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Week 1 Tissue Healing Flashcards

1
Q

Strains mainly affect:

Sprains mainly affect:

A

Muscle

ligament

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1
Q

What kind of muscles are most commonly strained?

A

Biarticulate

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2
Q

Sprain

Grade 1:

Grade 2:

Grade 3:

A

Ligament stretched

incomplete tear

complete tear

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3
Q

Subluxation vs dislocation

A

subluxation = incomplete/partial dislocation

dislocation = complete loss of anatomical relationship

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4
Q

What is the most common shoulder dislocation direction

hip direction?

A

anterior

posterior

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5
Q

tendonitis definition

A

inflammation that can result in scarring or calcium deposits

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6
Q

tendinosis definition

A

a pathology of chronic degeneration without inflammation

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7
Q

Tenosynovitis definition

A

inflammation of synovial membrane

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8
Q

tendovaginitis definition

A

inflammation with thickening of tendon sheath

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9
Q

synovitis definition

A

inflammation of synovial membrane leading to excessive synovial fluid

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10
Q

What is inflammation of the bursa called?

A

Bursitis

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11
Q

What bursa are most commonly inflamed

A

Subacromial

Olecranon

Trochanteric

Prepatellar

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12
Q

Ballooning of the wall of a joint capsule

potentially due to RA

A

Ganglion

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13
Q

Bleeding into a joint capsule

usually due to trauma

A

Hemarthrosis

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14
Q

Bruising from direct blow leading to capillary rupture and inflammatory response

A

Contusion

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15
Q

Adhesion vs Contracture

A

Adhesion- abnormal aherence of collagen fibers
Leads to reduced elasticity of tissue

Contracture- adaptive shortening of soft tissue (muscle, skin, fascia, capsule). Leads to reduced mobility and flexibility

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16
Q

How does a contracture affect MMT grading?

A

Still grade it through the available ROM

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17
Q

Reflex muscle guarding vs intrinsic muscle spasms

A

Muscle guarding- in response to pain

Instrinsic muscle spasm -in reponse to local circulatory and metabolic changes

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18
Q

Severity of tissue injury

grade 1:

grade 2:

grade 3:

A

Grade 1:Mild pain/swelling within 24 hours

grade 2: moderate pain affecting daily activity, tissues are partially torn

grade 3: near complete or complete tear or avulsion of the tissue
severe pain
later on stress to tissue is usually painless (because its already fully torn)
might see defect w/ palpatation

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18
Q

Myofascial Compartment syndrome

A

Increased interstitial pressure in a non-expanding myofascial compartment

results in ischemia and can cause tissue damage

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19
Q

What is the endfeel called when they have pain?

A

empty end feel

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20
Q

The inflammation phase is approximately how long?

A

Between 0 and day 10

note: stages overlap

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21
Q

The proliferation phase is approximately when

A

Between day 2 and day 22

note: stages overlap

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22
Q

the remodeling and maturation phase is approximately when?

A

Day 14 to over a year

note: stages overlap

23
What are the 5 cardinal signs of inflammation?
Pain Heat Swelling Redness Loss of function
24
In the acute stage, what 3 processes are occuring?
Cellular death coagulation: first vasoconstriction, followed by vaso dilation phagocytosis
25
What are the goals of the inflammation phase?
Protect area RICE (relative rest) Maintain PROM Mobilize soft tissues
26
What 3 processes are happening during the proliferation phase?
Angiogenesis- new blood vessels Collagen formation epiphelialization- new skin
27
What stage does granulation occur?
Proliferation note: this is also when formation of a scar begins
28
What are the therapeutic goals during the subacute/proliferation phase
Controlled motion phase develop mobile scar w/ selective stretching and mobilization progress to AROM, resistive exercises, build endurance
29
What happens at the tissue level during the remodeling/chronic stage
new collagen continues to increase its tissue strength for a year excessive production of collagen can form a scar
30
What are the clinical signs that someone has entered the remodeling stage/chronic stage
absence of inflammation pain only after tissue resistance
31
What are the PT goals for someone in the chronic phase?
Return to function increase tensile quality of scar develop functional independence
32
How long does it take ligaments to heal?
longer than muscles 5-8 days in skin/muscles 3-6 weeks for ligament and tendon
33
Normal collagen is __________ after an injury type ________ is laid down A mature repaired ligament is ________ weaker than an injured ligament
type 1 type 3 30-50% weaker
34
Ligament injury markers by week: By week 3: By week 6: By 12 weeks:
Can tolerate **mild** tenson can begin to resume **low-load normal** activities has regained almost **maximum tensile strength**
35
Where are tendon ruptures most common?
At the musculotendinous junction or the tenoperiosteal junction
36
if a tendon is torn more than __% of the diameter, it needs a surgical repair
50%
37
What heals slower, tendons or ligaments
tendons due to poor blood supply
38
Active tension of tendons across a repair site in the first 3 weeks of a repair leads to ______________
poor outcome
39
tendons exposed to little/no motion are ____________ than tendons exposed to limited motion at 3 weeks
weaker therefore we must preform passive exercise for these tendoms (PROM)
40
How does PROM help tendon repair sites
minimize adhesions assists in fiber orientation
41
What is the progression of exercise for surgical repairs ?
SLOW transition from passive -> Active assisted -> active -> resisted
42
Most tendon rehab programs are how long?
Over 6 months, some last 1-2 years
43
Muscle injury: day 2-5 what needs to happen?
Short term immobilization
44
Muscle injury: week 2-3
Balance between **protection** of site and **increasing tissue extensibility** through motion
45
Muscle injury: Week 4 to 6
Gentle AROM w/ full range is the goal no resistance yet
46
Muscle injury: 6+ weeks
Warm up period Focus on endurance can use resistance
47
W/ clinical management of muscle inuries ______________ is contraindicated especially in 2 joint muscles
eccentric contraction or overstretch
48
What is the difference between periosteum and articular cartilage
articular cartilage covers the joint surface periosteum covers everywhere else
49
What is wolfs law?
Bone is deposited in sites in response to stress bone is aligned in such a way to efficiently withstand stress
50
Dr. G says this is a test Q: For compression fractures, these patients tolerate ____ and not _____
Tolerate : extension DO not tolerate: flexion opposite of spondylosis
51
Fracture repair: inflammatory phase: What forms?
lasts 1-2 weeks Soft callus forms after one week Hard callus forms after several weeks to months
52
Fracture repair: remodeling phase
Fracture site is now firm and does not move immobilizaation no longer required, but avoid excessive force to avoid deforming the fracture site
53
What are the 4 phases of fracture repair?
Hematoma formation fibrocartilage callus formation boney callus formation bone remodeling
54
Fracture healing times Children: Adolescence: Adults:
4-6 weeks 6-8 weeks 10-18 weeks
55
What area of the body do fractures heal faster in?
UE > LE Distal faster than proximal
56
What are favorable conditions for fracture healing
fx to cancellous bone adequate blood supply fracture at end of bone minimal soft tissue injury fracture surface is in close proximity no infection

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