pathologies Flashcards
what is a brusae
a flattened sac like structure that is line with synovial membrane and filled w/ synovial fluid which allows smooth and fricitonless motion b/w continguous ms, tendons, bones, ligaments and skin
in the case of injury to the bursae, will there be pain in AROM, PROM or both
both since its considered to be an inert structure
how is the bursae under normal conditions
not very palpable
flattened and smooth
what is a bursitis
results from the inflammation of the bursae which generally occurs when the synovial fluid gets irritated due to excessive movements or as a result of direct trauma to the bursae
what happens to the synovial cells in an injured bursae
the bursae will inflame and the synovial cells will thicken
what are signs and symptoms associated w/ a bursitis
inflammation localized tendernesswarmth edema redness of the skin in the case of a superficial bursitis loss of function from pain
what are some common bursae that get inflammed
-subacromial bursitis olecranon bursitis illiopsoas bursitis trochanteric bursitis ischial bursitis infrapatellar bursitis anserine bursitis
how can a PT treat a bursitis
-generally pts present during the acute/inflammatory phase and hence principles to reduce inflammation are used PRICEMEM
Once the inflammatory phase is finished its important to reassess the strength, posture and mvmt patterns ti determine why the bursae is irritated
should pain from an insidious onset bursae even after treatment be reoccuring?
it can if the mvmt or pain provoking action/posture is not resolved. as opposed to if onset was traumatic, its generally will not return
what is the role of a tendon
attacges ms to bone at the periosteum
what is the role of a ligament
connects bones together at a joint in order to strengthen and stabilize that joint
what are ligaments made out of
dense connective tissue
how does a tendon compare to a ligament
a tendon will become taut or slack depending on if its shortened or lengthened as the ms belly is contracting while a ligament should remain taut throughout full ROM
how do injuries to tendons generally arise?
due to microtrauma to the tissue of the tendon as a result of repeptitive load from external forces s/a the incorrect use of training techniques, improper use of equipment and innapropriate footwear
can anatomical predispositions results in tendon pathology?
inflexibility
weakness
malposition
what are the main causes to tendon pathologies
mechanical over use
aging and poor vascular supply which causes tendons to weaken and become stiffer
what is a tendinitis
an inflammatory rxn to a injured tendon due to microscopic tearing of the tendon. it generally results from fatigue
if the patients show’s up with a tendinitis in the sub-acture phase, will PROM be painful,
since a tendon is a contractile tissue, it shouldnt be painful in PROM if patient is properly relaxed
what is a tendinosis
its a degenerative process of the tendon due to thickening of the tendon which is characterized by the presence of dense populations of fibroblasts, vascular hyperplasia and disorganized collagen
there should not be any inflammatory cells present as this is not an inflammatory reactions but rather a continuous repair cycle of the tendon leading to scar tissue formation
in what population group are tendinosis commonly seen in
people over the age of 35
What are common sites for tendon pathology
- rotator cuff of the shoulder –> supraspinatus and bicep tendon get pinched
- wirst extensors and flexors (lateral epicondylitis/medial epicondylitis)
- patellar tendon of the knee –> common in teens due to growth spurt
- insertion of the posterior tibial tendon leading to shin splints
- achilles tendon
what are signs that are indicative of a tendon pathology
- RISOM will be strong but painful
- will usually be tender with palpation
what methods are generally used to treat an tendon pathology
-if present in the inflammatory phase PT must use PRICEMEME (not effective in the case of tendinosis)
-once inflammatory phase is over need to work on factors causing tendinosis which generally involves correction of posture, flexibility and ms strengthening
thus important to locate any imbalances
provide an example on treatment of a rotator cuff tendinosis (supraspiantus)
pt will generally present with rounded shoulder thus have a weak ER (infra/teres minor and tight IR (subscap) thus the RC muscles will need to be strengthened and improve posture
