Musculoskeletal injuries 1 Flashcards
1
Q
what is malfeasance
A
commits an act that is not their responsibility
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
3
Q
what is nonfeasance
A
fails to perform their legal duty of care
4
Q
what is malpractice
A
commits a negligent act while providing care
5
Q
what is gross negligence
A
total disregard for the safety of others
6
Q
what are the three types of force
A
compression/ tensile
shear
tension
7
Q
what is a muscle contusion
A
a result of a sudden traumatic blow where a muscle is crushed (bruised muscle)
8
Q
what is hematoma
A
bruising
9
Q
what is the history of a muscle contusion
A
acute onset
10
Q
what is the mechanism of injury of a muscle contusion
A
due to a compressive force
11
Q
what is ecchymosis
A
bruising
12
Q
why might ROM be affected with a muscle contusion
A
swelling and haemorrhage
13
Q
what two types of injuries are graded
A
muscle contusion
muscle strain
14
Q
what is a muscle strain
A
pulling apart, stretch, tear, rip of a muscle, tendon or fascia
15
Q
what is the result of a passive force causing the muscle to length
A
muscle strain
16
Q
what are the 3 properties of muscles
A
viscoelasticity
irritability
contractility
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
18
Q
what is irritability
A
ability to respond to a stimulus
- electrochemical-nerve impulse
- mechanical-external blow
19
Q
what is contractility
A
ability to develop tension
- isometric
- concentric
- eccentric
20
Q
what is the history of a muscle strain
A
acute onset
21
Q
what is the mechanism of injury for a m. strain
A
due to an overstretch or overload on the m.
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
23
Q
is there any visible deformity in a m. strain
A
can be evident in the m.
24
Q
is there any decolouration in a m. strain
A
yes caused by blood pooling distal to the site of trauma
25
is there any m. weakness in a muscle strain
can be
26
what is a ligament sprain
disruption in the function or integrity of a ligament caused by a force that moves the bone apart
27
what is more elastic ligaments or tendons
ligaments
28
what is tendonitis
inflammation within the tendon or the tendon sheath
29
where does tendonitis occur
enthesitis (where muscle attaches to bone)
30
what is enthesitis
where the muscle attaches to the bone
31
what is the history or tendonitis
gradual onset of pain and swelling
32
what is tendinosis
tendonitis that lasts longer than 6 months
33
what is tendinosis caused by
micro tears in the connective tissue in and around the tendon
34
in tendinosis there is an increase in tendon repair cells and ________ ________ into the area
fatty infiltration
35
tendinosis results in a decreased _____ ____ and increased chance of ______ _____
tensile strength
| tendon rupture
36
your tendon is replaced by _____ _____ it is not very designed to take on heavy loads
fatty globules
37
what is quick to heal tendinitis or tendinosis
tendinitis
38
what is common tendonitis or tendinosis
tendinosis
39
what is aggravated by exercise tendinosis or tendonitis
tendonitis
40
what does NSAIDS help tendinosis or tendonitis
tendonitis
41
what colour does tendinosis and tendonitis show up on the colour on an MRI
tendonitis- white
| tendinosis- black
42
What is degenerative tendinosis or tendonitis
tendinosis
43
what usually feels better after proper training tendinosis or tendonitis
tendinosis
44
what hurts to move tendinitis or tendinosis
tendonitis
45
what responses well to ice and irritated by heat and vise versa tendinosis, tendinitis
tendinosis- irritated by ice and responds well to heat
| tendinitis- responds well to ice irritated by heat
46
what are common sites for tendinosis and tendinitis
elbow, Achilles tendon and patellar tendon
| may be caused by repetitive trauma or strain
47
what is the history or tendonitis
gradual onset
48
what is the mechanism of injury for tendonitis
due to overuse, repetitive stretch or overload
49
how is the pain described in tendonitis
localized throughout the length of the tendon on palpation
50
is there swelling in tendonitis
may range from minor to major and thickening of the tendon may be present
51
is crepitus present in tendonitis
yes
52
when does pain occur in tendonitis
in extreme ROM in passive and active movements
53
when does pain increase in tendonitis
during stretching and with resistance testing
54
what is bursitis
inflammation of the bursa the pocket of fluid within the synovial lining designed to decrease frictional forces between the tissues surrounding the joints
55
what are the 5 properties of a bursa
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
56
what is the history of bursitis
sudden onset of pain
57
what is the mechanism of injury for a bursitis
due to a single traumatic compression or by repeated compression associated with over use of the joint
58
how is the pain described with bursitis
localized pain and warmth on palpation
59
is there swelling with bursitis
localized swelling and may be minor or major
60
what are the three phases on soft tissue healing?
acute inflammatory phase
proliferation phase
maturation phase
61
how long does the acute inflammatory phase take
0-6 days
62
how long does the proliferation phase
3-21 days
63
how long is the maturation phase
21 days-year
64
in what phase does: collagen remodeling and increase in tensile strength of scare occur?
maturation phase
65
in what phase does phagocytosis remove debris
proliferation phase
66
what are the 3 mass cells released in the inflammatory phase
heparin
histamine
bradykinin
67
what is heparin
thins the blood and prolongs clotting
68
what is histamine
promotes further vasodilation
69
what is bradyskinin
opens the blood vessel walls; causes pain
70
when does the proliferation phase start
day 6 or 7
71
what are the 4 classifications of bone injuries
fracture
stress fracture
dislocation
subluxations
72
the outer surface of the bone is made of ____ bone
cortical
73
the inner surface of the bone is made of ____ bone
cancellous
74
bone has a complex network of blood vessels and lymphatic vessels that form canals known as the ______ _____
haverisan system
75
what is the diaphysis
shaft of the bone
76
what is the epiphysis
located on the end of the bone
77
what kind of cartilage is on the epiphysis
hyaline cartilage
78
what are the 5 functions of bone
1. body support
2. organ protection
3. movement
4. a reservoir for calcium
5. the formation of blood cells (haemopoiesis)
79
what are the 5 mechanical forces affecting bone
```
tension
compression
shear
bending
torsion
```
80
what are the 3 ways fractures are classified
1. anatomical site
2. mechanism of injury
3. extent of the injury to soft tissues
81
what are the 2 types of fractures identified by anatomical site
avulsion fracture
| epiphyseal fracture
82
what is a avulsion fracture
-tendon and ligament pulls a piece of bonce fragment off
83
what causes a avulsion fracture
s sudden, powerful twist or stretch, commonly occurs in the ankle
84
what is a epiphyseal fracture
growth plate fracture in the developing child that could result in a disruption of normal growth
85
what are the 3 fractures that are classified as mechanism of injury
traumatic
stress and fatigue
pathological
86
what is a traumatic fracture
caused by a direct blow or sudden force applied to the bone
87
what is a stress and fatigue fracture
caused by repeated stress on a bone
88
what is a pathological fracture
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
89
what are the two fractures classified by the extent of the injury to soft tissue
open/compound fracture
| closed/ simple fracture
90
what is a compound fracture
there is communication of the fractured bone with the exterior of the body, may be contaminated and infected
91
what is a simple fracture
there is no communication of the fractured bone with the exterior of the body
92
what to look for when diagnosing a fracture [7]
- mechanism of injury
- snap or pop
- presence of nausea
- onset of swelling or bruising
- functional level
- crepitus
- intensity of pain
93
what tests are used to diagnosis a fracture
x-ray
CT scan
MRI
bone scan
94
what are the two most important factors when treating a fracture
reduction
| immobilization
95
what needs to be reduced when treating a fracture
- may be required if fracture is displaced
| - may be achieved manually or with surgical interventions
96
what is immobilization in regards to fracture treatment
decrease pain
not always necessary
must be aware of the negative affects
97
what is vikmann's contracture
negative effect of casting
| -nerve and blood supply blocked
98
what is Volkmann's contracture also known as [2]
reflex sympathetic dystrophy sudeck's atrophy
| complex regional pain syndrome
99
what is avascular necrosis
death of the bone due to a disruption of the blood supply to the area
100
prevention of function when in cast:
move joints above and below fracture site; increase circulation
perform isometric and isotonic exercises
101
prevention of function when out of cast
stretching and strengthening exercise of the affected joints
gradual return to normal functional activities and sports
102
what is a stress/fatigue fracture
a micro fracture that is secondary to repeated stress
| starts small and gets larger if untreated
103
subjective history or a stress fracture
as per the diagnosis of fractures but the patient usually cannot report a single traumatic event causing the pain
104
objective physical assessment of a stress fracture
initially pain is present with activity but decreases with rest (early stages )
constant pain through the day and at night (later stage)
105
x-ray as a diagnosis test
a stress fracture is not visualized initially but may be present after one month post injury
106
bone scan as a diagnosis test
the most definitive diagnostic tools for stress fractures
107
what is a dislocation
complete displacement of the end of a bone from the joint usually injuring the joint capsule, ligament and the surrounding musculature
108
with dislocation is there a limited ROM
yes grossly
109
is there any deformity and swelling with a dislocation
yes
110
marked ______ impairment with dislocations
functional
111
what is the treatment for dislocations
- 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
what is subluxation
a partial displacement of the end of a bone from the joint , sleeping on your neck the wrong way
113
what are the three phases of fracture healing
acute inflammatory phase
proliferation phase
remodeling phase
114
how long is the acute inflammatory phase for fractures
4 days
115
how long is the proliferative phase for fractures
8-10 weeks in adults
| 4-6 weeks in children
116
how long does the remodeling phase take
1-2 years
117
in the proliferative phase in fractures how long does it take to form a immature form of bone
2 weeks in children
| 4 weeks in adults
118
what is a indication
a condition that could benefit from the use of a specific modality
119
what is a contraindication
a condition that is adversely affected if a particular modality is used
120
what is a electromagnetic spectrum
all modalities fall under electromagnetic spectrum (except ultrasound)
121
what is electromagnetic energy
therapeutic modalities are part of the electromagnetic
122
what are the two electromagnetic energy
ionizing range
| non-ionizing range
123
what is ionizing range
can alter the components of atoms (radiation) not used by most healthcare professionals
124
what is non-ionizing range
incorporates ultraviolet, visible and infrared light used in management of musculoskeletal injuries
125
what is cryotherapy
multiple types of cold application including the use of ice cubes, cold gel packs, cold water
126
what spectrum does cold application fall under
infrared radiation spectrum
127
what is vasoconstriction [cryotherapy]
decreases capillary permeability, circulation and blood flow to the area
128
what is increases absorption [cryotherapy]
decreases the swelling and fluid already present in the tissue assisting with healing and absorption
129
what is decrease muscle spasm [cryotherapy]
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
what is decrease tissue O2 demand [cryotherapy]
reduction in tissue hypoxia
| for heart surgery they induce hypothermia, controlling oxygen demands
131
what is the hunting response [cryotherapy]
cyclical period of vasoconstriction and vasodilation after the application of cold to an area
132
after 15 mins of icing application should be removed because it causes _______
hunting response
133
can use ice for the first ____ days of in injury
6
134
what is thermotherapy
application of heat to an area using hydro collator packs, moist towels, paraffin wax baths, whirl pool bath or other electrical modalities
135
indicators for use of cryotherapy
acute or chronic pain (12 week marker)
acute inflammatory
superficial first degree burns
136
indication for use of cryotherapy with exercise [3]
facilitate mobilization
relieve pain
decrease muscle spasticity
137
what are contraindications for the use of cryotherapy [7]
- hypersensitivity to cold
- circulatory or sensory impairment (hypertension/ diabetes)
- Raynaud's disease
- uncovered wounds
- nerve palsy
- certain arthritis (systemic lupus erythematous )
- Leukaemia
138
what are the effects of thermotherapy [5]
- analgesic and sedative effects
- increased circulation and hyperaemia
- increased cellular metabolism
- increase extensibility of connective tissues
- decreased muscle spasms
139
what are the indications for the use of thermotherapy [6]
- 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
what are the contraindications of thermotherapy [5]
- acute inflammation or injury
- circulatory impairment
- sensory impairment
- malignancy
- impaired thermal regulation
141
what is an ultrasound
uses high frequency sound waves to produce thermal and non thermal effects
142
what are the 7 thermal effects of an ultrasound
- 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
what are the 6 non-thermal effects of an ultrasound
- 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
what are the 8 indications for the use of ultrasound
- 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
what are the 7 contraindications to the use of the ultrasound
-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
what does TENS stand for
transcutaneous electrical nerve stimulation
147
what is transcutaneous electrical nerve stimulation
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
what are the 3 effects of TENS
- 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
what is the 1 indications for TENS
increased pain
150
what is the 3 contraindications for TENS
- the presence of a pace maker
- placement in the abdominal and pelvis region of pregnant females
- pain of unknown origin
151
what does IFC stand for
interferential current
152
what is interferential current?
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
what are the 7 effects of IFC ( outcome of the molality )
- 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
what are the 4 indications for the use of IFC ( what patients experience)
- increased pain
- increased acute and chronic swelling
- increased m. spasms and guarding
- may assist in chronic wound healing
155
what are the 4 contraindications for the use of IFC
- the presence of a pace maker
- placement in the abdominal and pelvic region of pregnant females
- thrombophlebitis
- pain of unknown origin
156
what is electrical neuromuscular stimulation (EMS)
the electrical current stimulates the peripheral nerve and elicits a m. contraction
157
what are the 6 effects of electrical neuromuscular stimulation
- 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
what are the 6 indications for the use of EMS
- 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
what are the 5 contraindications for the use of EMS
- 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
what is a dynamic muscle contractions
a muscle contraction in which the muscle alters its length
161
what is isometric contraction (first exercise to use on a rehab program )
a muscle contraction in which the internal force developed by the m. neither the lengthens nor shortens the m.
162
what is concentric contractions
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
what is a eccentric contraction
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
what is the most common injury for children
soft tissue injuries
165
what age range is it most common for a child to obtained a soft tissue injury
10-18
166
what is the mechanism of cartilage injuries in children
compressive and tensile force
167
what is apophyseal avulsion
suddenly applied forces to the bone may cause the apophyses to become partially or completely separated from the bone
168
what is Osgood schlatters disease
developing ossifications center in the tibial tuberosity may be avulsed and replaced by fibro-cartilaginous material
169
what is the mechanism of injury to Osgood schlatters disease
repetitive strain of the quadriceps
170
when do they have pain with Osgood schlatters disease
until they stop growing approx. 18
171
what are the 6 signs and symptoms of Osgood schlatters disease
- 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
what is the treatment for Osgood schlatters disease
rest from painful activities
| restore strength and flexibility to lower extremity m.
173
what is calcaneal apophysitis
- inflammation of the calcaneal apophysis (insertion of Achilles, plantar fascia and short m. of foot
174
what are the 5 signs and symptoms of calcaneal apophysitis
- 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
what is the 7 treatments of calcaneal apophysitis
- 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
what is sinding Larsen Johansson disease
occurs at the proximal end of the patellar tendon
| in adults this is known as patellar tendonitis
177
what is sinding Larsen Johansson disease called in adults
patellar tendonitis
178
what are the 8 signs and symptoms of sinding Larsen Johansson disease
- 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
what is the treatment for sinding Larsen Johansson disease
same as for Osgood schlatters disease:
rest from painful activities
restore strength and flexibility to lower extremity m
180
what is osteochondritis dissecans
- 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
what is legg calve perthes disease
avascular necrosis of the proximal femoral epiphysis
| needs surgical intervention
182
what are the signs and symptoms of legg calve perthes disease [4]
- 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
what is the treatment for legg calve perthes disease
- 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
what is plastic deformation
- growing bone is less mineralized than mature bone and has the capacity to bend rather than break and stay that way
185
what is a torus fracture
- 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
what is green stick fracture (unique for children )
the tension result in the bone bending at each end but the fracture is not complete
187
what is a hip pointer
- 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
what is consider grade 1 hip pointer
- normal gait pattern and posture
- slight pain on palpation
- little or no swelling
- full ROM of the lumbar spine and hip
189
what is consider grade 2 hip pointer
- 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
what is considered grade 3 hip pointer
- 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
what is the treatment of the hip pointer
- 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
what is NSAIDS
non steroidal anti-inflammatory mediations
193
what is trochanteric bursitis
inflammation of the trochanteric bursa of the hip
194
what causes trochanteric bursitis [2]
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
what is burning or aching pain over or posterior to the greater trochanter a sign of
trochanteric bursitis
196
with an individual with trochanteric bursitis what might a person report with movement
snapping sensation in hip region
197
what movements would someone with trochanteric bursitis report pain with
active flexion, abduction and internal rotation of the hip, (tensor fascia lata m.) and extension and external rotation of the hip
198
what test would someone with trochanteric bursitis report pain with
resistance testing
199
what are the 9 treatments of trochanteric bursitis
- 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
what is snapping hip syndrome
intra articular and extra articular causes
201
what are the two extra articular causes of snapping hip syndrome?
external
| internal
202
what is external articular cause of snapping hip syndrome
ITB or gluteus max. snapping over greater trochanter during hip flexion---> TROCHANTERIC BURSITIS
203
what is internal articular cause of snapping hip syndrome
iliopsoas snaps over structures deep to musculotendinous unit -->ILIOPSOAS BURSITIS
204
what is the intra articular causes of snapping hip syndrome
lesions of the joint-->LABRAL TEAR
| usually occurs when an individual externally rotates and flexes the hip joint
205
what does the Ober's test for?
snapping hip syndrome,
| ITB when it gets tight can cause the noise
206
what are the 3 treatments for snapping hip syndrome
- NSAIDS
- stretching of the tight structures and strengthening of the week m. involved
- alter the biomechanics and technique of the activity
207
what is the most commonly strained m. in the body
hamstrings
208
in what phase of knee flexion is someone likely to strain their hamstrings
initial swing phase
209
true or false a strength imbalance of the quads and hams can cause a hamstring strain
true
210
injury occurs when the hamstrings _____ a forceful contraction of the quad m.
decelerates
211
what is the history of a hamstring m. strain
poor posture, inflexibility and m. imbalance
212
how is antalgic gait pattern a result of a strained hamstring
inability to fully extend the knee at the heel strike
213
increase pain with hamstring strain with ___ hip flexion and knee flexion
active
214
increase pain with hamstring strain with _____ hip flexion and knee extension
passive
215
what is the treatment phase 1 for hamstring strain
- protected, rest, ice, compression and elevation
- NSAIDS
- use of crutches if an antalgic gait patterns is evident
216
what is the treatment phase 2 for hamstring strain
- electrical modalities such as ultrasound and EMS
- slow, pain free and gradual stretching program
- being gentle isometric strengthening exercises
217
what is the treatment phase 3 for hamstring strain
- progressive stretching and strengthening exercises
- sport specific exercises that involve rapid stops, starts and directional changes
- focus on the prevention of future injury
218
what is a quadriceps m. contusion
result of a direct blow to the quad m.
219
what is the most common sit for a quad contusion
anterolateral aspect
220
in what injury is the severity almost always underestimated
quad m. contusion
221
bruising and swelling over the anterior thigh
| antalgic gait pattern are signs of what?
quad m. contusion
222
with a quad m. contusion you have pain with ___ hip extension and knee flexion and pain with _____ hip flexion and knee extension
passive
| active
223
what is myositis ossificans
a direct blow to an area causes a deposition of bone within a m.
224
true or false may need surgery with myositis ossificans
true
225
what is medial collateral ligament MCL sprain caused by
an abnormal valgus force
226
what is the valgus stress test looking for?
tests for MCL sprain
227
what does the patellar apprehension test
patellar dislocation
228
what does the Thomas test look for
hip pointer
229
what does the resistance test detect
m. contusions (quads)
| trochanteric bursitis
230
hat does ober's test detect
snapping hip syndrome
| ITB friction syndrome
231
what does the valgus test detect
MCL sprain
232
what does the figure 8 test detect
if someone is ready to go back to sport after an MCL sprain
233
what does varus stress test detect
LCL sprain
234
what does anterior drawer test detect
ACL sprain
235
what does posterior drawer test detect
PCL sprain
236
what does posterior sag test detect
PCL sprain
237
lochment test detect
ACL sprain
238
what does McMarry's test detect
meniscal sprain
239
what does Apley's test detect
meniscal sprain
240
what are the 9 elements in the acute inflammatory phase in the soft tissue healing
- 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
what are the 7 elements in the proliferation phase in the soft tissue healing
- 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
what are the 5 elements in the maturation phase in the soft tissue healing
- 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
what are the 4 elements in the acute inflammatory phase in fracture healing
- 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
what are the 5 elements of the proliferation phase in fracture healing
- 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
what are the 2 elements of the remodeling stage in fracture healing
- strengthening of the bone and reshaping
| - takes 1-2 years to complete
246
what are the 5 effects of cryotherapy
- vasoconstriction
- increases absorption
- decreases muscle spasms
- decreases O2 demands
- Hunting Response
