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Pathophysiology 2 > MSK PATHOLOGIES - Contractile Tissues and Orthopaedics > Flashcards

MSK PATHOLOGIES - Contractile Tissues and Orthopaedics Flashcards

1
Q

What is Tendinopathy ?

A

Its pain and Dysfunction associated with any Tendon.

opathy = Disease/ Disorder

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2
Q

Name some Non Modifiable Risk Factors of Tendinopathy.

A

Genetic Factors
Age
Previous Injury
(Diabetes)

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3
Q

Name some modifiable risk factors for Tendinopathy.

A

Overload/Underload/ Changes in Load training.
BMI.
Medication

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4
Q

What are the different types of load ?

A
  1. ) Tensile Load

2. ) Compression Load

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5
Q

What are the 4 stages of Tendopathic Process ?

A
  1. ) ALTERED TENDON CELL POPULATION.
    - An increase number of tenocytes will increase tenocytes metabolism + the number of IMMATURE TENOCYTES, increasing rate of apoptosis(cell death).
  2. ) DISORGANISATION OF COLLAGEN.
    - Higher conc. of immature collagen bundles, reduces TYPE 1 fibres and increase in TYPE III fibres.
  3. ) GROUND SUBSTANCE CHANGES.
    - Chemical Alterations, causing cross fibres between collagen to be broken down making the tendon weaker.
  4. ) NEOVASCULARIZATION.
    - Influx of blood vessels and nerves ingrowing into the tendon.
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6
Q

What causes wearing of the tendon ?

A

Training Load/Error.
Previous Injury.
Muscle weakness.
Biomechanics.

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7
Q

what affects the repair of the tendon ?

A 
Age ( OLDER PEOPLE HEAL SLOWER )
Gender 
Genetics 
Medications
Diabetes
Tendon Structure
Increased BMI
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8
Q

What are some Clinical Signs and Symptoms of Tendinopathy ?

A 
Pain 
Weakness
Decreased Function
Swelling
Tenderness
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9
Q

What are some Physiotherapy Management for Tendinopathy ?

A
  1. ) EDUCATION ( tell patients what and how tendinopathy occur )
  2. ) EXERCISE ( stretching could aggravate their symptoms )
  3. ) LOAD MODIFICATION/MANAGEMENT
  4. ) STRETCHES
  5. ) SHOCKWAVE
  6. ) MAUNUAL THERAPY

OTHERS.

  • Surgery
  • Steroid Injections
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10
Q

Other info.

A
  1. ) Lower limbs make louder noise when teared.
  2. ) The Gluteal is the most common tendinopathy within the age range of 40-60y/o.
  3. ) Level of pain does not indicate severity/ level of damage as different individuals have different pain tolerance.
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11
Q

What are some Common areas affected at the lower limb ?

Tendinopathy

A

Gluteal Tendinopathy
Patella Tendinopathy
Achilles Tendinopathy
Plantar Fasciopathy

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11
Q

What are some Common areas affected at the upper limb ?

Tendinopathy

A 
Rotator Cuff Tendinopathy
Lateral Epicondylalgia ( Tennis Elbow )
Medial Epicondylalgia ( Golfers Elbow )
De Quervains (wrist)
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12
Q

How does Gluteal Tendinopathy occur ?

A

it occurs due to excessive compression and high load at the gluteal medius and minimus.
its more common in women than men.

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13
Q

What are the Prognosis/ cause of Patella Tendinopathy ?

A
  1. ) Its a high Prevalence in JUMPIMNG SPORTS.
  2. ) Chronic Overload of the patella tendon.
  3. ) WEIGHT/ BMI
  4. ) Leg length Difference / foot arches
  5. ) Quadriceps FLEXIBILITY/ STRENGTH.
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14
Q

What are the Prognosis/Cause of Achilles Tendinopathy ?

A
  1. ) common in athletes ( elite runners )
  2. ) Overload / Underload

3.) Biomechanical Factors
( overpronation of the foot // footwear // Training surfaces )

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15
Q

What are the Prognosis/Cause of Plantar Fasciopathy ?

A

Its common between the ages of 45-60y/o.
Risk of PF increases with BMI.

  1. ) Overpronated Foot.
  2. )Reduced Gastrocnemius Length
  3. ) severe Hallux Valgus
    - these all increase chance of PF
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16
Q

What are the Prognosis/Cause of Rotator Cuff Tendinopathy.

A

The Tendon can be compressed / overuse / underused.

These causes Sub-Acromial pain Syndrome ( Impingement )

17
Q

What are the Prognosis/Cause of Lateral Epicondylalgia ( TENNIS ELBOW )

A

Its the most common overuse elbow syndrome involving the EXTENSOR MUSCLES of the FOREARM.
Common between the age of 40-50y/o.

  • smoking/ obesity
  • excessive and repetitive use
    ( increases chance of tennis elbow )
18
Q

What are the Prognosis/Cause of Medial Epicondylalgia ( Golfers Elbow )

A

This occur due to the overuse of the FLEXOR & PRONATORS of the FOREARM.
( Pronator Teres & Flexor Carpi Radialis )

  • Its common between the age of 40-60y/o and female is at higher risk
19
Q

What are the Prognosis/Cause of DeQUERVAINS (wrist)

A

Its the inflammation of of the SYNOVIAL SHEATHS of EPB + APL.
Swelling of the sheaths causes the sheath to thickened therefore adhesion between the tendon and the sheath increases, RESTRICTING NORMAL TENDON MOVEMENT.

  • more common in women (40-50y/o) and new mothers
  • Overuse of the Thumb increases its chance of DeQuervains.
20
Q

What is strain.

A

its when a tendon/muscle tears up and its severity is graded 1-3.

21
Q

Physiotherapy Management for STRAIN.

depends on severity

A
  • POLICE/ PRICE
  • MOBILISATION
  • STRENGTH + LOADING
  • PROPRIOCEPTION
  • ENDURANCE TRAINING
22
Q

What is an Elective Procedure (EP) ?

A

Its a procedure that is planned in advance and does not need to be performed immediately.

23
Q

What is a Trauma Surgery (TS) ?

A

Its a treatment to manage traumatic injuries.

eg.) ORIF/ External Fixation.

24
Q

What is Joint Replacements ?

A

Its an orthopaedic Surgery procedure in which an ARTHRITIC or DYSFUNCTIONAL joint surface is replaced with a PROSTHESIS.

25
Q

What are some common ORTHOPAEDIC procedures ?

A
  1. ) Total Hip Replacement/ Arthoplasity.
  2. ) Total knee replacement
  3. ) Total shoulder Replacement
  4. ) ACL Reconstruction
  5. ) Achilles Repair.
  6. ) ORIF ( Open reduction Internal Fixation )
  7. ) External Fixation
26
Q

What happens during a total hip replacement ?

A
  • Its performed under spinal anaesthetic.
  • Incision is made in the hip to dislocate and cut off the femoral head.
  • Acetabulum is re-shaped so ACETABULAR CUP is placed in the socket.
  • Prosthetic femoral stem is placed on the shaft.
  • Muscles and soft tissue is repaired via INCISION OF THE SKIN (stitched).
27
Q

What Happens during Total Knee replacement ?

A
  • Performed under a spinal anaesthetic.
  • Incision is made at the front of the knee to allow access to the knee joint/knee cap.
  • Distal Femur and Proximal Tibia are cut to fit the prosthetic parts.
28
Q

Common surgery complications

A
  • Post-Op infection.
  • DVT
  • Malfunction of Prosthesis
  • Nerve Injury
  • Pain
  • Increase risk of Tendinopathy.
29
Q

What is the purpose of the Total Shoulder Replacement.

A

The procedure Aims to reduce pain and restore mobility in patients with late stage osteoarthritis or severe shoulder fracture.

30
Q

What are the two types of Total Shoulder Replacement ?

A
  1. ) TRADITIONAL SHOULDER REPLACEMENT.
    - Incision at the GHJ is made so that the subscapularis is accessed.
  2. ) REVERSE SHOULDER REPLACEMENT.
    - Shoulder is accessed anteriorly so that the Humeral cup (prosthesis) is placed at the humerus.
31
Q

What does Autograft mean ?

A

The tissue used for the surgery that is harvested from the patient.

32
Q

Aprx. How long does someone with ACL have to go through Physio Rehab before returning to sport ?

A

9 - 12 Months

  1. ) INITIAL PHASE - Gait education / strengthening
  2. ) EARLY PHASE - ROM / strength
  3. ) MID PHASE - continue to progress strength and ROM, Load is accepted.
  4. ) LATE PHASE - start sport specific drill.
33
Q

What is the treatment available for ACHILLES RUPTURE ?

A
  • SURGERY
    ( Posterior incision is made so ruptured ends of Achilles is stitched together. )
  • TREATMENT
    ( Boots in PF for 8/12 weeks )
34
Q

What is the difference of OPEN REDUCTION and INTERNAL FIXATION.

A

OPEN REDUCTION
The process of resetting the bones into the correct position.

INTERNAL FIXATION
Its the use of Implants to maintain a position allowing the bone to heal.

35
Q

What is EXTERNAL FIXATION ?

A

Its a surgical treatment where the rods are screwed into the bone and exits the body to be attached to a stabilising structure.

36
Q

What are 2 common Spinal surgery ?

A
  1. ) DISCECTOMY / DECOMPRESSION

2. ) SPINAL FUSION

37
Q

Why would someone have Discectomy spinal surgery ?

And what are the possible cause ?

A

Indicated in patients who have NERVE ROOT or SPINAL CORD COMPRESSION.

This may be due to :

  • disc prolapse
  • bony spurs in the Intervertebral foramen
  • Spinal canal Stenosis.
38
Q

What is the difference between DISCECTOMY and DECOMPRESSION.

A

DISCECTOMY
Involves removing disc material that is extruding into the foramen / spinal canal.

DECOMPRESSION
Involves the removal of OSTEOPHYTES / LAMINECTOMY / THICKENED LGT.

39
Q

What happens during SPINAL FUSION ?

A

Surgeon uses screws and rods to fix vertebra in place.

Pathophysiology 2 (10 decks)

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