MSK Conditions Flashcards
What are the key components of the inflammatory stage of healing and how long does this stage last?
Myofiber rupture and necrosis, hematoma, inflammatory cell reaction
Length: 24hr to 3-4 days
What are the key components of the fibroblastic stage of healing and how long does this stage last?
Phagocytosis of necrotic fibres, regeneration of myofibers, capillary ingrowth, formation of scar tissue
Length: 5-14 days
What are the key components of the maturation stage of healing and how long does this stage last?
Maturation of myofibers, contraction and organization of scar tissue, recovery of function
Length: 14-21+ days
Name 2 complications that can occur with muscle contusion
Compartment syndrome and myositis ossificans
What is the MOI for muscle strain?
Eccentric loading or high intensity, explosive activities (usually in biarticular muscles at musculotendinous junction)
Explain the grading for muscle strains
I - microscopic tearing = pain, tightness, no weakness
II - partial, macroscopic tear = pain, structural change (decreased strength)
III - complete tear = weak and painless, may see lump
What are the risk factors for muscle strain?
Prior injury, age, biomechanics factors (poor control, inflexible), unaccustomed activity, training errors
Name the 3 possible condition progressions for pelvic girdle dysfunction.
Cystocele (bladder), rectocele, uterine prolapse
Explain the grading system for ligament sprains.
I - minor rupture = pain, no laxity (few fibres torn)
II - partial rupture = pain, laxity, firm end feel
III - full rupture = gross instability
Name the 3 possible structures affected with a high ankle sprain.
AITFL, PITFL, interosseous (could also # fibula, tear deltoid if evert)
What are the risk factors for Achilles Tendinopathy?
Age, BMI, male, sport, training errors, footwear, pronation, dec. DF, dec. LE strength, tight/weak calf
What is Sever’s disease?
Inflamed calcaneal apophysis (growing, active children)
Name the 2 structures affected in De Quervain’s.
EPB, APL
Name the 2 structures that may be involved in lateral elbow pain. Which is more commonly involved?
ECRB (more common), ECRL and common extensor tendon
What are 3 tests commonly used to diagnose lateral elbow pain?
Resisted D3 extension, Cozen’s test, LTT of wrist extensors
Explain primary impingement vs. secondary impingement
Primary = narrowed subacromial space (older pt) - intrinsic (anatomy, degenerative change) or extrinsic factors (posture, muscle imbalance) Secondary = instability (younger pt) - micro trauma = instability = subluxation of humeral head = impingement
What are the risk factors for patellar tendinopathy?
Male, jumping athletes, jump height, dec. DF, age, BMI
Name 5 structures that can contribute to hypomobility. How?
Muscle - atrophy, weakness
Tendon - dec. tensile strength
Ligament - dec. tensile strength, inc. stiffness and adhesions
Cartilage - dec. synovial fluid, water content
Bone - inc. resorption, dec. bone mass/mineral content
Name 5 contributing factors to hypomobility.
Prolonged immobilization, muscle imbalance, sedentary lifestyle, aging, postural dysfunction, paralysis or tone abnormality
Name the 2 dislocation types.
TUBS - traumatic onset, unidirectional anterior, Bankart lesion, surgery
AMBRI - atraumatic, multidirectional, bilateral shoulder findings, rehab appropriate, rarely requires Inf capsule shift
Name the types of lesions that can occur with dislocation.
Bankart = injury of ant/inf glenoid labrum (bony bankers if # glenoid) Hill-Sachs = compression # of humeral head SLAP = superior labrum lesion ant -> post # dislocation = usually acromion or humeral head
Name 4 possible # complications
Avascular necrosis, muscle weakness, re-#, infection, delayed union, non-union, CRPS
Name the 3 types of hip arthroplasty.
Cemented = inc. stability, better for sedentary with poor bone quality Uncemented = components coated with beads where new bone can grow (better for younger pts) Hybrid = femoral component cemented; acetabular component non-cemented
What are precautions post THR?
No hip flex past 90, no IR, no hip adduction past 0, no active or resisted hip abduction if lateral approach
What are the types of shoulder arthroplasty and their associated precautions/contraindications?
Hemiarthroplasty = humeral replacement
TSA = glenoid + HOH (precautions = immobilization daily for 1 week; nightly for 1 month; sling 4 weeks)
Reverse TSA = ‘ball and socket’ components switched (precautions = flex in scapular plane passively to 90, pure abduction; contraindications = IR for 6 weeks
Name 5 cancer signs and symptoms.
Night pain, night sweats, sudden weight loss/gain, malaise, fatigue
Describe sway back posture.
Head forward, long T-spine kyphosis, flat lumbar spine, PPT with ant translation, hips in extension
Describe flat back posture.
Head forward, straight L-spine, PPT, hips in extension, plumb line post to hip joint, knees in extension
Name the 3 types of scoliosis.
Congenital = vertebral deformities Idiopathic = most common Neuromuscular = 2° to other conditions
What is osteomyelitis?
Inflammatory response due to infection in the bone
What is developmental dysplasia of the hip?
Abnormality in the head of femur or acetabulum shape at birth = not in close contact = subluxation/dislocation
What are the 4 types of talipes equinovarus (club foot)?
Idiopathic - most common, picked up in utero, otherwise healthy
Neurogenic - spina bifida, cerebral palsy
Syndromic - mobius syndrome or arthrogryposis (contracture of at least 2 or more joints)
Postural - feet squished in utero, resolves quickly
What is osteogenesis imperfecta?
Connective tissue disorder - issue converting collagen (bones are brittle) 4 types (I - least severe, most common; II - lethal in perinatal period; III - severe, progressive deformity, short; IV - rare and mild, moderate deformity, can ambulate)
What is Legg Calve-Perthes Disease?
Avascular necrosis of femoral head
Name the 4 common impingement sites associated with TOS?
Superior thoracic outlet, scalene triangle, between clavicle and first rib, between pec minor and thoracic wall
Describe the 3 types of peripheral nerve injuries.
Neuropraxia - compression of nerve = segmental demyelination and transient disruption
Axonotmesis - disruption of axon, myelin sheath still intact, likely crush injury
Neurotmesis - completely severed axon and sheath
What is myasthenia gravis?
Autoimmune attack of ACh receptors at NMJ (signal can’t travel from nerve to muscle)
Describe Charcot Marie Tooth Disease.
Hereditary condition of the PNS = extensive demyelination of motor and sensory nerves of the hands and feet
Name 6 precautions to mobilization.
Neuro signs, dizziness, severe movement loss, hyper mobility, osteoporosis, pregnancy, spondylolithesis, hx of malignancy, diabetes, haemophilia, children
Name 6 contraindications to mobilization.
Malignancy, cauda equine lesions, spinal cord lesions, multiple nerve root involvement, rheumatoid collagen necrosis, #/dislocation, active bone disease, acute inflammation, sign of the buttock, VA disease, CV ligament instability, non mechanical cause
Name 4 types of tumors affecting bone.
Osteosarcoma, synovial sarcoma, malignant tumors, osteoid osteoma (benign bone tumor)
Name 6 types of degenerative joint disease.
Vertebral - lateral stenosis, central stenosis, spondylosis, spondylolysis, spondylolisthesis
Other joints - OA
Name 3 nerves commonly affected by entrapment and where this commonly occurs.
Ulnar nerve - cubital tunnel, Guyon tunnel
Median nerve - in pronator teres, carpal tunnel
Radial nerve - radial tunnel
Name 6 contraindications to stretching
bony block, recent #, acute inflammatory process of joint, sharp or acute joint pain, hematoma or tissue trauma, contracture or soft tissue providing stability to area
