Orthopedic Pathology 2

Question 0

Hypotonia and Hypertonia

Answer 0

Hypotonia: decreased muscle tone
Hypertonia: increased muscle tone

Question 1

Muscle tone

Answer 1

Resistance of a relaxed muscle to passive stretch or elongation, resistance of muscles and CT to palpation. Continuous and passive partial contraction of muscle in response to the stimulation of the nervous system

Question 2

Trigger points

Answer 2

Hyperirritable spot, usually within a taut band of skeletal muscle or its fascia. Healthy muscle do not contain trigger points

Question 3

Etiology and pathogenesis of Trigger points

Answer 3

Not well understood, Theorized that muscle fibers become damaged in a trauma, and damaged sacroplasmic reticulum allows calcium to spill out onto the sacromeres causing sustained, uncontrolled contraction. Exacerbated by sedentary lifestyle

Question 4

Contributing and perpetuating factors

Answer 4

shortened position muscle for prolonged duration
Metabolic imbalances, psychological factors, chronic infection, impaired sleep, mechanical stress (bony asymmetries) postural stress, muscle constrictions (e.g. back pack, sporting equipment) nutritional imbalances

Question 5

Characteristics of Trigger point

Answer 5

Is an area of increased metabolism and decreased circulation
Local vasoconstriction possibly a reflexive attempt to control the metabolism
Palpation produces a local twitch response

Question 6

Classification of Trigger points

Answer 6

Active
Latent

Primary
Secondary
Satellite

Question 7

management of Trigger point

Answer 7

Stretching, strengthening, heat, nutrition, massage, chiropractic, injections, spray

Question 8

laxations

Answer 8

Partial (subluxation) or complete (dislocation)dissociation of articulating surfaces of a joint
Some joints are more unstable due to their configuration

Question 9

Dislocation of Glenohumeral joint

Answer 9

Most common is anterior dislocation (person falls backwards onto an outstretched hand)

Question 10

Dislocation of posterior dislocation of GH

Answer 10

Falls forward on a flexed elbow

Question 11

Dislocation of Lunate

Answer 11

a fall on the outstretched hand, forcing the wrist into hyperextension

Question 12

Dislocation of Elbow

Answer 12

usually accompanied by a fracture, a fall on an outstretched hand or in a motor vehicle accident (the ulna and radius are displaced posteriorly)

Question 13

Dislocation of Hip

Answer 13

Uncommon but can occur during motor vehicle accident, if the person is seated, the femur is forced posteriorly by direct impact to the knee

Question 14

Dislocation of the knee

Answer 14

usually dislocates in a lateral direction

Question 15

Cruciate ligament (ACL, PCL)

Answer 15

ACL resists pull of the quadracepts, prevent knee extension, anterior movement. Injured by a blow to the lateral knee, forced hyperextension with internal rotation of the tibia, often injured along with a medial collateral ligament

PCL resists the pull of the hamstrings, PCL is stronger than ACL, and is therefore injured less often. a blow to the anterior tibia, excessive hyperextension or in motor vehicle accidents where the tibia is forced posteriorly (dashboard injury)

Question 16

Treatment of Knee dislocation

Answer 16

Support, rest, exercise, rehab, meds, surgery, Continued Passive Movement (CPM), complications can include reflex sympathetic dystrophy syndrome (RSDS), complex regional pain syndrome (CRPS, body tends to cause a lot of pain for no reason, problem with CNS)

Question 17

Menisci injury

Answer 17

Middle and inner portions of the menisci are avascular, only outer portion is vascularized. Medial Menisci attaches to Medial collateral ligament. Lateral meniscus doesn’t attach to LCL. Menisci is injured by twisting while foot is weight bearing and anchored to the ground.
The knee may give away, buckle or lock.

Question 18

Bursitis

Answer 18

Inflammation of a bursa
subacromial (b/w acromion and supraspinatus)
Subscapular (b/w deltoid and humerus)
Iliopectineal (b/w Iliopsoas and iliofemoral lig)
Ishial (b/w glut max and ischial tub)
Olacranon (b/w olecranon and fascia)
Trochanteric (b/w glut and trochanter)
Pes anserine (b/w satorious, gracillis, semitendinousis and tibia)

Question 19

Bunion

Answer 19

first MTP joint capsule formed by excessive bone growth (exostosis) due to joint hypermobility, poor biomechanics

Question 20

Baker’s cyst

Answer 20

synovial cyst that usually appears at the medial side of the popliteal space, can spontaneously resolve

Question 21

Fibrosis

Answer 21

formation or development of excess fibrous connective tissue in an organ or tissue as a reparative or reactive process

Question 22

Fibrositis

Answer 22

a term to describe local tenderness and hardness in a muscle

Question 23

Hypermobility

Answer 23

increase degree of motion at a joint, can cause joint instability. stretching and joint mobilization contraindicated
Strengthening of the muscles surrounding the joint

Question 24

Hypomobility

Answer 24

Loss of motion at joint including loss of normal joint plan
Indication for massage, Mobilizations, chiropractic
Contraindications : do not mobilize joint that is stabilized with rods, screws and plates. or surgically shortened ligaments