Pathophysiology Flashcards
Test 1
The complete physical, mental, and social well being of a person, not only the lack of disease or infirmity
Health (by the World Health Organization)
The branch of science that studies structural and functional changes in tissues and organs that lead to disease
Pathophysiology
The study of changes to cells and tissue associated with disease
Pathology
Any deviation from the normal state of health or wellness, leading to disruption of homeostasis of the body
Disease
What things can influence an individuals normal state in regard to vitals?
Age, gender, family hx, environment, activity level
Any physical, mental, cognitive, or developmental condition that impairs, interferes with, or limits an individual’s ability to engage in specific tasks or actions, or to participate in common daily activities and interactions?
Disability
What do we use that allows for assessment of degrees of disability and is applicable to all people of all health conditions?
ICF - International classification of functioning, disability, and health
Can ICF classify characteristics of developing children?
No
Levels of ICF qualifiers
0 - no problem 0-4%
1 - mild problem - 5-24%
2 - mod problem - 25-49%
3 - severe problem - 50-95%
4 - complete problem - 96-100%
Prevention of disease is by?
Vaccines, routine testing, genetic testing, etc
Causes of diseases can be intrinsic or extrinsic. What does intrinsic mean and examples?
Intrinsic causes come from within the body. Examples are infectious agents or behaviors like smoking, drug use, poor diet, no exercise
What disease termed if there is no known cause?
Idiopathic
___ and ___ diseases are caused by developmental disturbances such as chromosomal or genetic abnormalities, injury within the womb, or a combo of environmental and genetic factors. Ex. congenital heart disease
Congenital and hereditary
____ diseases cause degeneration of body parts, often as a result of aging. Ex. arthritis and arteriosclerosis
Chronic diseases
____ diseases cause loss of normal function and may result in inability to work. Ex. arthritis, cancer, depression
Disabling diseases
____ diseases occur when the body reacts to injury or harmful agents with inflammation. Ex. pneumonia or sore throat (think tonsils)
Inflammatory diseases
___ diseases cause disturbances in normal metabolic processes. Ex. diabetes or thyroid conditions
Metabolic diseases
____ diseases cause abnormal cell growth with benign and malignant tumors
Neoplastic diseases
Term for a short term diseases with extreme symptoms
Acute
Term for a long term disease developing gradually with lesser sx’s usually causing more permanent damage
Chronic
Term for the causative factor of a disease
Etiology
Term for if a treatment, procedure, or error is responsible for a disease
Iatrogenic
Term for is the cause of a disease is unknown
Idiopathic
Term for the number of new cases in a particular period
Incidence
Term for the disease rate within a group
Morbidity
Term for the relative number of deaths from a disease
Mortality
Term for conditions that trigger acute episodes
Precipitating factors
Term for factors that indicate a high risk for disease but not certain development of that disease
Predisposing factors
Term for the number of people in a population who have a disease at a given time
Prevalence
Term for the probability or likelihood for recover or other outcomes
Prognosis
What are the 4 categories of preferred practice patterns that help guide treatment of various conditions?
Integumentary (skin), cardiopulmonary (heart and lungs), neuromuscular (mms and nervous system), and musculoskeletal (bones and mms)
T or F?
The role of health care has gone from curing and healing to preventing sickness and promoting health and wellness? Healthy behaviors are taught to all its, regardless of if they are healthy or ill.
TRUE
What are the three levels of education/preventative medicine?
Primary, secondary, and tertiary
Which level of education promotes early disease detection through things like blood work, pap smears, mammograms?
Secondary - trying to catch before it starts
Which level of education works toward removal or reduction of risk factors and disease? Ex. quitting smoking
Primary - preventing the disease from happening
What level of education focuses on limiting impacts of disease once someone has it? Treating the disease and creating a life s close to normal as possible
Tertiary
T or F? The term “clinical picture” is a drs interpretation based on a pt’s signs and sx’s and tests that is a discussion of the injury or disorder
True
What is the term for the causative factor of a particular disease? Remembering that the cause could be idiopathic or iatrogenic
Etiology
What is the term for the # of new cases in a particular period?
Incidence
Direct, indirect or overuse muscle/tendon injury?
Injury is likely to be a result of contact with another player, object or the ground
Direct
Direct, indirect, or overuse muscle injury?
Injury is likely to be a result of a physical injury without contact (ACL tear, hamstring strain)?
Indirect
Direct, indirect, or overuse mm injury?
Injury that is likely to be a result of continual impact on the tendon leading to wear and tear and breakdown (tendinopathy like tennis elbow)
Overuse
Does a strain pertain to tendon/muscles or ligaments?
Tendons/muscles
Mild (1st degree), mod (2nd degree), or severe (3rd degree) strain? Tear of a few muscle fibers with minor swelling and tenderness, minimal or no loss of strength/restriction of movement, and can continue normal activities AMAP
Mild (1st degree)
Mild (1st degree), mod (2nd degree), or severe (3rd degree) strain? Greater damage to the muscle and a definite loss of strength, pain with activity that can prevent further participation, mod to severe pain with some loss of joint and joint stability, and usually requires 3-28 days rehab
Moderate (2nd degree)
Mild (1st degree), mod (2nd degree), or severe (3rd degree) strain? Involves a tear across the whole muscle belly with severe pain or loss of function, possibly no pain if it is a complete tear, surgery is often necessary, and healing can take up to 3 mo of rehab
Severe (3rd degree)
What is always a potential consequence of muscle injury?
Muscle atrophy
What is the incidence of strains?
They nearly affect everyone at some point in life and have the same incidence to sprains. They are linked to activities like falls, running, jumping, throwing, and lifting
What is the prognosis of strains?
Good with adequate rest and treatment, do regular stretching and strengthening exercise to prevent stains, and have overall good physical health for any new sport or intense activity
What is a common injury called that is pain/swelling of an injured tendon?
It used to be referred to as tendinitis. The mechanism for this injury varies from region and patient.
Tendinopathy
What is tendinopathy most caused by?
Overuse and tensile load, and results in pain and loss of function
What are common sites of tendinopathy?
Rotator cuff, origin or wrist extensors and flexors, shin splints (o of anterior tibialis, Achilles tendon)
What is a common injury called that is a chronic mid portion tendon pathology?
Degeneration of tendon and thickening of tendon
Tendinosis
What is the common injury called that is inflammation of a fully developed synovial sheath? It presents with acute swelling with or w/o popping and triggering
Tenosynovitis
What is the common injury called that is used to describe involvement of the paratendon, alone or in combination with tendinosis? It has similar presentation to tendinosis
Paratendonitis or peritendinitis
What are the two ways that tendon load can be increased for rehab?
- Increase amount of resistance
- Increase speed of exercise
What are the four phases of healing for tendons?
- Clotting (5 min ~48 hrs)
- Inflammatory (~1 week but may be longer if tx is not good enough)
- Proliferation (begin around day 5-6 and up to 4-6 weeks or more)
- Remodeling (around day 20 and last up to a year or more)
Ways to improve tendinopathy?
Corticosteroids, injections, surgery, shockwave therapy
Does a sprain involve tendons or ligaments?
Ligaments
Grade 1, 2, or 3 ligament sprain?
Involved stretching of the ligament but no fiber damage. There is no abnormal ROM, little or no swelling, some tenderness, small bruising, and little loss of structural integrity
Grade 1
Grade 1, 2, or 3 ligament sprain?
Involves stretching of the ligament and tearing of SOME fibers. There is some abnormal ROM, more bruising and edema, some hemarthrosis and effusion, and lots of structural weakening.
Grade 2
Grade 1, 2, or 3 ligament sprain?
Complete abnormal motion, lots of bruising and hemarthrosis, and complete loss of structural integrity.
Grade 3
What is the term for bleeding into the joint cavity?
Hemarthrosis
What is the incidence of sprains and where?
Ankles and 1 out of every 320 people (myself included last week!)
What is the prognosis for sprains?
Good unless there is a fracture in the area. As long as the treatment regimen is followed right, most sprains resolve with little future complications and have full functional ranges.
T or F?
Ligament injuries usually occur on their own with no other simultaneous injuries.
FALSE - they rarely occur in isolation and often simultaneous injuries occure to other ligaments or structures
T or F?
Extra articular ligaments heal faster than intra-articular ligaments due to the decreased blood supply to intra-articular ligaments
TRUE
What are the 4 steps of healing extra-articular ligaments?
- Hemorrhagic - gap is filled with hematoma
- Inflammatory - first 24-48 hrs
- Proliferation - fibroblast make collagen and other proteins within 1 week of injury
- Remodeling - tissue matrix becomes denser
T or F?
Ligament injuries can take as long as 3 years to heal to the point of regaining near-normal tensile strength
True
What does surgical repair of tendons look like to resort tendon continuity and function within 7 days of injury?
Suture two ends of tendon together and do post-surgical splinting or bracing
What does surgical repair of ligaments look like?
It is based on how bad the injury is, the potential for healing, the amt of jt instability, and the expected level of pt’s participation in future sport activities.
What are the effects of immobilization of body parts in a shortened state when healing?
Cartilage degeneration, change in mm length, mm atrophy, decreased bone density, and decreased mechanical and structural properties of ligaments
What is the conservative minimus for a minor injury to heal?
6 weeks
What are some complications to healing? Along with the size of the injury, type of tissue injured, and its blood supply?
Age, overall health, nutrition, meds, poor O2 supply, dehydration, smoking, repeated trauma
What is the term for decreased oxygenation due to the mm spasm restriction blood flow to a given area?
Ischemia
What is the term for a complete separation of bone from its normal position within a joint?
Dislocation
What is the term for a partial separation of a bone from its joint?
Subluxation
What is the pathophysiology of subluxation? How does it happen usually?
It usually happens from a blow or fall, extreme force applied to a joint
T or F?
In subluxation, the damage to the joint will be similar in the ligaments around the joint as well
True
What is the incidence for subluxation? What accounts for 45% of all dislocations?
Shoulders account for 45% of all dislocations with the knees, elbows, wrist, hips, feet common too
what is the etiology of subluxations?
Caused by major trauma like sport injuries, car accidents, falls, joint abnormalities, and diseases
What is the treatment of subluxations?
The joint is repositioned by a healthcare provider and sometimes may need surgery if really bad
What is the term for inflammation of a synovial membrane?
Synovitis
What is the term for an abnormal benign swelling on a tendon sheath?
Ganglion
What is a bruise also called?
Contusion
What is the term for a localized swelling that is filled with blood caused by a breaking in the wall of a blood vessel?
Hematoma
What is the term for a band of scar tissue that joins two surfaces of the body that are usually separate?
Adhesion
What is the term for a long, narrow incision in the skin made by something sharp?
Cut
What is the term for a surgical cut made in the skin or flesh?
Incision
What is the term for a scrape on your skin caused by friction?
Abrasion
What is the term for a deep cut or tear in skin or flesh?
Laceration
What is the term for inflammation of the bursa, the small fluid filled sacs near joints that help reduce friction during movement?
Bursitis
What is the pathophysiology of bursitis? What causes it?
Caused by repetitive movements and excessive pressure upon any of the bursa of the body
What is the incidence of bursitis?
1 out of every 31 people in the US, most commonly in shoulders, hips, elbows, and knee caps
What is the etiology of bursitis?
Idiopathics and also things like repeated trauma, infection, unusual exercise
What is the tx of bursitis?
Analgesics, anti-inflammatory meds, rest and PT
What is the prognosis of bursitis?
Good as long as rest and tx’s are adequate. The best prevention is reduction of repetitive movements, exercise, and stretching
What are some red flags in PT that may require immediate attention and which supersede PT?
Not feeling well, fever, chills, fatigue, nausea/vomiting, SOB, dizziness, cancers, bowel dysfunction, severe pain, numbness, or unexplained weight changes
What is the time range for delayed onset muscle soreness (DOMS)?
0-3 days
What is the time range for Grade 1 muscle healing (1st degree)?
0-3 days to 5-7 weeks
What is the time range for Grade 2 mm healing?
3-4 weeks to 3-6 mo
What is the time range for Grade 3 mm healing?
5-7 weeks to 6-12 mo
What is the time range for Grade 1 ligament helaing?
4-14 days to 5-7 weeks
What is the time range for Grade 3 ligament healing?
5-7 weeks to over 1 year
Do intra-articular ligament injuries normally heal?
NO
What is the time range for acute tendon repair?
3-4 weeks to 2-3 mo
What is the time range for subacute tendon repair?
2-3 mo to 6-12 mo
What is the time range for chronic tendon repair or surgical repair?
3-6 mo to over 1 year
What is the time range for bone healing?
5-7 weeks to 3-6 mo
