer 24

Myofascial compartment syndromes

Question 25

severity of tissue injury

Answer 25

Grade 1 (first degree). Mild pain at the time of injury or within the first 24 hours. Mild swelling, local tenderness, and pain occur when the tissue is stressed.13,14

Grade 2 (second degree). Moderate pain that requires stopping the activity. Stress and palpation of the tissue greatly increase the pain. When the injury is to ligaments, some of the fibers are torn, resulting in some increased joint mobility.13,14

Grade 3 (third degree). Near-complete or complete tear or avulsion of the tissue (tendon or ligament) with severe pain. Stress to the torn tissue is usually painless; palpation may reveal the defect. A torn ligament results in instability of the joint.

Question 26

signs of inflammation develop; they are swelling, redness, heat, pain at rest, and loss of function.16 When testing the range of motion (ROM), movement is painful and the patient usually guards against the motion before completion of the range is possible (Fig. 10.2A). The pain and impaired movement are from the altered chemical state that irritates the nerve endings, increased tissue tension due to edema or joint effusion, and muscle guarding, which is the body’s way of immobilizing a painful area. This stage usually lasts 4 to 6 days unless the insult is perpetuated

Answer 26

Acute

Question 27

the signs of inflammation progressively decrease and eventually are absent. When testing ROM, the patient may experience pain synchronous with encountering tissue resistance at the end of the available ROM (Fig. 10.2B). Pain occurs only when the newly developing tissue is stressed beyond its tolerance or when tight tissue is stressed. Muscles may test weak, and function is limited as a result of the weakened tissue. This stage usually lasts 10 to 17 days (14 to 21 days after the onset of injury) but may last up to 6 weeks in some tissues with limited circulation, such as tendons.

Answer 27

Subacute stage of healing (proliferation, repair, healing)

Question 28

There are no signs of inflammation during the ________ stage . There may be contractures or adhesions that limit range, and there may be muscle weakness limiting normal function. During this stage, connective tissue continues to strengthen and remodel in response to the stresses applied to it.7,23,27,29 A stretch pain may be felt when testing tight structures at the end of their available range (Fig. 10.2C). Function may be limited by muscle weakness, poor endurance, or poor neuromuscular control. This stage may last 6 months to 1 year depending on the tissue involved and amount of tissue damage

Answer 28

chronic stage (maturation/remodeling stage)

Question 29

A state of prolonged inflammation may occur if injured tissue is continually stressed beyond its ability to repair. There are symptoms of increased pain, swelling, and muscle guarding that last more than several hours after activity. There are also increased feelings of stiffness after rest, loss of ROM 24 hours after activity, and progressively greater stiffness of the tissue as long as the irritation persists.

Answer 29

Chronic inflammation

Question 30

This is a state that persists longer than 6 months. It includes pain that cannot be linked to a source of irritation or inflammation resulting in activity limitations and participation restrictions that affect many parameters of function.

Answer 30

Chronic pain syndrome