Soft tissue injuries

Question 1

what are the stage of healing in a acute/traumatic injury

Answer 1

-Inflammatory Phase
* Vasodilation
* Plasma proteins/exudate of tissue fluid/ oedema * Stimulation of pain fibres
* Cellular response

-Proliferative Phase
Elimination of debris
* Revascularisation
* Fibroblast proliferation

• Remodelling
  Contraction of wound
• Maturation of collagen fibres * Continues up to 6 months

Question 2

Aims of treatment during inflammatory phase

Answer 2

1. Minimise traumatic exudate,
2. Minimise pain, loss of
   function,
3. Promote rapid acceleration to subsequent phases

Question 3

Aims of treatment during proliferative phase

Answer 3

Facilitate removal of debris Optimise fibroblast production and promote revascularisation

Question 4

Aims of treatment during remodelling phase

Answer 4

Ensure mobile and well conditioned scar

Question 5

Grade 1 mild ligament sprain signs and implication

Answer 5

Grade 1 sprain is microscopic or minimal tearing or a few fibres

Its is painful, minimal bruising and little swelling . Little to none loss of structural integrity

Main implications it there is MINIMAL function loss and there is early return to activity

Question 6

Grade II moderate ligament sprain signs and implication

Answer 6

• Moderate tearing of the ligaments collagenous fibres with some loss of structural integrity

Signs - structural weakness, more bruising and swelling

Implications - Rest and rehab and timeframe of 6-8 weeks

there is a tendency of recurrence so rehab should be focused on balance/proprioception to prevent recurrence

Question 7

Grade III - Severe

Answer 7

• A complete tear of ligament with loss of structural integrity

Signs - abnormal motion, bleeding, bruising

May require immobilisation fro 3-6 weeks or surgical repair

Question 8

Treatment of ligament sprain

Answer 8

P- Protect, OL - optimally load, I - ice, C - Compress, E - Elevate

Restoration of function and prevention of recurrence

Question 9

what is a dislocation

Answer 9

complete dissociation of the articulating surface

Question 10

subluxation

Answer 10

when the articulating surfaces remain partially in contact with each other

Question 11

Muscle strain/tear

Answer 11

when some or all of the fibres fail to cope with he demands placed upon them

Question 12

Contusion/ haematoma

Answer 12

bleeding into a muscle due to a direct blow

Question 13

Grade 1 muscle tear

Answer 13

small number of muscle fibres , localised pain and no major loss of strength

Question 14

Grade 2 muscle tear

Answer 14

Tear of significant number of fibres with associated pain and swelling
Movement is limited and strength is reduced

Question 15

Grade 3 tear

Answer 15

Complete tear of muscle often at musculotendinous junction. Function severely impaired

Question 16

Tendon rupture

Answer 16

• Occurs at the point of least blood supply
• Examples in the lower limb is achilles and example in upper limb long head of biceps

Question 17

Assessment of Partial tear tendon repute

Contraction
stretch
palpation

Answer 17

Contraction- pain and week
Stretch -pain
palpation - tender

Question 18

Complete tear assessment

Answer 18

Contraction - No contraction No pain
Stretch 0 no pain

Palpation - GAP

Question 19

Tendinopathy

Answer 19

Overuse condition which potential to become chronic
Collagen disarray and separation

Question 20

Tendinopathy - assessment

Answer 20

Contraction
Pain on contraction
May be weak due to pain or if degenerative tear
Stretch
May or may not be painful
May limited flexibility due to pain
Palpation
Tender /thickening over specific area of tendon

Question 21

What is tenosynovitis and an example

Answer 21

Inflammation of synovial sheath surrounding a tendon . An example is De Quervains tenosynovitis

Question 22

What is bursa and bursitis

Answer 22

Bursa is a small fluid filled sacs between bone and tendon . While bursitis is the inflammation father bursa