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MSK - AL > Soft Tissue Disorders > Flashcards

Soft Tissue Disorders Flashcards

1
Q

Types of soft tissue injuries

A

Strains and sprains
Lacerations
Tendon ruptures
Muscle injuries
Myofascial compartment syndromes
Dislocations, and subluxations

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2
Q

Strains definition

A

stretching or tearing of the musculotendinous unit; can be partial or full

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3
Q

Types of tendon injuries

A

tendinitis
tendon rupture
tendinosis or tendinopathy

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4
Q

tendinosus or tendinopathy is a (chronic/acute) condition, with ________ inflammatory process detected histologically

A

chronic; minimal or no

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5
Q

Changes at cellular level in tendinosus/tendinopathy

A

expansion of local cells
thinner collagen fibrils

(these two changes being present result in a chronic inflammatory condition)

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6
Q

Muscle contusion is common in ________

A

contact sports

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7
Q

Muscle contusion clinically manifests as

A

local pain
edema
inc. temp
ecchymosis
hypermobility/instability
loss of function

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8
Q

a muscle contusion incites ________ response and sometimes involves ___________ formation

A

inflammatory, hematoma

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9
Q

myofascial compartment syndrome definition

A

increased interstitial pressure within a closed myofascial compartment
(messes with nerves, vessels, muscles)

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10
Q

compartment syndromes can be (acute/chronic) and are most likely to occur in what areas of the body?

A

can be acute or chronic

leg, forearm, thigh, foot

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11
Q

Predisposing factors of compartment syndrome

A

(think injury/trauma)

fractures
severe contusions
crush injuries
excessive skeletal traction
reperfusion injuries
trauma
burns
circumferential wraps/restrictive dressings
cast/immobilization

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12
Q

Compartment syndrome can cause ________ and (irreversible/reversible) muscle loss.

A

ischemia; irreversible

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13
Q

5 P’s of compartment syndrome

A

pain, paresthesia, pallor, pulselessness, paralysis

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14
Q

Severe compartment syndromes

A

◦ Objective signs visible (swollen extremity with smooth, shiny, or red skin)
◦ The extremity is tense on palpation, and passive stretch increases the pain.
◦ standard intervention = surgery

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15
Q

Growth Cartilage injury occurs in who

A

skeletally immature children and adolescents

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16
Q

when are cartilage cells more prone to injury?

A

during adolescent growth spurts, where the cells of the physis become more active

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17
Q

subluxation definition

A

Partial disruption of the anatomic relationship within a joint

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18
Q

which joints are at the most risk for subluxation

A

glenohumeral
acromioclavicular
sacroiliac
atlantoaxial

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19
Q

rehab for subluxation should address…….

A

local muscle imbalances and adjacent joint hypomobility

(both of which could increase mechanical stress at the joint)

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20
Q

Dislocation most often occurs at the _________ joint.

A

glenohumeral

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21
Q

congenital dislocations most often seen at ____ joint

A

hip

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22
Q

after dislocation what must be assessed?

A

integrity of nerve and vascular tissue

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23
Q

joint dislocation can also be a late manifestation of ……..

A

chronic disease
(i.e. rheumatoid arthritis, paralysis, neuromuscular disease

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24
Q

PT implications for SOFT TISSUE injuries

A

immediate stabilization & early mobilization is IMPORTANT
promote tissue flexibility and strength by minimizing inflammation
isometric training first, progress to isotonic
limit exercise to client’s pain tolerance
progress to isokinetic with minimal load once isometric & isotonic can be done without pain

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25
heterotopic ossification (HO) definition
bone formation in nonosseous tissues (soft tissue) a benign condition of abnormal bone formation in soft tissue
26
heterotopic ossification most commonly occurs after? (5)
**TRAUMA** ... like fractures surgery spinal cord injury/TBI burns amputation
27
T/F heterotopic ossification and myositis ossificans mean the same thing
False, they occur in different locations. MO forms in bruised/damaged/inflamed muscle
28
Hallmark sign of HO
progressive loss of ROM (when posttraumatic inflammation should be resolving)
29
Most common presenting symptoms of HO and when they present?
muscle pain and loss of motion; often within 2 weeks of the trauma
30
Sites most often affected by HO (5)
hip, elbow, knee, shoulder, TMJ
31
PT implications for HO
maximize motion, restore function, and reduce the risk of developing HO PROM good - prevents loss of motion forcible muscle stretching bad - lead to muscle tears and ossification within the muscle
32
T/F connective tissue disease may have features of multiple autoimmune diseases
T
33
T/F mixed connective tissue disease and overlap connective tissue disease refer to different things
False
34
OCTD definition
refers to at least two connective tissue diseases occur at the same time or in different time frames
35
connective tissue disease affects
adult women predominantly
36
RA is present in ____% of connective tissue disease cases
75%
37
neurologic abnormalities occur in approximately ___% of people with OCTD
10%
38
common clinical manifestations of connective tissue disease
RA proximal muscle weakness with or without tenderness trigeminal sensory neuropathy (more common with this disorder vs other rheumatic diseases) pulmonary, cardiac, renal involvement
39
OCTD combines clinical manifestation features from...? (4)
SLE scleroderma polymyositis polyarthralgias
40
Polymyalgia rheumatica (PMR) definition
marked by diffuse pain and stiffness in multiple muscle groups that primarily affects the shoulder and pelvic girdle musculature
41
most cases of PMR occur after age ___ in more (women/men)
70; women
42
% of people with PMR who also develop giant cell arteritis (condition characterized by inflammation of head and neck arteries)
15-20%
43
Symptoms of PMR are often (uni or bilateral) and commonly affect what areas of the body?
bilateral (and symmetric); affects the neck, sternoclavicular joints, shoulders, hips, low back, and buttocks
44
Rhabdomyolysis definition
rapid breakdown of skeletal muscle tissue because of a mechanical, physical, or chemical traumatic injury
45
muscle breakdown products seen from rhabdomyolysis
creatine phosphokinase enzymes myoglobin (other cell by-products) **these get released into the bloodstream
46
with rhabdomyolysis, accumulation of muscle breakdown products can lead to what?
acute renal failure
47
3 main causes of rhabdomyolysis
physical, mechanical, chemical
48
physical causes of rhabdomyolysis
prolonged high fever; hyperthermia electrical current (electrical and lightning injuries) excessive physical exertion (push-ups, cycling, marathon running)
49
Mechanical causes of rhabdomyolysis
crush injury burns (including electrical injuries) compression (i.e. tourniquet left on too long) compartment syndrome
50
chemical causes of rhabdomyolysis
medications herbal supplements containing ephedra (rare) excessive alcohol use electrolyte abnormalities infections endocrine disorders heritable muscle enzyme deficiencies mushroom poisoning (rare)
51
Clinical manifestations of rhabdomyolysis
excessive fatigue and inability to recover myalgia & weakness (can be mild to severe) change in urine color hyperkalemia causing disruptions in heart rhythm massive skeletal necrosis can also occur
52
myopathy definition
nonspecific muscle weakness secondary to an identifiable disease or condition
53
the term myositis is also used to describe
idiopathic inflammatory myopathies
54
Critical illness myopathy (CIM) is associated with.....
prolonged stays in ICUs
55
CIM definition
non-necrotizing myopathy accompanied by fiber atrophy, fatty degeneration of muscle fibers, and fibrosis
56
myopathies can be classified into what two categories
hereditary or acquired
57
Types of acquired myopathy
inflammatory myopathy endocrine myopathy myopathy associated with systemic illness drug-induced or toxic myopathy
58
clinical manifestations of myopathies
progressive proximal weakness distal involvement is possible but more common with myositis early stages: acute inflammation of muscles fever, fatigue, morning stiffness, anorexia statin-induced myopathy can produce respiratory myopathy
59
trigger points (TrPs) definition
hyperirritable spots in a taut band of skeletal muscle that is painful on compression or stretch or overload or contraction of the tissue
60
when are TrPs classified as active?
when they cause spontaneous local and referred pain
61
when are TrPs classified as latent?
when they cause pain only on stimulation
62
TrPs are (peripheral/central) sources of persistent ____________ input
peripheral; nociceptive
63
Both active and latent TrPs can cause ________ and primary & secondary __________
allodynia; hyperalgesia
64
hyperalgesia is also known as
referred pain; referred sensation
65
afferent fibers from TrP nociceptors can ______ ______ ____________ ___________ with dorsal horn neurons that normally process info from remote body organs
make new effective connections
66
TrPs have been reported in what age groups?
all except infants
67
what type of activity contributes to TrPs
sustained or repetitive activity
68
TrPs can restrict _______, alter movement ________ patterns, cause (local/referred/both) pain, and cause _________
ROM; activation; both; weakness
69
during a physical examination of TrPs, palpation should be (first/middle/last) step?
last
70
relevant criteria for the identification of TrPs include
presence of taut band in a relevant muscle presence of a TrP in that band referred pain
71
most common metabolic and hormonal factors of myofascial pain are
hypothyroidism gonadal hormone conditions other hormonal imbalances protozoal infestations deficiencies/insufficiencies (B12, D, iron, magnesium, testosterone, estrogen)
72
causes of pelvic floor muscle dysfunction (under activity)
pregnancy alone and/or birth-related trauma abdominal or pelvic surgery chronic increased intraabdominal pressure (like from obesity, chronic constipation, chronic coughing, poor lifting techniques) psychogenic origin SCI or other neurologic condition
73
causes of pelvic floor muscle dysfunction (over activity)
MSK injury or trauma habitual postural dysfunction fibromyalgia nerve entrapment/injury abdominal/pelvic surgery
74
most common factor associated with under activity of pelvic floor muscles
birth-related trauma
75
origin of dysfunction of overactivity of pelvic floor can be categorized how?
as tissue-based/nociceptive or as neuropathic/central sensitization
76
Coccygodynia (coccydynia) definition
pain related to the coccyx and muscles attaching there
77
Coccydynia is characterized by
pain with sitting, sit<>stand, defecation

MSK - AL (11 decks)

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