Tissue Healing

Question 1

what is tendinitis?

Answer 1

inflammation of tendon
resulting in scarring or calcium deposits

Question 2

what is tendinosis?

Answer 2

a pathology of CHRONIC degeneration without inflammation

Question 3

what is tenosynovitis?

Answer 3

inflammation of synovial membrane

Question 4

what is tenovaginitis?

Answer 4

inflammation with thickening of a tendon sheath

Question 5

consequences of tendinosis

Answer 5

changes collagen; weakens tendon
reduces tensile strength
increases risk of tendon rupture

Question 6

De Quervain’s is a example of ____

Answer 6

tenosynovitis of EPL

Question 7

T/F: there is no pain with tendinosis

Answer 7

F

Question 8

how does a tendon progress when a person is sedentary?

Answer 8

normal –> mechanically weakened –> (normal or excessive load +/- individual factors) –> reactive tendinopathy –> tendon dysrepair –> degenerative tendinopathy

Question 9

symptoms of a grade I tissue injury

Answer 9

mild pain at time of injury or w/i 24 hrs
mild SWELLING, local tenderness
pain when injured tissues are stressed
normal joint feel

Question 10

symptoms of a grade II tissue injury

Answer 10

moderate pain that affect ADLs
stress and palpation increases pain
tissue is partially torn
increased mobility

Question 11

symptoms of a grade III tissue injury

Answer 11

near-complete/complete tear or avulsion
severe pain
stress is painLESS
palpation may reveal defect
unstable joint

Question 12

what are the stages of tissue healing?

Answer 12

acute - inflammatory reaction
subacute - proliferation, repair, healing
chronic - maturation, remodeling

Question 13

when is pain felt in the acute stage during ROM?

Answer 13

before full ROM is reached

Question 14

when is pain felt in the subacute stage during ROM?

Answer 14

at the end of full ROM

Question 15

when is pain felt in the chronic stage during ROM?

Answer 15

slightly after full ROM WITH OVERPRESSURE

Question 16

how long does phase 1 of tissue healing last?

Answer 16

day 0-10

Question 17

how long does phase 2 of tissue healing last?

Answer 17

day 2-22

Question 18

how long does phase 3 of tissue healing last?

Answer 18

day 12 to 1 year+

Question 19

what are the 5 cardinal signs of inflammation?

Answer 19

pain
heat
redness
swelling
loss of function

Question 20

wound closure in skin and muscle occurs ____ after injury

Answer 20

5-8 days

Question 21

wound closure in ligament and tendon occurs ___ after injury

Answer 21

3-6 weeks

Question 22

in a normal adult, 85% is type ____ collagen

Answer 22

type I

Question 23

after an injury, fibroblasts synthesize type ____ collagen

Answer 23

type III

Question 24

mature repaired ligament is ____% weaker than uninjured ligament

Answer 24

30-50%

Question 25

by ____ weeks, can tolerate mild tension to ligament after injury

Answer 25

3 weeks

Question 26

by ____ weeks, can begin to resume normal activities after ligament injury

Answer 26

6 weeks

Question 27

by ____ weeks, maximal tensile strength is regained after ligament injury

Answer 27

12 weeks

Question 28

the proliferative stage after tendon injury occurs _____ after injury

Answer 28

48-72 hours

Question 29

type ___ collagen synthesis predominates the proliferative stage of tendon healing

Answer 29

III

Question 30

how are collagen fibers oriented during the proliferative stage of tendon healing?

Answer 30

randomly

Question 31

the remodeling phase beings ____ weeks after injury and may continue for years

Answer 31

6-8 weeks

Question 32

how are type 1 collagen fibers oriented?

Answer 32

longitudinally

Question 33

active tension of TENDON across repair site in first ____ results in a poor outcome

Answer 33

3 weeks need to perform PROM

Question 34

most rehab programs for tendon injury is _____

Answer 34

> 6 months sometimes 1-2 years

Question 35

there should be no or limited recruitment of injured muscle-tendon for the first ______ following a repair

Answer 35

4-6 weeks

Question 36

_____ contractions or overstretch, especially with ____ muscles can cause injury

Answer 36

eccentric 2 joint

Question 37

how long is a muscle immobilized after injury?

Answer 37

short term: 2-5 days

Question 38

what is periosteum?

Answer 38

the outer layer of bone where tendons attach

Question 39

what is the shaft of the bone called?

Answer 39

diaphysis

Question 40

what motion is encourage for a spondy vs a compression fracture?

Answer 40

spondy: flexion compression fx: extension

Question 41

type of fracture? bone fragments into 3 or more pieces common in aged, brittle bones

Answer 41

comminuted

Question 42

type of fracture? bone is crushed subjected to extreme trauma (ex: fall) common in osteoporosis

Answer 42

compression

Question 43

type of fracture? ragged break occurs with excess twisting common sports fracture usually long bone

Answer 43

spiral

Question 44

type of fracture? epiphysis separated from diaphysis along epiphyseal plate

Answer 44

epiphyseal

Question 45

where does an epiphyseal fracture usually occur?

Answer 45

where cartilage cells are dying and calcification of matrix is occuring

Question 46

type of fracture? broken bone portion pressed inward typical of skull fracture

Answer 46

depressed

Question 47

type of fracture? bone breaks incompletely part of shaft breaks, other bends common in children

Answer 47

greenstick