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Myology 2 > Pathologies > Flashcards

Pathologies Flashcards

1
Q

What is the condition Contusions?

A

This is a Crush Injury to Muscle Tissue.

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2
Q

What is a hematoma?

A

A large area off hemorrhage following a trauma.

The pooling blood causes swelling and pain as it compresses nearby nerve endings.

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3
Q

What is a Myositis ossification?

A

This is a Occasional complication following a Hematoma.

It is Idiopathic and occurs in the area within a muscle where the Blood Calcifies.

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4
Q

What are the causes of a contusion?

A

Contusions are caused by direct blows to the Muscle tissue.

They can be classified by 3 levels of severity.

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5
Q

What are the 3 levels of severity that a contusion can be?

A

Mild
Moderate
Severe

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6
Q

What are other soft tissue injuries that may occur with a Contusion?

A

This includes:

Strains, Sprains and Dislocations.

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7
Q

What is a Mild Contusion?

A

This is a Minor crush to the Muscle with minimal Bleeding.
There is minimal or on loss of Strength or ROM.
The Client can continue the Activity with mild discomfort.

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8
Q

What is a Moderate Contusion?

A

Moderate crushing of the Muscle with bleeding and Swelling.

The Client has difficulty continuing the Activity due to pain and muscle weakness.

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9
Q

What is a Severe Contusion?

A

Severe Crushing of the with Rapid bleeding and Swelling.

The Client cannot continue the Activity due to pain and muscle weakness.

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10
Q

What is the Symptom picture for a Moderate Acute contusion?

A

There is a crushing of several or many fibers of the tissue.
Local Swelling due to Hematoma.
20 - 50 % loss of ROM.
Pain when contracting or Stretching the muscle.

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11
Q

What is the Symptom picture for a Severe Acute Contusion?

A

There is Crushing of many of the Muscle Fibers.
Rapid Swelling due to Hematoma and Edema.
Heat and bruising is present.
More than 50 % ROM loss and pain at the Lesion Site.

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12
Q

What is the symptom picture for a Mild Acute Contusion?

A

Minimal Edema, Heat & Bruising.
Tenderness at the Lesion site.
Activaty that contracts or stretches the affected muscle causes discomfort.
There is 5 - 20 percent ROM loss and minimal or no loss of strength.

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13
Q

What occurs only in the Moderate and Severe Contusions?

A

Swelling and Hematoma occur in these types of Contusions.
The swelling of Hematoma Occurs much quicker than Edema.
This is caused by the Arterial pressure pushing blood into the damaged blood vessels.

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14
Q

When can Rebleeding occur in a contusion?

A

This can occur the 10 days after a Severe contusion.

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15
Q

When can Rebleeding occur in a contusion?

A

This can occur the 10 days after a Severe contusion from the Arterial pressure or external factors like stretching the affected site.

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16
Q

What is the Symptom picture for a Contusion in the Early Sub-Acute Stage of Healing?

A

The Bruising is going to be Black and Blue only if it was Moderate or Severe / and Hematoma is still present but reduced from the Acute stage.
Adhesions develop around the Injury.
Muscle guarding diminishes and only TrPs are present in the affected Comp Muscles.

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17
Q

What does the Symptom picture look like for a Contusion in the Late Sub-Acute stage of Healing?

A

The Bruising is now Yellow, Green and Brown in colour.
The Pain, Edema and Heat are Diminishing.
Adhesions are maturing around the affected area.
The protective Muscle spasms are replaced with increased tone of the tissue.
TrPs occur in the Affected muscle and its compensating structures.

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18
Q

What does the Symptom Picture look like for a Contusion in the Chronic Stage of Healing?

A

The Bruising is gone.
Adhesions have matured around the injury site.
hypertonicity and trigger points are present in the affected muscle and Compensating structures.
The tissue may be cool due to Ischemia.

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19
Q

What do you do before treating a Client with a Contusion in the Acute Stage?

A

1st you would asses the client to see if the condition Is Mild to severe. If it is Moderate or severe, refer the client out of the clinic.
If the condition is Mild you would work to Reduce Inflammation.

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20
Q

What are the Goals of Treatment for a Acute Mild Contusion?

A

Reduce pain and SNS firing.

Treat Compensating Structures.

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21
Q

What is a General Treatment plan for a Mild Acute Stage Contusion?

A

GMS is used on the unaffected leg first to Reduce SNS and treat Compensating structures.
The affected leg is treated with GSM proximal to the injury site only.
care is take to not touch the hematoma or to completely get rid of Muscle guarding.

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22
Q

What are the Treatment Goals for a Late Sub-Acute Contusion?

A

Reduce pain and SNS Firing.
Treat Compensating structures.
Reduce Edema, Hypertonicity and trigger points and Adhesions.

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23
Q

What would a General Treatment plan be for a Early Sub-Acute Contusion?

A

GSM is similar to Acute stage treatment but GTOR is used to reduce Spams of the affected limb / injury site.
Care is taken not to disturb the hematoma with proximal work.
treatment to TrPs and hypertonic muscle is treated proximal to the injury.
On site work is CI and distal; work is restrained to non circulatory.

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24
Q

What are treatment goals for a Chronic stage Contusion?

A

Reduce SNS firing, Hypertonicity and Trigger points. Reduce adhesions.
Treat compensating structures.
Restore ROM.
increase Local Circulation.

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25
Q

What is a General Treatment plan for a Late sub-Acute Contusion?

A

Pain free passive relaxed ROM is used on the affected area.
Trigger points and Hypertonicity are treated using Ishcemic Compressions.
GSM and Petrisage is used on the affected area.
Distal to the affected area Circulatory work is used, Risk of congestion and Disturbing the Hematoma is diminishing.

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26
Q

What is a General Treatment plan for a Chronic Contusion?

A

Compensatory work is used and Now the client may be positioned on the Affected area to work on other areas.
Passive Relaxed ROM can be used.
GSM used to increase local circulation.
TrPs are dressed in the affected area.
A combination of Fascial release and stretching is used.

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27
Q

What is the Definition of a Spasm?

A

A involuntary, sustained contraction of a muscle.

A “Cramp” is a common term for a painful, prolonged muscle spasm.

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28
Q

What does the term “Reflex Muscle Guarding” mean?

A

This refers to a Muscle Spasm in responce to pain.

The painful stimulus is due to local tissue injury and present in the Acute stages of a condition.

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29
Q

What does a muscle Spasm do for the body?

A

It is used by the body to help protect injured structures and restrict movement.
It may also result from referred pain.

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30
Q

How does a Muscle guard / Spasm go away?

A

It will go away when the pain is relieved.

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31
Q

What is a “Intrinsic Muscle Spasm”?

A

This is a Spasm that is apart of a Self perpetuating pain Spasm cycle.
It results from direct or indirect trauma, Inflammation or infection can initiate a muscle contraction.
The contraction of the affected muscle restricts movement of the joint the muscle crosses.
The muscle will stay in spasm even when the initiation injury is no longer acute.

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32
Q

What are Golgi tendon Organs?

A

These are Nerve receptors located in the tendons near the Muscular attachments.
The receptors are sensitive to tension, to ether passive stretch or active contraction.
When they fire, they inhibit contraction of the muscle to protect it from an overstretch injury.

33
Q

What is the Symptom Picture for a Spasm in a client?

A

There is pain in the muscle due to ischemia & Retension of Metabolites. Acute trauma and referred pain may also cause the spasm.
Spasm and Hypertonicity are present.
There is decreased ROM of the Joint crossed by the shortened affected muscle.
whether it is Intrinsic or Muscle guarding.

34
Q

What are the Treatment goals for a Client with a Muscle guarding or Intrinsic muscle Spasm?

A

Break the pain-Spasm cycle ad Decrease the Spasm.

If the Spasm is muscle guarding in response to an Acute injury do nothing to disturb the healing process and only reduce a portion of the Spasm.

Decrease pain and SNS firing.

increase local Circulation.

increase ROM and treat Antagonist and Synergist .

35
Q

What would a general Treatment for a Client with Intrinsic Spasm or Muscle Guarding be?

A

Reduce the Spasm by using GSM and compensating structures.
Once the spasm has reduced or is less painful, onsite work such as Shaking, petrissage and effleurage are used the the affected area and surrounding tissue to flush out metabolites and Decrease pain.
Muscles with Intrinsic muscle spasm will have Ischemia.

36
Q

What is the condition Duputyren’s Contracture?

A

This is a Contracture of the Palmar Fascia, Resulting in a flexion deformity of the Fingers.

37
Q

What is the Symptom Picture for a client with Duputyren’s Contracture?

A

Often Bilateral, Initially the palmar fascia becomes tender thickened and nodule, Active extension of the digits is difficult due to contraction, increase in tone of the Wrist flexors, Ischemia of the affected area do to contraction.

38
Q

What are the Treatment goals for a client with Duputyyren’s Contracture?

A

The flexors of the forearm are treated using petrissage.
thumb needing of the palmar fascia.
The adhesions and thickening of the palmar fascia are treated with frictions and treating the tendons around the area followed with ICE.
Or general Fascial Work to the affected area.

39
Q

What is a Strain?

A

It is an overstretch injury to the Muscle and its tendon.

40
Q

What are the Causes for a Strain?

A

Things such as:
Sudden over-stretching of the muscle.
An extreme contraction of the muscle against heavy load.

41
Q

How may grades does a Strain have?

A

3

42
Q

What is a Symptom picture for a client with an Acute grade 1 Strain?

A

Minor Discomfort in the injury site on activity.
Local Edema, heat and Bruising are minimal or not present.
Tenderness on the lesion site.
Little or no loss of ROM.
Client can continue Activity.

43
Q

What is a Symptom picture for a Client with an Acute Grade 2 Strain?

A

There is a Snapping noise or Sensation at the time of the Injury.
Moderate local Edema, Heat, Hematoma And bruising are present.
A gap may be palpated in the Tissue.
Moderate tenderness at the lesion site.
Moderate pain when performing activities that contract / Stretch the muscle.

44
Q

What is a Symptom picture for a client with an Acute Grade 3 Strain?

A

There is a snapping noise at time of Injury.
Marked local Edema, Heat, Hematoma & bruising are present.
Palpable Gap in tissue.
Severe pain at Lesion site.
Client cannot continue activity.

45
Q

What only occurs in a Grade 2-3 Strains?

A

The Bruising is Red, Black and Blue.
A hematoma is present at the lesion site.
Loss of ROM due to Muscle guarding / Spasms in the surrounding tissue.

46
Q

What is a Symptom Picture for a client with a Chronic Strain?

A

If there was any bruising is now gone.
Hypertonicity And TrPs are present in the affected muscle & any Comp structures.
Adhesions have matured around the injury.
Tissue may present Ishcemia.
if muscle is stretched there is Discomfort.
Posible Disuse Atrophy.

47
Q

What is a Symptom Picture for a Client with a Grade 1-3 Strain in the Early Sub-acute Stage?

A

Grade 1 has little or no pain and reduced strength.
Garde 2 has pain and moderately reduced strength.
Garde 3 has more pain and with Active resisted testing.

2 - 3 have bruising black and blue & Hematoma is present.
Pain & Edema is present but reduced from the Acute.
Adhesions Are developing around the injury site.
Muscle Guarding demises and Trigger points Form in the Affected muscles and its Supporting Muscles

48
Q

What is the Symptom Picture for a Client with a Grade 1 - 3 Strain in the Late Sub-Acute Stage?

A

Grade 2 - 3 the bruising is yellow, green and brown.
The hematoma diminishes and a Gap is still palpable in the tissue.

With all Strains, The pain, edema and inflammation are demolishing.
Muscle guarding is replaced by increased tone in the affected muscles. Trigger points form in the affected muscles.
Adhesions mature around the injury.

49
Q

What would a treatment look like for a client with a Strain in the Acute stage?

A

Injury Site not Stretched and A ice pack placed on the injury Site.
GSM are used on the unaffected area / Limb to treat comp Structures and Decrease SNS firing and Pain.
Working proximal to the injury site reduce a little Spasm but not enough to weaken the affected joint.

50
Q

What would a Treatment look like for a client with a Strain in the Early Sub-Acute Stage?

A

Similar to Acute treatment as in using Contrast Hydro and then treating the Unaffected location and Comp structures.
Focus on reducing Spasms of the affected muscle and Addressing Trigger points. Especially the trigger points referring into the Injury Site.
non-circulatory work is used on site if no hematoma s present.
No GMS distal to injury Site.

51
Q

What would a Treatment look like for a client with a Strain in the Late Sub-Acute stage?

A

Less time spent on MLD and more time spent on Proximal Pettrisage and Trigger point work.
Muscle stripping Distal to proximal over lesion site.
and Skin rolling over lesion site.
Passive stretching of affected muscle.
Distal Circulatory work is used to promote tissue health with circulation through the affected area.

52
Q

What would a Treatment look like for a client with a Strain in the Chronic Stage?

A

Facial work and Frictions are performed on the lesion site.
and GSM used to increase local Circulation.
Addressing trigger points referring into the Injury site.

53
Q

What would a Treatment look like for a client with a Strain in the Chronic Stage?

A

Facial work and Frictions are performed on the lesion site.
and GSM used to increase local Circulation.
Addressing trigger points referring into the Injury site.
Passive relaxed Stretching is used to the affected site.

54
Q

What is the Condition Torticollis?

A

An abnormal positioning of the head and neck Relative to the body.

55
Q

What is “Acute Acquired Torticollis”?

A

A painful unilateral shortening or Spasm of Neck muscles resulting in an abnormal head position.

56
Q

What are causes for Acute Acquired torticollis?

A 
Activation of latent trigger points. 
Subluxation of  C1 on C2. 
Facet Joint irritation. 
Infection. 
Disc-related pain.
57
Q

What are the Types of torticollis?

A

Acute Acquired Torticollis, Congenital Torticollis & Spasmodic Torticollis.

58
Q

What is a Symptom Picture for a client with Acute Acquired Torticollis?

A

The client will wake up with the condition suddenly.
The head and neck are in the indicated position for the condition.
Pain on movement or the client may not be able to move head or neck for fear of increasing pain.

59
Q

What are the Treatment goals for a Client with Acute Acquired Torticoliis?

A

Decrease pain, Spasms and abnormal Positioning.

While working within the clients pain tolerance as it is a painful condition so you must gain the clients trust.

60
Q

What is a Treatment for a Client with Congenital Torticollis?

A

Gentle Fascial Stretching applied to the affected SCM in segments.
Treat comp structures around the neck and shoulders.
With GSM.
Gentle Stretching is applied to affected areas.

61
Q

What are the treatment goals for client with Congenital torticollis?

A

Lengthen the Contractured structures.
Reduce abnormal Positioning of the head and neck.
Restore ROM of the Head and neck.
Strengthen any weak structures if needed.

62
Q

What is a Treatment for a client with Spasmotic Torticollis?

A

Main focus is full body relaxation.
Diaphramatic breathing and gentle GSM.
And treating comp structures.
Do not treat the neck itself as it may make the spasm worse.

63
Q

What are treatment goals for a client with Spamsmotic torticollis?

A

Reduce SNS firing and Spasm.

Restore normal head position and ROM.

64
Q

What are things that can cause a Reflex muscle Contraction / Guarding?

A

Pain, SNS firing, Emotional Stress, Cold, Immobilization.

65
Q

What is the “Pain-spasm Cycle”?

A

When a Reflex Muscle Contraction occurs and isn’t treated and continues to Stay contracted for the following reasons.
Lack of movement - Tissue Ischemia - Pain - Muscle Spasm.

66
Q

In what stage of healing of a Contusion are the Adhesions around a injury site Maturing?

A

This occurs in the Late Sub-Acute Stage.

67
Q

In what stage of healing of a contusion are Adhesions developing around a injury site?

A

This occurs in the Early Sub-acute stage.

68
Q

In what stage of healing of a Contusion is Hematoma diminished from the Acute stage but still present?

A

This is in the Early Sub-Acute stage.
The pain, Edema, Heat and Hematoma diminish in the Late sub-acute stage.
This is all for moderate - Severe contusions.

69
Q

In what stage of healing for a contusion when treating do you want to avoid the Healing process as it is to fragile?

A

This is for Early Sub-acute and Acute.

70
Q

What stage of healing can you start to use more vigorous work on the affected area of a Contusion?

A

This begins in the Late Sub-acute Stage into the Chronic.

71
Q

What stage of healing for a contusion can you work distal to the injury site with circulatory work?

A

This begins in the Chronic stage to increase local venous return.

72
Q

What stage of healing for a Strain do you not want to reduce to much Reflex muscle guarding?

A

This is in the Acute stage.

73
Q

In what stage of healing for a Strain would you only want to treat the Antagonist of the affected muscle if the trunk or neck is affected?

A

This is only in the Acute stage as you cannot congers the injury site or interfere with the healing process.

74
Q

In the Early sub-acute stage of healing for a Strain how would you maintain local circulation proximal to the injury site?

A

You treat the proximal limb to Reduce Hypertonicity and maintain venous return.
GSM and repeated Petrisage and Origin and insertion.

75
Q

In the Early Sub-Acute stage of a Strain why would On site work be Delayed until Late Sub-Acute Stage?

A

This could be because of a Hematoma still being present if the Strain was Grade 2-3.

76
Q

Can you use a Full Stretch and Heat on a Client with a Late Sub-Acute Contusion?

A

No this is CI’d until Chronic Stage because these things will compromise the Contused Tissue.

77
Q

How would you address the lesion site of a Late sub-acute contusion?

A

You Would work from the periphery - into the lesion site - & then back out.
As the inflammation subsides the focus of treatment turns to reducing adhesions and helping to realign the developing connective tissue.

78
Q

Can you use Full ROM on a client with a Chronic Contusion?

A

Yes you would use this…

Myology 2 (9 decks)

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