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MSK2 LEC > PRINCIPLES OF INTERVENTION > Flashcards

PRINCIPLES OF INTERVENTION Flashcards

1
Q

How many days does the acute stage of inflammation and repair last?

A

4-6 days unless insult is perpetuated

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2
Q

The body’s way of immobilizing a painful area

A

Edema/joint effusion, and muscle guarding

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3
Q

Occurs during any injury/insult caused by trauma, repetitive use, or chemical irritants to reinstate homeostasis

A

Acute stage of inflammation and repair

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4
Q

Proliferation, repair, and healing stage that lasts 10-17 days (14-21 days after onset of injury)

A

Subacute stage

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5
Q

May last up to _ weeks in tendons d/t limited circulation

A

6 weeks

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6
Q

Noxious stimuli are removed and capillary beds begin to grow into the area

A

subacute stage

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7
Q

Pain synchronous c encountering tissue resistance at the end of available ROM and occurs only when newly developing tissue is stressed beyond its tolerance

A

Subacute stage

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8
Q

Maturation & Remodeling stage which may last for 6 months to 1 yr depending on what type of tissue is involved and the magnitude of damage

A

Chronic stage

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9
Q

Scar retraction is completed by day __

A

21

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10
Q

May have contractures or adhesions that limit ROM c muscle weakness, limiting normal function

A

Chronic stage

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11
Q

Factors affect density and activity level of the fibroblasts in remodeling time

A

+ amount of time immobilized
+ stress placed on tissue
+ location of lesion
+ vascular supply

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12
Q

T/F: Tendons and ligaments have shorter healing time compared to muscle

A

False, muscles are more vascularized than tendons and ligaments, thus, making mm recovery time shorter

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13
Q

Difference between late subacute and chronic stages are

A
  • improvement in quality (orientation and tensile strength) of collagen
  • reduction of wound size during chronic stages
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14
Q

If there is a progressive loss of ROM due to stretching, what do you do?

A

do not stretch

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15
Q

Prolonged or recurring pain, and resulting limitations in activity & function occur as a result of stress being imposed on tissues that are unable to respond to the nature of the stress

A

Chronic inflammation

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16
Q

Tissue responses and characteristics during acute stage

A
  • vascular changes
  • exudation of cells and chemicals
  • clot formation
  • phagocytosis, neutralization of irritants
  • early fibroblastic activity
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17
Q

Tissue responses and characteristics during subacute stage

A
  • removal of noxious stimuli
  • growth of capillary beds into area
  • collagen formation
  • granulation tissue
  • very fragile, easily injured tissue
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18
Q

tissue responses and characteristics during chronic stage

A
  • maturation of connective tissue
  • contracture of scar tissue
  • remodeling of scars
  • collagen aligns to stress
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19
Q

Impairments during the chronic stage of tissue repair

A

-contracture & adhesions
-weakness, poor endurance & neuromuscular control
-dec functional usage of the involved body part
-inability to function as expected

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20
Q

Tissue responses and characteristics during the acute stage

A

vascular changes, exudation of cells and chemicals, clot formation, phagocytosis, neutralization of irritants, early fibroblastic activity

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21
Q

Removal of noxious stimuli, growth of capillary beds into area, collagen formation, granulation tissue, very fragile and easily injured tissue

A

Subacute stage

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22
Q

Absence of inflammation and pain after tissue resistance

A

clinical signs of chronic stage

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23
Q

Area at high risk for injury in a skeletal muscle

A

myotendinous junction

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24
Q

MOI for muscle injuries

A

high demand/impact activities d/t a significant force that can lead to muscle strain or contusion

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25
Q

Tearing of a few muscle fibers with minimal loss of strength d/t pain

A

Grade 1/Minor

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26
Q

More damage to fibers c associated loss of contractile strength

A

Grade 2/moderate

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27
Q

Cross-sectional rupture c complete loss of contractile strength

A

Grade 3/severe

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28
Q

Phases of healing in muscle injuries

A

Destruction phase > Repair Phase > Remodeling Phase

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29
Q

Necrosis of contractile elements

A

Destruction Phase

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30
Q

Hematoma formation and inflammation

A

Destruction Phase

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31
Q

Fibrin and fibronectin form early linkages to provide support against contraction

A

Destruction Phase

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32
Q

Phagocytosis of nectrotic tissue

A

Repair phase for mm injury

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33
Q

Regeneration of contractile elements

A

Repair phase

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34
Q

Stimulation of myofiber formation and scar formation

A

Repair Phase

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35
Q

Needs at least 4-6 weeks for re-organization of tissue integrity and functional maturation

A

Remodeling Phase

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36
Q

Small injuries heal with ____ tissue while Large injuries heal with ____ tissue

A

Muscle; Scar

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37
Q

In muscle injury rehab, modalities may be used to

A

control inflammation, edema, and stiffness

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38
Q

Early activity is advocated to prevent adhesion formation. Active stretching is advocated for muscle injuries

A

First statement is true, second is false

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39
Q

How long should active stretching be postponed for post-injury?

A

3-7 days to prevent re-injury

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40
Q

Causes of tendinopathies

A

Repetitive motions/load, causing microtears

abrupt, forceful contraction of the tendon’s muscle

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41
Q

Tendons have ___ consistent blood supply compared to othe rtissues

A

Less

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42
Q

Most common tendon rupture alongside supraspinatus tendon

A

achilles tendon rupture

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43
Q

Healing process of tendinous injuries

A

Inflammatory > Proliferative repair > Remodeling > Scar formation

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44
Q

Healing process of tendon wherein collagen is produced

A

Proliferative repair

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45
Q

Healing process of tendon wherein realignment of collagen happens

A

Remodeling

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46
Q

Healing stage wherein there is decline of tendon metabolism and vascularity

A

Scar formation phase

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47
Q

Tendon healing phase where the faulty biomechanics and compensatory posture should be corrected

A

proliferative repair

48
Q

healing phase of tendon which involves induction of fibrous repair

A

remodeling phase

49
Q

_______ is important during the proliferative repair phase to correct faulty biomechanics and compensatory posture

A

patient education

50
Q

Tissue strengthening for tendon injury begins at the

A

remodeling phase

51
Q

MOI for ligament injuries

A

excessive lengthening

52
Q

Most common injured ligaments

A

ATFL > ACL

53
Q

microfailure c a few fibers in the part of the plastic range are ruptured

A

grade 1

54
Q

only needs intervention and protection s surgery

A

grade 1 injury

55
Q

Surgical intervention is dependent on pt’s goal & instability present

A

grade 2

56
Q

with moderate joint instability

A

grade 2

57
Q

Significant joint laxity & involves surgical intervention

A

grade 3

58
Q

Football, basketball, and soccer players, as well as skiers are most prone to this ligamental injury

A

ACL tear

59
Q

Most common knee injuries sustained in sports

A

ACL Tear

60
Q

Healing process of ligament injuries

A

inflammatory > regenerative > remodeling

61
Q

ligament healing phase that involves fibroblast proliferation & collagen formation

A

regenerative phase

62
Q

involves remodeling of the ligament & improved collagen alignment

A

remodeling phase

63
Q

Stressing the injured ligament during regenerative & remodeling phases leads to

A

more organized collagen alignment

64
Q

Common causes for bone pathology

A

direct trauma, overuse, aging & osteoporosis, cancer, other metabolic abnormalities

65
Q

Types of complete fx

A

transverse, oblique, spiral

66
Q

examples of segmental fx

A

avulsion

67
Q

incomplete fx example

A

greenstick

68
Q

healing process of bones

A

hematoma formation > cellular proliferation > callus formation > ossification > consolidation & remodeling

69
Q

Phase wherein a fibrin meshwork is created

A

hematoma formation

70
Q

the fibrin meshwork is the?

A

framework that the fibroblasts & capillary buds use to surround the bony ends of the fx

71
Q

phase wherein the process and progression of forming a fibrocartilage collar around the site begins

A

cellular proliferation

72
Q

phase wherein healing of the bone happens

A

callus formation

73
Q

callus formation is slower in _____ patients compared to ____ and ____

A

geriatric; pediatric/adult

74
Q

phase wherein osteoblasts continue to move into the site; cartilage is slowly replaced by bone

A

ossification

75
Q

phase where callus is slowly reabsorbed and the bone remodels based on the mechanical stress placed on it

A

consolidation and remodeling

76
Q

how long does consolidation and remodeling phase usually last

A

may take up to a year

77
Q

_____ is required until evidence of callus formation is seen

A

immobilization

78
Q

in fx, muscle atrophy is expected

A

true

79
Q

presence of callus allows what

A

mobilization

80
Q

what type of MD clears the patient for WB

A

orthopedic surgeon

81
Q

Common cause of cartilage damage

A

overuse, trauma, degeneration from faulty biomechanics

82
Q

Normal cartilage

A

grade 0

83
Q

nearly normal c superficial lesions, soft indentations, fissures, or cracks which can be seen as a rough surface in macroscopy, and inhomogenous, high signal, and intact surface in MRI

A

grade 1

84
Q

irregular surface defects c <50% of cartilage thickness seen in macroscopy

A

Grade II

85
Q

ulceration, fissuring, fibrillation >50% of cartilage depth

A

grade III

86
Q

full thickness chondral wear with exposure of subchondral bone

A

grade IV

87
Q

What causes pain in cartilage damage

A

nociceptors in bone to bone contact are triggered which produces pain

88
Q

the cartilage is highly vascular but receives nutrients via diffusion which greatly impedes its regenerative capacities

A

false, cartilage have no vascular supply

89
Q

focus of rehabilitation in cartilage injuries

A
  • restoring joint mobility
  • dec inflammation and pain
  • removing contributory factors such as faulty biomechanics, postural deviations, muscle activation dysfunction
90
Q

nerves are directly injured from

A

too much compression/tension, laceration, stretch, electricity and radiation

91
Q

nerves are indirectly injured by

A

poor circulation, temperature, chemicals

92
Q

classification of nerve injuries according to seddon

A

neuropraxia > axonotmesis > neurotmesis

93
Q

nerve injury with segmental demyelination which is due to mild ischemia from nerve compression or traction

A

neuropraxia

94
Q

signs of neuropraxia

A

blocked or slowed action potential

95
Q

signes of axonotmesis and neurotmesis

A

wallerian degeneration distal to lesion

96
Q

loss of axonal continuity

A

axonotmesis

97
Q

complete severance of nerve fiber usually from gunshot/stab wounds or avulsion rupture

A

neurotmesis

98
Q

neurotmesis usual intervention

A

surgery

99
Q

muscle affectation of neuropraxia

A

no muscle atrophy c temporary sensory loss

100
Q

healing process of peripheral nerve injuries

A

acute > recovery > chronic

101
Q

healing stage of nerves wherein healing and prevention of complications must be emphasized

A

acute phases

102
Q

signs of re-innervation are usually seen in this stage

A

recovery phase

103
Q

re-innervation potential peaked with minimal or no signs of neurological affectation

A

chronic phase

104
Q

phase wherein the PT should focus on retraining and re-education

A

recovery phase

105
Q

phase wherein the focus is training compensatory techniques

A

chronic phase

106
Q

neural mobilization may be used to:

A

promote normal nerve gliding and prevent restrictions

107
Q

rehabilitation phases

A

protection > controlled motion > return to function

108
Q

rehab phase where the PT should control inflammation, facilitate wound healing, and maintain normal function in associated areas

A

protection phase

109
Q

usual interventions during the protection phase of rehab

A

PRICES, selective rest/immobilization, Gr. I joint oscillations, passive movement, mm setting c caution, Gr. I-II distraction/glide, massage

110
Q

contraindications for protection phase of rehab

A

stretching and resistance exercises

111
Q

rehab phase wherein the PT should initiate and progress non-destructive exercises and restore mobility & function

A

controlled motion phase

112
Q

usual interventions during controlled motion phase

A

AROM, multiple-angle submaximal isometrics, muscular endurance, stabilization exercises, functional training, hold-relax technique (stretching), gr III oscillations, GPS, massage

113
Q

rehab phase where the PT should increase the pt’s strength and flexibility

A

return-to-function phase

114
Q

usual interventions of return-to-function phase

A

progressive stretching, cross-fiber massage, strengthening, muscular endurance training, aerobic exercises, specificity drills

115
Q

precautions for controlled motion interventions

A

proper dosage of movement/activity, eccentric exercises in muscular injuries, heavy resistance exercises

MSK2 LEC (7 decks)

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