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Science For Physio Practise > Q's for assessment > Flashcards

Q's for assessment Flashcards

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1
Q

Define inflammation

A

Localised physical condition where the part of the body becomes red, swollen and hot.

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2
Q

5 cardinal signs of inflammation

A

Pain, redness, heat, swelling, loss of function

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3
Q

What are the 4 stages of soft tissue repair and what are the time frames?

A

Stage 1 - Bleeding, lasts 4-6 hrs
Stage 2 - Inflammation, lasts 2-3 days
Stage 3 - Proliferation, 24-48 hrs to 2-3 weeks
Stage 4 - Remodelling 1-2 weeks

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4
Q

Describe briefly each stage of inflammation

A

1 - Blood vessels severed, blood cells released.
2 - Histamine released , plasma leaks out. Vasodilation and phagocytosis.
3 - Scar formation using fibroplasts and angiogenesis
4 - Refinement of collegen, weak (type II) replaced with strong

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5
Q

Define acute and chronic inflammation

A

Acute - response to sudden body damage
Chronic - Body continues sending inflammatory cells

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6
Q

What are general and local factors that may affect tissue healing?

A

Age, body type, radiation therapy, nutrition

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7
Q

Define a fracture

A

Discontinuity in a bone (or cartilage) resulting from mechanical forces which exceed the bones ability to withstand them.

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8
Q

Causes of fractures and explain

A

Acute trauma - overlaoding force on bone
Fragility fracture - Mechanical forces that might not usually result in fracture
Insufficiency fracture - Normal repetitive stress
Stress fracture - Abnormal loading
Pathological fracture - Bone may have lesion that weakens bone eg cyst

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9
Q

List and be able to identify from an image or a simple x-ray the different patterns of fracture

A

LOOK AT EXAMPLES ONLINE TEST MYSELF

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10
Q

Define a closed fracture and an open fracture in a single sentence each

A

Closed - Bone is broken but skin is in tact
Open - Bone pierces through the skin and shows

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11
Q

Define a complete and incomplete fracture in a single sentence each

A

Complete - Bone completely broken into separate pieces
Incomplete - Bone cracks but not completely

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12
Q

Define a stable and unstable fracture in a single sentence each

A

Stable - Can be treated with a boot, still positioned correctly
Unstable - More serious, loss of movement

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13
Q

List the ways children’s bones and bone healing differs from adults

A
  • Babies have more bones
  • Children’s are continuously growing
  • Children’s bones are more flexible
    -Children heal faster
    -Children’s ligaments are stronger
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14
Q

List the four main stages of bone healing and their approximate timeframes

A

Stage 1 - Haematoma formation, Lasts hours/days
Stage 2 - Callus formation, Lasts days/weeks
Stage 3 - Callus ossification, Lasts 1 to 4 month
Stage 4 - Bone Remodelling, Lasts 4-12 months

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15
Q

List the potential complications of a fracture

A
  • Shock
  • Compartment syndrome (pressure increases, low blood flow)
  • Tetanus (infection)
  • Fat embolism
  • DVT
  • Non union, Mal union
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16
Q

In a short paragraph describe osteoporosis and how/why it occurs

A

Loss of bone mass weakens the bone
Due to age, hormones, injury

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17
Q

Define osteopenia in a short paragraph

A

Stage before osteoporosis bone density is low for age but not too low

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18
Q

List the normal structural components of a synovial joint?

A
  • Articular cartilage
  • Synovial fluid
  • Synovial Membrane
  • ligament
  • Synovium
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19
Q

Describe in no more than a short paragraph the function of each component and how it
achieves this.

A

Articular cartilage contains chondrocytes and extracellular matrix which provides a smooth surface for friction to occur between bones and carry load.
Synovial membrane provides a pathway for substances to maintain articular homeostasis, containing A cells (engulfing) and B cells (hyaluronic acid).
Tendons attach the muscle to bone to allow the bone to be moved,
Ligaments attach bone to bone, providing structural support.

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20
Q

List where there is and isn’t a vascular, lymphatic or nerve supply within a joint?

A

Every joint has a vascular and nerve supply, but there is no lymphatic supply in the cartilage of the joint

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21
Q

In one or two sentences describe what is meant by joint or cartilage homeostasis?

A
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22
Q

In a sentence describe what is meant by negative intra-articular pressure?

A

The stable state between the synovium and cartilage matrix in and out of bloodstream is maintained.

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23
Q

List and briefly describe (a sentence or two each) the normal changes that occur to the joint
with age?

A

-Joint movement becomes stiffer because of less synovial fluid and hyaluronic acid being formed to lubricate the articulate cartilage.
-Structure and thickness of articulate cartilage due to friction from loads and movement of ligaments and tendons, as they may shorten.

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24
Q

Define osteoarthrosis in no more than a paragraph.

A

Common disorder of synovial joints, mainly occurring in older patients in knees, hips, back and hands. The articulate cartilage starts to wear due to friction and the debris is engulfed by A cells and there is less lubricant. Therefore, the cartilage becomes thinner

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25
Q

Define osteoarthritis in no more than a paragraph.

A

Degenerative joint disease, the articulate cartilage begins to breakdown and becomes thinner, this means it changes the bone surrounding it. This can cause stiffness.

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26
Q

Explain how these differ in a short paragraph?

A

Osteoarthritis is degenerate, osteoarthrosis is caused by inflammation.

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27
Q

List the structural and physiological changes that occur with osteoarthritis?

A
  • Cartilage thinning
  • Cracking
  • Osteophytes
  • Thickening
  • Reduced lubrication
  • Reduced load attenunation
  • Increased intra articular pressure
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28
Q

In a sentence or two each describe these changes.

A
  • The cartilage becomes thinner due to friction because there is less lubrication formed by the chondrocytes
  • It has not reached homeostasis because there is a negative articular pressure so less synovial fluid is formed because of the extra cellular matrix not being balanced.
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29
Q

Discuss how these may impact function in one or two paragraphs.

A

Means that there is less elasticity of the articular cartilage and therefore can begin to break away. Due to friction, debris may be formed, and this is engulfed by the A calls, however there is a loss of proteoglycans so more catabolic and becomes thinner.

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30
Q

List the clinical features associated with osteoarthritis?

A
  • Pain
  • Stiffness
  • Limitation of movement
  • Dislike of cold weather
  • Muscle weakens
  • Loss of function
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31
Q

List the risk factors of osteoarthritis and in which joints does it most commonly occur?

A
  • Most commonly occurs in knees, hips, back, hands
  • Age
  • Gender
  • Genetic factors
  • Diet
  • Weather
  • Foods
  • Joint damage
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32
Q

Describe why each of these is a risk factor in a sentence or two

A
  • Overuse of muscles over years may shorten them so the joint stiffens
  • May be injured or have joint damage from other joint diseases
  • When atmospheric pressure is falling it can stiffen the joint
  • Eating high sugar/carb foods
33
Q

In two or three sentences describe the prevalence of osteoarthritis

A
  • It is the most common form of arthritis
  • Affects 8.5 million people in uk
  • X-ray studies show that at least 50% of people older than 65 have evidence of osteoarthritis.
34
Q

Discuss in a short paragraph or bullet points how obesity impacts osteoarthritis

A
  • The more weight you have, the more your bones and skeleton is loaded. Pressure is exerted onto the synovial joint and can cause the cartilage to thin.
35
Q

In a short paragraph describe what a ligament sprain is

A
  • Stretching or tearing of ligaments, the fibrous tissue.
36
Q

Define the three grades of a ligament sprain
a. Identify basic structural change
b. Approximate healing time
c. Clinical signs

A

a. Identify basic structural change
* Grade 1 = mild ligament tear, Grade 2 = moderate ligament tear, rade 3 = complete ligament tear (rupture)
b. Approximate healing time
* Grade 1 = within a few weeks
* Grade 2 = Take up to 6 weeks with correct taping and support
* Grade 3 = Takes 3-4 months with bracing
c. Clinical signs
* Grade 1 = ligament stretch but don’t tear, may not swell
* Grade 2 = Tears partially, swelling and bruising and painful joint
* Grade 3 = Swelling and sometimes bleeding under skin, unable to bear weight

37
Q

Discuss in a paragraph what effect a ligament sprain might have on the stability of a joint

A
  • Ligaments hold bone to bone. If there is damage to the ligament, the bones are less compact and adjacent at the joint, they could become stiff if not moved.
38
Q

In a few sentences define rheumatoid arthritis

A
  • Autoimmune disease, attacks cells that line the joints and causes them to become stiff
39
Q

In a few sentences define ankylosing spondylitis

A
  • Genetic factors involved, people possessing gene HLA-B27 are at great risk of developing this where the spine and other joints become inflamed.
40
Q

Write a one sentence definition of:
a. Contractibility
b. Excitability
c. Extensibility
d. Elasticity

A

-Contractility: ability of a muscle to shorten with force
* Excitability: capacity of muscle to respond to a
stimulus
* Extensibility: muscle can be stretched to its normal
resting length and beyond to a limited degree
* Elasticity: ability of muscle to recoil to original resting
length after stretched

41
Q

List the three types of muscle

A
  • Cardiac
  • Skeletal
  • Smooth
42
Q

Write a one sentence description of the anatomy/structure and one sentence description of
the function of:
a. Tendon

A

-predominantly composed of collagen, which is arranged in a hierarchical manner parallel to the long axis of the tendon, resulting in high tensile strength
- Attach muscle to bone

43
Q

b. Fascia

A
  • Layer of fiborous tissue
  • provide support for surrounding tissues, help reduce friction, and play a supportive role for the tissues and organs.
44
Q

c. Muscle

A

-Each muscle is made up of groups of muscle fibers called fascicles surrounded by a connective tissue layer called perimysium
-Allow for movement of joint/bone

45
Q

d. Myotendinous junction

A

-a complex specialized region located at the muscle-tendon interface that represents the primary site of force transmission
-the interface between muscle and tendon and where force is transmitted between the two tissues

46
Q

e. Osteotendinous junction

A
47
Q

f. Tendon sheath

A

-consist of two layers: a fibrous layer, made of tight collagenous tissue, and a synovial layer
-allowing the tendons to move smoothly and freely through them

48
Q

In a sentence or two describe each way a muscle contraction can be stopped:
a. Energy system fatigue
b. Nervous system fatigue
c. Voluntary nervous system control
d. Involuntary nervous system control

A

a. Energy system fatigue – Muscles can stop contracting when it runs out of ATP and becomes fatigued. Calcium ions are pumped back into the SR causing the tropomyosin to cover the binding sites on actin strands.
b. Nervous system fatigue – When the stimulation of the motor neuron providing the impulse to the muscle fibres stops, the chemical reaction that causes the rearrangement of muscle fibres protein is stopped.
c. Voluntary nervous system control – Contraction will stop when signals from the motor neurone ends, repolarizing the T-tubules. This happens when the stimulus stops (person stops moving purposely).
d. Involuntary nervous system control – Once the stimulus is detected and action potential is released, the all or nothing principle is apparent and so will always cause a new action potential being generated. Calcium is released, so the muscle fibre can contract.

49
Q

Describe muscle spindles and their function in a few sentences

A

They act as stretch receptors controlling the length of the muscles, proprioceptors.

50
Q

Describe golgi tendon organs and their function in a few sentences

A

Nerve fibres which weave between collagen fibres on the tendon. They are sensitive to the change in muscle tension, the nerve fibres contract and trigger the stimulus, the golgi tendon can then inhibit the further tension.

51
Q

Define in a few sentences or a short paragraph Muscle tone

A

‘the tension in the relaxed muscle’ or ‘the resistance, felt by the examiner during passive stretching of a joint when the muscles are at rest’

52
Q

Define in a few sentences or a short paragraph Isotonic contraction

A

Change in length but tension is constant (concentric or eccentric)

53
Q

Define in a few sentences or a short paragraph Concentric contraction

A

Muscle shortens as internal force generated is greater than external force applied

54
Q

Define in a few sentences or a short paragraph Eccentric Contraction

A

Muscle lengthens whilst maintaining tension as external force is greater than the internal force generated.

55
Q

Define in a few sentences or a short paragraph Isometric contraction

A

No change in length but tension increases

56
Q

Define in a few sentences or a short paragraph Isokinetic contraction

A

Velocity of the muscle contraction remains constant while the length of the muscle changes

57
Q

In a paragraph or two explain the different factors that can affect the strength of a muscle
contraction including recruitment, type of muscle fibre, the length/tension relationship and
age.

A

Number of muscle fibres
Past experience
Type of muscle fibre type (11a + 11 b)

58
Q

In a few sentences describe the distinction between inner range, mid-range and outer range
with regards to muscle length

A

Outer range = from full stretched to mid-point of the full range
Inner range = from the midpoint of full contraction
Mid-range = middle point at point of muscle stretching and contracting

59
Q

List the anatomical and functional changes for each of the three grades of muscle strain

A

Grade one - swelling and inflammation of the muscle fibre, still use muscle just pain and a bit sore
Grade 2 – slight tear – non weight bearing, visible bruising
Grade 3 – complete rupture – structural support needed – rehabilitation

60
Q

Describe in a paragraph or less the cause of tendinopathy

A

Term that described tendon degeneration
It is characterised by pain, swelling and impaired performance. It is caused from a repetitive strain of a tendon and causes tissue damage, which slow down the healing process

61
Q

In a paragraph define tendinopathy, describe its cause and list the structural changes that
occur.

A

Overuse injury of the tendon, there is capillary in growth and it is less stable due to matrix remodelling .
Inflammation plays a role in the initiation of tendinopathy

Common areas
Achilles, patella, hamstring, rotator cuff, lateral and medial elbow

62
Q

List the symptoms of tendinopathy

A
  • Pain
  • Swelling
  • Impaired performance
63
Q

In a single sentence define sarcopenia

A

it is a progressive and generalised skeletal muscle disorder that involves the accelerated loss of muscle mass and function.

64
Q

List the structural changes involved in sarcopenia and the symptoms of this

A

Loss of muscle fibres, cross sectional areas and preferential loss of fast twitch muscles

65
Q

List the risk factors for sarcopenia

A
  • Lack of exercise ‘
  • Hormone and cytokine imbalance
  • Protein synthesis and regeneration
  • Motor unit remodelling
  • Evolutionary basis
  • Early development influence
66
Q

Define kinetics, kinematics and moments in a single sentence each

A
  • Kinetics = describes how the human body can be considered in terms of a series of interrelated links or segments
  • Kinematics = the independent motion of joints or body segments.
  • Moments = when a body is balanced, the total clockwise moment about a point equals the total anticlockwise moment about the same point. For example, if two people push on a door, the moment force on the door is equal to the sum of the moment force applied by each person.
67
Q

Identify the two components that affect the magnitude of a moment

A

The magnitude of the force applied.
The distance of line of action of the force from the axis of rotation.

68
Q

Define in a single sentence each the following terms a. Centre of gravity

A

the point at which the weight of the body appears to act.

69
Q

Define in a single sentence each the following terms b. Centre of pressure

A

the point where the total sum of a pressure field acts on a body, causing a force to act through that point.

70
Q

Define in a single sentence each the following terms c. Ground reaction force

A

the force exerted by the ground on a body in contact with it.

71
Q

Define in a single sentence each the following terms d. Joint reaction force

A

force generated within a joint in response to forces acting on the joint. in the hip

72
Q

Define in a single sentence each the following terms e. Base of support

A

the area beneath an object or person that includes every point of contact that the object or person makes with the supporting surface.

73
Q

Define in a single sentence each the following terms f. Elasticity

A

ability of a deformed material body to return to its original shape and size when the forces causing the deformation are removed

74
Q

Define in a single sentence each the following terms g. Viscosity

A

the rate at which your muscles perform demands

75
Q

Define in a single sentence each the following terms h. Viscoelasticity

A

the stress (force) and subsequent strain (deformation/change of shape) in the muscle dependent on the rate of loading.

76
Q

Define in a single sentence each the following terms i. Creep

A

the capacity of fascia and other tissue to lengthen when subjected to a constant tension load resulting in less resistance to a second load application.

77
Q

Define in a single sentence each the following terms j. Stress relaxation

A

a property of biological tissues that is related to their viscoelastic properties

78
Q

Define in a single sentence each the following terms k. Hysteresis

A

by holding the tissue at a constant length and observing change in the force that develops in the tissue

Science For Physio Practise (15 decks)

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