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Musculoskeletal injuries 1 Flashcards

1
Q

what is malfeasance

A

commits an act that is not their responsibility

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2
Q

what is misfeasance

A

commits an act that is their responsibility to perform but uses the wrong procedure or does the right procedure in an improper manner

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3
Q

what is nonfeasance

A

fails to perform their legal duty of care

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4
Q

what is malpractice

A

commits a negligent act while providing care

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5
Q

what is gross negligence

A

total disregard for the safety of others

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6
Q

what are the three types of force

A

compression/ tensile
shear
tension

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7
Q

what is a muscle contusion

A

a result of a sudden traumatic blow where a muscle is crushed (bruised muscle)

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8
Q

what is hematoma

A

bruising

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9
Q

what is the history of a muscle contusion

A

acute onset

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10
Q

what is the mechanism of injury of a muscle contusion

A

due to a compressive force

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11
Q

what is ecchymosis

A

bruising

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12
Q

why might ROM be affected with a muscle contusion

A

swelling and haemorrhage

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13
Q

what two types of injuries are graded

A

muscle contusion

muscle strain

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14
Q

what is a muscle strain

A

pulling apart, stretch, tear, rip of a muscle, tendon or fascia

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15
Q

what is the result of a passive force causing the muscle to length

A

muscle strain

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16
Q

what are the 3 properties of muscles

A

viscoelasticity
irritability
contractility

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17
Q

what is viscoelasticity

A

allows m. to return to stretch to greater lengths over time in response to a sustained tensile force

  • extensibility -ability to stretch
  • elasticity- ability to return to normal length
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18
Q

what is irritability

A

ability to respond to a stimulus

  • electrochemical-nerve impulse
  • mechanical-external blow
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19
Q

what is contractility

A

ability to develop tension

  • isometric
  • concentric
  • eccentric
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20
Q

what is the history of a muscle strain

A

acute onset

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21
Q

what is the mechanism of injury for a m. strain

A

due to an overstretch or overload on the m.

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22
Q

how is the pain described for a m. strain

A

pain is localised over the injury, which tends to be at or near the musculotendinous junction

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23
Q

is there any visible deformity in a m. strain

A

can be evident in the m.

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24
Q

is there any decolouration in a m. strain

A

yes caused by blood pooling distal to the site of trauma

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25
Q

is there any m. weakness in a muscle strain

A

can be

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26
Q

what is a ligament sprain

A

disruption in the function or integrity of a ligament caused by a force that moves the bone apart

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27
Q

what is more elastic ligaments or tendons

A

ligaments

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28
Q

what is tendonitis

A

inflammation within the tendon or the tendon sheath

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29
Q

where does tendonitis occur

A

enthesitis (where muscle attaches to bone)

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30
Q

what is enthesitis

A

where the muscle attaches to the bone

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31
Q

what is the history or tendonitis

A

gradual onset of pain and swelling

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32
Q

what is tendinosis

A

tendonitis that lasts longer than 6 months

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33
Q

what is tendinosis caused by

A

micro tears in the connective tissue in and around the tendon

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34
Q

in tendinosis there is an increase in tendon repair cells and ________ ________ into the area

A

fatty infiltration

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35
Q

tendinosis results in a decreased _____ ____ and increased chance of ______ _____

A

tensile strength

tendon rupture

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36
Q

your tendon is replaced by _____ _____ it is not very designed to take on heavy loads

A

fatty globules

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37
Q

what is quick to heal tendinitis or tendinosis

A

tendinitis

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38
Q

what is common tendonitis or tendinosis

A

tendinosis

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39
Q

what is aggravated by exercise tendinosis or tendonitis

A

tendonitis

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40
Q

what does NSAIDS help tendinosis or tendonitis

A

tendonitis

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41
Q

what colour does tendinosis and tendonitis show up on the colour on an MRI

A

tendonitis- white

tendinosis- black

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42
Q

What is degenerative tendinosis or tendonitis

A

tendinosis

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43
Q

what usually feels better after proper training tendinosis or tendonitis

A

tendinosis

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44
Q

what hurts to move tendinitis or tendinosis

A

tendonitis

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45
Q

what responses well to ice and irritated by heat and vise versa tendinosis, tendinitis

A

tendinosis- irritated by ice and responds well to heat

tendinitis- responds well to ice irritated by heat

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46
Q

what are common sites for tendinosis and tendinitis

A

elbow, Achilles tendon and patellar tendon

may be caused by repetitive trauma or strain

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47
Q

what is the history or tendonitis

A

gradual onset

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48
Q

what is the mechanism of injury for tendonitis

A

due to overuse, repetitive stretch or overload

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49
Q

how is the pain described in tendonitis

A

localized throughout the length of the tendon on palpation

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50
Q

is there swelling in tendonitis

A

may range from minor to major and thickening of the tendon may be present

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51
Q

is crepitus present in tendonitis

A

yes

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52
Q

when does pain occur in tendonitis

A

in extreme ROM in passive and active movements

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53
Q

when does pain increase in tendonitis

A

during stretching and with resistance testing

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54
Q

what is bursitis

A

inflammation of the bursa the pocket of fluid within the synovial lining designed to decrease frictional forces between the tissues surrounding the joints

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55
Q

what are the 5 properties of a bursa

A

1- fluid filled sac
2- reduced friction
3- common sites- area of friction
4- characterized by a sudden onset of pain and swellings
5- common sites include the olecranon bursa of the elbow and the patellar bursa of the knee

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56
Q

what is the history of bursitis

A

sudden onset of pain

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57
Q

what is the mechanism of injury for a bursitis

A

due to a single traumatic compression or by repeated compression associated with over use of the joint

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58
Q

how is the pain described with bursitis

A

localized pain and warmth on palpation

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59
Q

is there swelling with bursitis

A

localized swelling and may be minor or major

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60
Q

what are the three phases on soft tissue healing?

A

acute inflammatory phase
proliferation phase
maturation phase

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61
Q

how long does the acute inflammatory phase take

A

0-6 days

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62
Q

how long does the proliferation phase

A

3-21 days

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63
Q

how long is the maturation phase

A

21 days-year

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64
Q

in what phase does: collagen remodeling and increase in tensile strength of scare occur?

A

maturation phase

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65
Q

in what phase does phagocytosis remove debris

A

proliferation phase

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66
Q

what are the 3 mass cells released in the inflammatory phase

A

heparin
histamine
bradykinin

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67
Q

what is heparin

A

thins the blood and prolongs clotting

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68
Q

what is histamine

A

promotes further vasodilation

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69
Q

what is bradyskinin

A

opens the blood vessel walls; causes pain

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70
Q

when does the proliferation phase start

A

day 6 or 7

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71
Q

what are the 4 classifications of bone injuries

A

fracture
stress fracture
dislocation
subluxations

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72
Q

the outer surface of the bone is made of ____ bone

A

cortical

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73
Q

the inner surface of the bone is made of ____ bone

A

cancellous

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74
Q

bone has a complex network of blood vessels and lymphatic vessels that form canals known as the ______ _____

A

haverisan system

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75
Q

what is the diaphysis

A

shaft of the bone

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76
Q

what is the epiphysis

A

located on the end of the bone

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77
Q

what kind of cartilage is on the epiphysis

A

hyaline cartilage

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78
Q

what are the 5 functions of bone

A
  1. body support
  2. organ protection
  3. movement
  4. a reservoir for calcium
  5. the formation of blood cells (haemopoiesis)
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79
Q

what are the 5 mechanical forces affecting bone

A 
tension 
compression
shear
bending
torsion
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80
Q

what are the 3 ways fractures are classified

A
  1. anatomical site
  2. mechanism of injury
  3. extent of the injury to soft tissues
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81
Q

what are the 2 types of fractures identified by anatomical site

A

avulsion fracture

epiphyseal fracture

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82
Q

what is a avulsion fracture

A

-tendon and ligament pulls a piece of bonce fragment off

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83
Q

what causes a avulsion fracture

A

s sudden, powerful twist or stretch, commonly occurs in the ankle

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84
Q

what is a epiphyseal fracture

A

growth plate fracture in the developing child that could result in a disruption of normal growth

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85
Q

what are the 3 fractures that are classified as mechanism of injury

A

traumatic
stress and fatigue
pathological

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86
Q

what is a traumatic fracture

A

caused by a direct blow or sudden force applied to the bone

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87
Q

what is a stress and fatigue fracture

A

caused by repeated stress on a bone

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88
Q

what is a pathological fracture

A

fracture to a bone that is already weakened. the bone may be weakened due to the presence of a tumour, osteoporosis or prolonged corticosteroid medication use

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89
Q

what are the two fractures classified by the extent of the injury to soft tissue

A

open/compound fracture

closed/ simple fracture

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90
Q

what is a compound fracture

A

there is communication of the fractured bone with the exterior of the body, may be contaminated and infected

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91
Q

what is a simple fracture

A

there is no communication of the fractured bone with the exterior of the body

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92
Q

what to look for when diagnosing a fracture [7]

A
  • mechanism of injury
  • snap or pop
  • presence of nausea
  • onset of swelling or bruising
  • functional level
  • crepitus
  • intensity of pain
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93
Q

what tests are used to diagnosis a fracture

A

x-ray
CT scan
MRI
bone scan

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94
Q

what are the two most important factors when treating a fracture

A

reduction

immobilization

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95
Q

what needs to be reduced when treating a fracture

A
  • may be required if fracture is displaced

- may be achieved manually or with surgical interventions

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96
Q

what is immobilization in regards to fracture treatment

A

decrease pain
not always necessary
must be aware of the negative affects

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97
Q

what is vikmann’s contracture

A

negative effect of casting

-nerve and blood supply blocked

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98
Q

what is Volkmann’s contracture also known as [2]

A

reflex sympathetic dystrophy sudeck’s atrophy

complex regional pain syndrome

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99
Q

what is avascular necrosis

A

death of the bone due to a disruption of the blood supply to the area

100
Q

prevention of function when in cast:

A

move joints above and below fracture site; increase circulation
perform isometric and isotonic exercises

101
Q

prevention of function when out of cast

A

stretching and strengthening exercise of the affected joints
gradual return to normal functional activities and sports

102
Q

what is a stress/fatigue fracture

A

a micro fracture that is secondary to repeated stress

starts small and gets larger if untreated

103
Q

subjective history or a stress fracture

A

as per the diagnosis of fractures but the patient usually cannot report a single traumatic event causing the pain

104
Q

objective physical assessment of a stress fracture

A

initially pain is present with activity but decreases with rest (early stages )
constant pain through the day and at night (later stage)

105
Q

x-ray as a diagnosis test

A

a stress fracture is not visualized initially but may be present after one month post injury

106
Q

bone scan as a diagnosis test

A

the most definitive diagnostic tools for stress fractures

107
Q

what is a dislocation

A

complete displacement of the end of a bone from the joint usually injuring the joint capsule, ligament and the surrounding musculature

108
Q

with dislocation is there a limited ROM

A

yes grossly

109
Q

is there any deformity and swelling with a dislocation

A

yes

110
Q

marked ______ impairment with dislocations

A

functional

111
Q

what is the treatment for dislocations

A
  • splint and immobilize the affected joint in position that it is found and seek medication attention
  • reduction of the dislocation by the attending physician
112
Q

what is subluxation

A

a partial displacement of the end of a bone from the joint , sleeping on your neck the wrong way

113
Q

what are the three phases of fracture healing

A

acute inflammatory phase
proliferation phase
remodeling phase

114
Q

how long is the acute inflammatory phase for fractures

A

4 days

115
Q

how long is the proliferative phase for fractures

A

8-10 weeks in adults

4-6 weeks in children

116
Q

how long does the remodeling phase take

A

1-2 years

117
Q

in the proliferative phase in fractures how long does it take to form a immature form of bone

A

2 weeks in children

4 weeks in adults

118
Q

what is a indication

A

a condition that could benefit from the use of a specific modality

119
Q

what is a contraindication

A

a condition that is adversely affected if a particular modality is used

120
Q

what is a electromagnetic spectrum

A

all modalities fall under electromagnetic spectrum (except ultrasound)

121
Q

what is electromagnetic energy

A

therapeutic modalities are part of the electromagnetic

122
Q

what are the two electromagnetic energy

A

ionizing range

non-ionizing range

123
Q

what is ionizing range

A

can alter the components of atoms (radiation) not used by most healthcare professionals

124
Q

what is non-ionizing range

A

incorporates ultraviolet, visible and infrared light used in management of musculoskeletal injuries

125
Q

what is cryotherapy

A

multiple types of cold application including the use of ice cubes, cold gel packs, cold water

126
Q

what spectrum does cold application fall under

A

infrared radiation spectrum

127
Q

what is vasoconstriction [cryotherapy]

A

decreases capillary permeability, circulation and blood flow to the area

128
Q

what is increases absorption [cryotherapy]

A

decreases the swelling and fluid already present in the tissue assisting with healing and absorption

129
Q

what is decrease muscle spasm [cryotherapy]

A

as a result of the increased relaxation time and decreased conduction rate the muscle cannot contract as much and it is slower to contract when it does

130
Q

what is decrease tissue O2 demand [cryotherapy]

A

reduction in tissue hypoxia

for heart surgery they induce hypothermia, controlling oxygen demands

131
Q

what is the hunting response [cryotherapy]

A

cyclical period of vasoconstriction and vasodilation after the application of cold to an area

132
Q

after 15 mins of icing application should be removed because it causes _______

A

hunting response

133
Q

can use ice for the first ____ days of in injury

A

6

134
Q

what is thermotherapy

A

application of heat to an area using hydro collator packs, moist towels, paraffin wax baths, whirl pool bath or other electrical modalities

135
Q

indicators for use of cryotherapy

A

acute or chronic pain (12 week marker)
acute inflammatory
superficial first degree burns

136
Q

indication for use of cryotherapy with exercise [3]

A

facilitate mobilization
relieve pain
decrease muscle spasticity

137
Q

what are contraindications for the use of cryotherapy [7]

A
  • hypersensitivity to cold
  • circulatory or sensory impairment (hypertension/ diabetes)
  • Raynaud’s disease
  • uncovered wounds
  • nerve palsy
  • certain arthritis (systemic lupus erythematous )
  • Leukaemia
138
Q

what are the effects of thermotherapy [5]

A
  • analgesic and sedative effects
  • increased circulation and hyperaemia
  • increased cellular metabolism
  • increase extensibility of connective tissues
  • decreased muscle spasms
139
Q

what are the indications for the use of thermotherapy [6]

A
  • increased pain
  • increased sub acute and chronic inflammation and ecchymosis
  • increased muscle spasm and guarding
  • decreased ROM
  • joint contractures and scare adhesions
  • wound healing and infection
140
Q

what are the contraindications of thermotherapy [5]

A
  • acute inflammation or injury
  • circulatory impairment
  • sensory impairment
  • malignancy
  • impaired thermal regulation
141
Q

what is an ultrasound

A

uses high frequency sound waves to produce thermal and non thermal effects

142
Q

what are the 7 thermal effects of an ultrasound

A
  • increases the extensibility of the collagen
  • increases circulation to the area
  • increases the velocity of the sensory & motor neurons
  • decreased muscle spasm
  • decreases inflammation
  • decreases pain
  • increases enzymatic activity
143
Q

what are the 6 non-thermal effects of an ultrasound

A
  • increase cell membrane & vascular wall permeability through the production of cortisol
  • increased blood flow
  • protein synthesis
  • decrease swelling
  • mechanical disruption of the tissue causes the healing tissue to heal in a proper alignment
  • micro massage
144
Q

what are the 8 indications for the use of ultrasound

A
  • increased pain
  • increased inflammation and the presence of a hematoma
  • increased spasticity and m. spasm
  • decreased extensibility
  • neuritis
  • the presence of joint adhesions and contractures
  • post acute myositis ossificans
  • plantar warts
145
Q

what are the 7 contraindications to the use of the ultrasound

A

-infection thrombophlebitis (acute inflammation of a vein)
- circulatory impairment
- sensory impairment
-malignancy
-over epiphyseal growth plates of children ( causes growth plate to fuse early)
- over a stress fracture
over the eyes, heart and genitals

146
Q

what does TENS stand for

A

transcutaneous electrical nerve stimulation

147
Q

what is transcutaneous electrical nerve stimulation

A

portable unit that applies a current to the skin via carbon electrodes that are placed over the painful site allowing pain control via a high frequency, low frequency and brief intense stimulation

148
Q

what are the 3 effects of TENS

A
  • pain relief in the body is based on the gate theory of pain
  • large diameter nerves are stimulated and the pain impulse is modulated at the spinal cord level inhibiting transmission of this impulse to the brain
  • pain relief via the production of endorphins
149
Q

what is the 1 indications for TENS

A

increased pain

150
Q

what is the 3 contraindications for TENS

A
  • the presence of a pace maker
  • placement in the abdominal and pelvis region of pregnant females
  • pain of unknown origin
151
Q

what does IFC stand for

A

interferential current

152
Q

what is interferential current?

A

a current applied to the skin via paired carbon electrodes that are positioned perpendicular to one another creating a pattern of interference that targets both the sensory and motor neurons

153
Q

what are the 7 effects of IFC ( outcome of the molality )

A
  • 2 generators with quadripolar electrodes arrangement and AC current
  • decreased pain
  • decreased both acute and chronic swelling
  • decreases m. spasm
  • increases circulation to the area
  • strengthen weakened m.
  • increases cellular activity thereby facilitating the healing process
154
Q

what are the 4 indications for the use of IFC ( what patients experience)

A
  • increased pain
  • increased acute and chronic swelling
  • increased m. spasms and guarding
  • may assist in chronic wound healing
155
Q

what are the 4 contraindications for the use of IFC

A
  • the presence of a pace maker
  • placement in the abdominal and pelvic region of pregnant females
  • thrombophlebitis
  • pain of unknown origin
156
Q

what is electrical neuromuscular stimulation (EMS)

A

the electrical current stimulates the peripheral nerve and elicits a m. contraction

157
Q

what are the 6 effects of electrical neuromuscular stimulation

A
  • decreases pain
  • decreases inflammation
  • decreases m. spasm
  • maintains m. strength and size during period of immobilization
  • re-educate m.
  • increases circulation to the tissue
158
Q

what are the 6 indications for the use of EMS

A
  • increased pain
  • increased acute and chronic swelling
  • increased m. spasms and guarding
  • during periods of immobilization to prevent m. atrophy
  • decreased range of motion and strength
  • peripheral nerve injuries
159
Q

what are the 5 contraindications for the use of EMS

A
  • the presence of a pace maker
  • placement in the abdominal and pelvic region of a pregnant women
  • thrombophlebitis
  • malignancy
  • superficial skin and lesions and abrasions
160
Q

what is a dynamic muscle contractions

A

a muscle contraction in which the muscle alters its length

161
Q

what is isometric contraction (first exercise to use on a rehab program )

A

a muscle contraction in which the internal force developed by the m. neither the lengthens nor shortens the m.

162
Q

what is concentric contractions

A

a contraction in which the internal force generated is greater than the external forced applied so that the m. activity shortens (lifting a weight)

163
Q

what is a eccentric contraction

A

a contraction in which the external force applied us greater than the internal force generated. the m. is allowed to lengthen while still maintaining tension, the . contraction acts as a braking force.

164
Q

what is the most common injury for children

A

soft tissue injuries

165
Q

what age range is it most common for a child to obtained a soft tissue injury

A

10-18

166
Q

what is the mechanism of cartilage injuries in children

A

compressive and tensile force

167
Q

what is apophyseal avulsion

A

suddenly applied forces to the bone may cause the apophyses to become partially or completely separated from the bone

168
Q

what is Osgood schlatters disease

A

developing ossifications center in the tibial tuberosity may be avulsed and replaced by fibro-cartilaginous material

169
Q

what is the mechanism of injury to Osgood schlatters disease

A

repetitive strain of the quadriceps

170
Q

when do they have pain with Osgood schlatters disease

A

until they stop growing approx. 18

171
Q

what are the 6 signs and symptoms of Osgood schlatters disease

A
  • pain localized over the tibial tubercle
  • swelling over the patellar tendon
  • pain increases with activity and decreased with rest
  • usually present bilaterally
  • more common in males between the ages 11-15
  • x-rays show regularity of tibial tuberosity
172
Q

what is the treatment for Osgood schlatters disease

A

rest from painful activities

restore strength and flexibility to lower extremity m.

173
Q

what is calcaneal apophysitis

A
  • inflammation of the calcaneal apophysis (insertion of Achilles, plantar fascia and short m. of foot
174
Q

what are the 5 signs and symptoms of calcaneal apophysitis

A
  • localized pain on the calcaneal apophysis
  • pain increases on palpation and with activity and decreased with rest
  • more common in males
  • more common between ages 11-15
  • x-rays reveal sclerosis and irregularity of apophysis
175
Q

what is the 7 treatments of calcaneal apophysitis

A
  • heel lifts
  • ice and rest
  • casting (only way to make the child rest)
  • orthotics
  • proper athletic shoes
  • stretching of gastrocnemius and soleus m.
  • strengthening of lower extremity m.
176
Q

what is sinding Larsen Johansson disease

A

occurs at the proximal end of the patellar tendon

in adults this is known as patellar tendonitis

177
Q

what is sinding Larsen Johansson disease called in adults

A

patellar tendonitis

178
Q

what are the 8 signs and symptoms of sinding Larsen Johansson disease

A
  • pain over the distal pole of patella
  • palpable prominence edvident
  • pain increases with activity and decreases with rest
  • higher location than Osgood schlatters disease
  • common in females between 8-13
  • common males 10-15
  • bilateral involvement usually
  • x-rays reveal irregularity of fragmentation of the inferior part of the patella
179
Q

what is the treatment for sinding Larsen Johansson disease

A

same as for Osgood schlatters disease:
rest from painful activities
restore strength and flexibility to lower extremity m

180
Q

what is osteochondritis dissecans

A
  • the articular cartilage may separate from the surrounding bone and form a loose body
  • segment of subcondral bone undergoes avascular necrosis and ischemia
  • associated with physical activity, repetitive micro trauma and high level sports in young athletes
181
Q

what is legg calve perthes disease

A

avascular necrosis of the proximal femoral epiphysis

needs surgical intervention

182
Q

what are the signs and symptoms of legg calve perthes disease [4]

A
  • pain in the groin, anterior thigh and knee
  • antalgic gait pattern
  • decreased hip abduction, extension and external rotation
  • more common in males between the ages 3-8
183
Q

what is the treatment for legg calve perthes disease

A
  • immobilization in an abducted position in non weight bearing immobilization may last 1-2 years
  • surgery to prevent further deformity of the femoral head
184
Q

what is plastic deformation

A
  • growing bone is less mineralized than mature bone and has the capacity to bend rather than break and stay that way
185
Q

what is a torus fracture

A
  • caused by a longitudinal force along that shaft of a long bone resulting in a compressive force on the distal end of the bone
  • damages growth plate
186
Q

what is green stick fracture (unique for children )

A

the tension result in the bone bending at each end but the fracture is not complete

187
Q

what is a hip pointer

A
  • contusion type if injury
  • blow localized to the ASIS or AIIS
  • possible causes may include a direct blow to the area or a force contraction of the muscles attaching to the region
  • involved the Sartorius, rectus femoris or abdominal m,
188
Q

what is consider grade 1 hip pointer

A
  • normal gait pattern and posture
  • slight pain on palpation
  • little or no swelling
  • full ROM of the lumbar spine and hip
189
Q

what is consider grade 2 hip pointer

A
  • antalgic gait pattern with shorten swing phase
  • patients stands in flexed and side flexed towards the side of injury
  • pain on palpation
  • visible swelling and bruising
  • active lumbar spine and hip flexion
  • ROM decreased and painful
  • pain and weakness with resistance testing
  • positive Thomas test
190
Q

what is considered grade 3 hip pointer

A
  • pain with coughing sneezing or laughing
  • severe pain, swelling and bruising (must role our a fracture or a eruption of m. or ligament )
  • all other findings as per grade 2
191
Q

what is the treatment of the hip pointer

A
  • rest, ice, compress and elevate the area
  • crutches for walking
  • non steroidal anti-inflammatory mediations (NSAIDS)
  • TENS, IFC and ultrasound
  • protective pad over area
  • stretch and strengthen the appropriate m.
192
Q

what is NSAIDS

A

non steroidal anti-inflammatory mediations

193
Q

what is trochanteric bursitis

A

inflammation of the trochanteric bursa of the hip

194
Q

what causes trochanteric bursitis [2]

A
  1. direct blow to the lateral aspect of the hop resulting in bleeding into the bursa
  2. excessive friction or shear forces from the tensor fascia latea m. gluteus max m. or the iliotibial band
195
Q

what is burning or aching pain over or posterior to the greater trochanter a sign of

A

trochanteric bursitis

196
Q

with an individual with trochanteric bursitis what might a person report with movement

A

snapping sensation in hip region

197
Q

what movements would someone with trochanteric bursitis report pain with

A

active flexion, abduction and internal rotation of the hip, (tensor fascia lata m.) and extension and external rotation of the hip

198
Q

what test would someone with trochanteric bursitis report pain with

A

resistance testing

199
Q

what are the 9 treatments of trochanteric bursitis

A
  • ice
  • protected rest
  • NSAIDS
  • electrical modalities such as ultrasound and interferential current
  • no compression because that is the while cause of bursitis
  • stretching of the tight m.
  • determine the potential cause of this problem and modify
  • aspiration of the bursa
  • surgical removal of bursa
200
Q

what is snapping hip syndrome

A

intra articular and extra articular causes

201
Q

what are the two extra articular causes of snapping hip syndrome?

A

external

internal

202
Q

what is external articular cause of snapping hip syndrome

A

ITB or gluteus max. snapping over greater trochanter during hip flexion—> TROCHANTERIC BURSITIS

203
Q

what is internal articular cause of snapping hip syndrome

A

iliopsoas snaps over structures deep to musculotendinous unit –>ILIOPSOAS BURSITIS

204
Q

what is the intra articular causes of snapping hip syndrome

A

lesions of the joint–>LABRAL TEAR

usually occurs when an individual externally rotates and flexes the hip joint

205
Q

what does the Ober’s test for?

A

snapping hip syndrome,

ITB when it gets tight can cause the noise

206
Q

what are the 3 treatments for snapping hip syndrome

A
  • NSAIDS
  • stretching of the tight structures and strengthening of the week m. involved
  • alter the biomechanics and technique of the activity
207
Q

what is the most commonly strained m. in the body

A

hamstrings

208
Q

in what phase of knee flexion is someone likely to strain their hamstrings

A

initial swing phase

209
Q

true or false a strength imbalance of the quads and hams can cause a hamstring strain

A

true

210
Q

injury occurs when the hamstrings _____ a forceful contraction of the quad m.

A

decelerates

211
Q

what is the history of a hamstring m. strain

A

poor posture, inflexibility and m. imbalance

212
Q

how is antalgic gait pattern a result of a strained hamstring

A

inability to fully extend the knee at the heel strike

213
Q

increase pain with hamstring strain with ___ hip flexion and knee flexion

A

active

214
Q

increase pain with hamstring strain with _____ hip flexion and knee extension

A

passive

215
Q

what is the treatment phase 1 for hamstring strain

A
  • protected, rest, ice, compression and elevation
  • NSAIDS
  • use of crutches if an antalgic gait patterns is evident
216
Q

what is the treatment phase 2 for hamstring strain

A
  • electrical modalities such as ultrasound and EMS
  • slow, pain free and gradual stretching program
  • being gentle isometric strengthening exercises
217
Q

what is the treatment phase 3 for hamstring strain

A
  • progressive stretching and strengthening exercises
  • sport specific exercises that involve rapid stops, starts and directional changes
  • focus on the prevention of future injury
218
Q

what is a quadriceps m. contusion

A

result of a direct blow to the quad m.

219
Q

what is the most common sit for a quad contusion

A

anterolateral aspect

220
Q

in what injury is the severity almost always underestimated

A

quad m. contusion

221
Q

bruising and swelling over the anterior thigh

antalgic gait pattern are signs of what?

A

quad m. contusion

222
Q

with a quad m. contusion you have pain with ___ hip extension and knee flexion and pain with _____ hip flexion and knee extension

A

passive

active

223
Q

what is myositis ossificans

A

a direct blow to an area causes a deposition of bone within a m.

224
Q

true or false may need surgery with myositis ossificans

A

true

225
Q

what is medial collateral ligament MCL sprain caused by

A

an abnormal valgus force

226
Q

what is the valgus stress test looking for?

A

tests for MCL sprain

227
Q

what does the patellar apprehension test

A

patellar dislocation

228
Q

what does the Thomas test look for

A

hip pointer

229
Q

what does the resistance test detect

A

m. contusions (quads)

trochanteric bursitis

230
Q

hat does ober’s test detect

A

snapping hip syndrome

ITB friction syndrome

231
Q

what does the valgus test detect

A

MCL sprain

232
Q

what does the figure 8 test detect

A

if someone is ready to go back to sport after an MCL sprain

233
Q

what does varus stress test detect

A

LCL sprain

234
Q

what does anterior drawer test detect

A

ACL sprain

235
Q

what does posterior drawer test detect

A

PCL sprain

236
Q

what does posterior sag test detect

A

PCL sprain

237
Q

lochment test detect

A

ACL sprain

238
Q

what does McMarry’s test detect

A

meniscal sprain

239
Q

what does Apley’s test detect

A

meniscal sprain

240
Q

what are the 9 elements in the acute inflammatory phase in the soft tissue healing

A
  • blanching of the skin as the site does not bleed immediately
  • vasoconstriction (first 10mins to try and coagulate)
  • platelet reaction in which the clot is formed by celling combining with one another to form a mechanical plug to seal ruptured vessel
  • coagulation cascade affects clot formation
  • followed by increase in blood flow for the next 5-60 minutes
  • redness, heat, swelling, pain and loss of function is evident with an increase in blood flow to the area
  • chemical and cellular events occur in which macrophages and neutrophils and various kinins released in the area
  • mass cell release (heparin- thins the blood and prolong clotting; histamine- promotes further vasodilation; Bradykinin- opens blood vessel walls and causes pain)
  • the length of the acute inflammatory phase is approx. 0-6 days
241
Q

what are the 7 elements in the proliferation phase in the soft tissue healing

A
  • starts on day 6 or 7
  • before any repair can occur the debris must be removed by phagocytosis
  • Angiogenesis occurs in which new blood vessels are formed
  • fibroplasia occurs in which type 1 and 3 collagen is laid down forming a mass of immature connective tissue
  • the generation of new epithelial tissue occurs as a result of these processes
  • overlap between the acute inflammatory phase and proliferation phase
  • lasts approx. 3-21 days
242
Q

what are the 5 elements in the maturation phase in the soft tissue healing

A
  • scar tissue formation in the region occurs, the scar tissue is fibrous inelastic and nonvascular as compared to the original tissue
  • collagen remodeling and the increase in tensile strength of scar occurs
  • early mobilization insures that the collagen fibres are laid down in proper orientation along the lines of habitual stress
  • return to normal histochemical activity occurs
  • last from 21 days to 1 year post injury
243
Q

what are the 4 elements in the acute inflammatory phase in fracture healing

A
  • damage to the periosteum and the surrounding soft tissues results in massive bleeding into the area
  • the formation of hematoma results
  • vasodilation, edema formation and histochemical changes as per soft tissue occurs (mass cells)
  • lasts approx. 4 days
244
Q

what are the 5 elements of the proliferation phase in fracture healing

A
  • also known as the repair and regenerative phase
  • osteoclasts resorb the damaged bone
  • osteoblasts lay down new bone trying to bridge the gap where the fracture was
  • osteoblasts la down a matric which forms a callous. this matric becomes impregnated with calcium and form an immature form of bone. the process takes approx.. 2 weeks in children and 4 weeks in adults
  • radiological union occurs in approx. 4-6 weeks in a child and 8-10 weeks in an adult
245
Q

what are the 2 elements of the remodeling stage in fracture healing

A
  • strengthening of the bone and reshaping

- takes 1-2 years to complete

246
Q

what are the 5 effects of cryotherapy

A
  • vasoconstriction
  • increases absorption
  • decreases muscle spasms
  • decreases O2 demands
  • Hunting Response

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