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Pathophysiology 2 > MSK PATHOLOGIES - Inert Structures and Neurological (msk) conditions > Flashcards

MSK PATHOLOGIES - Inert Structures and Neurological (msk) conditions Flashcards

1
Q

Name 7 INERT STRUCTURE PATHOLOGY ?

A
  • Femoral Acetabular Impingement (FAI)
  • Ligament Injuries (Sprain)
  • Frozen shoulder (adhesive capsulitis)
  • Osteoarthritis (OA)
  • Meniscal Issues
  • Patellofemoral Pain Syndrome (PFPS)
  • Shoulder Instability
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2
Q

What is Femoral Acetabular Impingement (FAI) ?

A

Its a pathological mechanical process by which morphological abnormalities of the acetabulum / femur combined with vigorous hip motion can damage the soft tissue structures within the hip.

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3
Q

What are the 3 different types of Femoral acetabular Impingement ?

A
  1. ) CAM IMPINGEMENT
    • The affected part is the femoral neck (below head)
  2. ) PINCER IMPINGEMENT
    • Affected side is the outside of the Acetabulum
  3. ) COMBINED/MIXER
    • both cam + pincer
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4
Q

What are some possible cause of FAI ?

A
  • CAM morphology is more common in MEN
  • Repeated stress of supraphysiological Hip Rotation + Flexion (childhood/hockey)
  • SURGICAL OVER CORRECTION
  • History of childhood Hip Disease, followed by a femoral neck fracture.
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5
Q

What is a Ligament Injury (Sprain) ?

and what is the ligament function ?

A

Its an Injury to the band of Collagen Fibres.

- the function id to provide stability of the joint.

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6
Q

What causes a Ligament Injury ?

A

This occur when a joint is being forced suddenly outside its usual range of movement and the inelastic fibres are stretched through too great a range.

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7
Q

What are the classification of SPRAINS ?

and what are some of it signs and symptoms ?

A

GRADE I (overstretch w/ micro tears)

  • No visible bruising
  • Localised Pain
  • Minimal Loss of function / muscle strength / ROM
  • No ligament Laxity

GRADE II ( partial tear / immediate onset of Inflammatory signs )

  • Bruising
  • Poorly localised pain
  • Impairment of function / muscle strength / Painful ROM
  • Unstable joint due to Ligament

GRADE III ( complete rupture / later symptoms may be less than Grade II )

  • Immediate acute pain / often w/ audible pop & crack
  • Cardinal signs
  • Inability to contract muscle ( separation may be evident )
  • Unstable Joint
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8
Q

What are some non modifiable cause of ligament injuries ?

A
  • INTRINSIC JOINT ANATOMY
  • SEX & HORMONES
  • JOINT LAXITY
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9
Q

What are some Modifiable cause of ligament injuries ?

A
  • NEUROMUSCULAR CONTROL ( strength proprioception )

- ENVIRONMENT ( sport specific / fatigue resistance )

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10
Q

What is Frozen Shoulder (adhesive capsulitis) ?

A

Its an Inflammatory condition that causes FIBROSIS of Glenoid Humeral capsule with progressive stiffness and ROM restriction. ( External Rotation )

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11
Q

Who is more likely to get frozen shoulder ?

A
  • Common in women (70%)
  • Age 35 - 65
  • Diabetic population
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12
Q

What are the different phases of Frozen Shoulder ?

A

1.) ACUTE / FREEZING / PAINFUL PHASE = (PAINFUL/FREEZING)
- Gradual onset of shoulder pain at rest with sharp pain at extremes of motion
( lasting 2 - 9 months )

2.) ADHESIVE / FROZEN / STIFFENING PHASE = (DECREASED ROM)
- Pain starts to subside, progressive loss of GH motion in capsular pattern.
Pain is only apparent only at extremes of movement ( 4 - 12 months )

  1. ) RESOLUTION / THAWING PHASE = (RESOLUTION)
    - Progressive Improvement in Functional ROM ( 5 - 24 months )
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13
Q

What is Osteoarthritis (OA) ?

A

Its the most common chronic condition of the joints whereby the articular cartilage degenerates w/ fibrillation, fissures and full thickness loss of the joint surface.

  • It only affects the cartilage but involves the entire joint
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14
Q

Name some OA risk factors.

A
  • AGE
  • FEMALE
  • OBESITY
  • ANATOMICAL FACTORS
  • MUSCLE WEAKNESS
  • JOINT INJURY
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15
Q

What are some OA signs and symptoms ?

A
  • PAIN (weight bearing activities)
  • REDUCED ROM/AROM/PROM
  • SLIGHT SWELLING OVER THE JOINT
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16
Q

How can you manage OA

A
  • Education & Self management
  • (non) / Pharmacological Management
  • Referral for Joint Surgery
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17
Q

What is the cause of a Meniscal tear / issues ?

A

Its due to an excessive force applied to a normal meniscus
(normal force acting on a degenerative meniscus)

  • twisting motion during a semi-flexed limb
  • associated with Ligament Injuries
18
Q

What are some Signs and symptoms of a Meniscal Tear / Issue ?

A
  • Pain in the knee joint
  • Swelling / Catching / Locking of the knee
  • Inability to fully EXTEND / BEND the knee
  • Difficulty with Weight Bearing
19
Q

What are the 2 different kinds of Meniscal tears ?

A
  1. ) ACUTE TEARS
    • Due to trauma / sports injury ( different types )
  2. ) DEGENERATIVE TEARS
    • often occur in elderly people, often after a minimal trauma on the knee
20
Q

Name the different kinds of meniscal tears.

A
  • LONGITUDINAL TEAR
  • HORIZONTAL TEAR
  • RADIAL TEAR
  • BUCKET HANDLE TEAR
  • FLAP TEAR
  • DEGENERATIVE TEAR
21
Q

What is Patellofemoral Pain Syndrome (PFPS) ?

A

Its an umbrella term used for pain arising the Patellofemoral Joint.
- This can be a chronic condition.

22
Q

What are some causes of Patellofemoral pain Syndrome ?

A
  • Overuse / Overload of PF joint
  • Anatomical / Biomechanical Abnormalities
  • Patella Orientation and alignment
  • Muscular weakness
23
Q

What are some risk factor that can cause Patellofemoral pain Syndrome ?

A
  • KNEE HYPEREXTENSION
  • Valgus + Vera knee
  • Tightness in the ITB / HAMSTRING / GASTROCNEMIUS
  • Pronation and Supination can provoke PFPS
  • Increased Q-Angle
24
Q

How do you manage Patellofemoral Pain Syndrome ?

A
  • Education
  • Open + Closed Chain Exercise
  • Quads / Ham / Glutes / Calf strengthening
  • Manual Therapy
  • Patellar Taping
25
Q

What is Shoulder Instability ?

A

Its when the labrum and / or the ligament stretch or tear, the shoulder has a greater tendency to dislocate.

26
Q

What are the different types of Shoulder Dislocation ?

A

1.) BANKHART LESIONS
- Due to the amount of force, labrum is torn from the bone resulting in unstable
shoulder. ( require surgery )
2.) HILL SACHS LESIONS
- Dent in the back of the humeral head which occurs during the dislocation as the
humeral head impacts against the front glenoid.

  1. ) SLAP TEAR
    • A tear at the top of the labrum.
  2. ) BONY BANKHART
    • Fragment of bones breaks off.
27
Q

How do you manage Shoulder Instability ?

A

1.) PHYSIOTHERAPY
- Train the shoulder muscles to control the shoulder correctly and prevent further
instability.

  1. ) SURGERY (depends on the cause and findings)
    - ARTHROSCOPIC PROCEDURE ( keyhole surgery )
    - OPEN SHOULDER Procedure (depends on the problem)
28
Q

What is MYELOPATHY ?

A

Its the compression on the spinal cord in the central canal (Vertebral Foramen).

29
Q

What causes Myelopathy ?

A
  • Central stenosis
  • Central Disc Herniation
  • Trauma
  • Spondylolisthesis
  • Ligament Thickening
  • Age related changes ( Bony spurs / Osteophytes )
30
Q

What are some signs and symptoms of Myelopathy ?

A
  • GAIT DISTURBANCE (Ataxia = loss of coordination)
  • Changes in Fine motor skills and Co-ordination.
  • Possible neck & lower back pain.
  • HYPER-REFLEXIA (overactive / overresponsive )
  • Bladder and Bowel Disturbances
31
Q

What are some risk factors of Myelopathy ?

A
  • Older age (degenerative changes)
  • Stenosis
  • RA & ANKYLOSING SPONDYLITIS (systemic autoimmune)
  • Trauma
32
Q

What are some Myelopathy Management ?

A

Conservative / Surgical

Fusion / Stabilisation

33
Q

What is Cauda Equina Syndrome (CES) ?

A

The compression on the collection of nerves at the bottom of the spinal cord.
(HORSE TAIL )

34
Q

What are some signs and symptoms of Cauda Equina Syndrome ?

A
  • Retention of Urine (urology)
  • Loss of Anal tone
  • Sexual Dysfunction
  • Bilateral leg pain / numbness
  • SADDLE ANAESTHESIA ( reduced sensation )
35
Q

What is a possible management for Cauda Equina Syndrome ?

A

Spinal Decompression.

36
Q

What is RADICULOPATHY ?

A

Its a change in neurological function from nerve root compression, irritation or sensitivity.
(the nerve root is where the intervertebral foramen comes out)

37
Q

What are some common signs and symptoms of Radiculopathy ?

A
  • (CERVICAL) = Arm symptoms
  • (LUMBAR) = Leg symptoms
  • Pain in Dermatomal Distributions
  • Sensory symptoms in Dermatomes
    ( Paraesthesia / Anaesthesia / Allodynia = pain & extremely sensitive to touch )
  • Motor loss in the relevant Nerve root
    -Reflex Changes
38
Q

What is Peripheral Nerve Entrapment / Irritation. ?

A

An area in the Peripheral nerves (not in the spine) in which the nerve becomes irritated or compressed by a bone or oedema.

39
Q

What are some signs and symptoms of Peripheral Nerve Irritation ?

A

Its all depends on the level of irritation of compression and the type of nerves that is irritated.

  • CARPAL TUNNEL
    Median Nerve = Fingers 1&2 / Thumb / wrist
  • CUBITAL TUNNEL SYNDROME
    Ulnar Nerve = medial aspect of the elbow
  • PERONEAL NERVE
    Irritated with Fractures
  • GLUTEAL
    Sciatic Nerve = passes through the Piriformis
  • ELBOW
    Radial Nerve = Radial tunnel syndrome commonly mistaken as the Tennis Elbow.
40
Q

What are some Peripheral Nerve Entrapment / Irritation Management ?

A
  • PHYSIOTHERAPY ( non invasive )
  • EDUCATION
  • Oral Medication
  • Splinting ( carpal tunnel syndrome )
  • Steroid Injections
  • Surgery ( decompression / release )
41
Q

What is the difference between DERMATOMES + MYOTOMES ?

A

DERMATOMES
- Its a specific area of skin that is supplied by a specific nerve root level.

MYOTOMES
- Specific set of muscles that are supplied by a specific nerve root level.

Pathophysiology 2 (10 decks)

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