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PAR3012 - Extended Care > Week 10 > Flashcards

Week 10 Flashcards

1
Q

What are the tissue types?

A
  • Soft tissue
  • Hard tissue
  • Special tissues and organs
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2
Q

difference between sprain and strain?

A

sprain a ligament

strain a muscle

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3
Q

what is the stress strain curve?

A

stress - the amount of load placed on a tissue

Strain - the relative change in length associated with the stress applied

(the amount of stress it can absorb before it gets damaged)

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4
Q

what are the grades of soft tissue injury?

A

Grade 1 - mild injury involving tearing of only a few fibres

Grade 2 - moderate injury involving a considerable portion of fibres

Grade 3 - complete tear or rupture

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5
Q

how does a grade 1 injury present for a muscle?

A

focal pain, no loss in strength

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6
Q

how does a grade 1 injury present for a ligament?

A

pain on applied stress/load

normal end feel

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7
Q

how does a grade 2 injury present for a muscle?

A

pain, swelling, loss of strength

pain reproduced on mm contraction and stretch

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8
Q

how does a grade 2 injury present for a ligament?

A

pain on applied stress

increased joint laxity, end feel still present

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9
Q

how does a grade 3 injury present for a muscle?

A

Often musculotendinious junction

  • very painful
  • loss of function
  • visual and palpable deformit
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10
Q

how does a grade3 injury present for a ligament?

A

complete tear

gross join laxity, empty or no end feel

pain significant or absent

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11
Q

What are the 3 stages of soft tissue repair?

A
  • acute inflammatory
  • initial injury -> 2-3days
  • Repair (reconstructive/proliferative)
  • 2-3 days -> 2-6 weeks
  • Remodelling (maturation)
  • 3 weeks ->6-12 months
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12
Q

what are the advantage of immobilisation?

A
  • provides protection for injured area
  • allows undisturbed inflammatory phase to occur
  • mobilise too intensely too early = more type 3 collagen = weaker tissue
  • avoids re-injury when tissue not fully recovered
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13
Q

what are the disadvnatged of immobilisation

A
  • shortening of ligaments (contractures)
  • decreased length of muscle tissue
  • decreased bone desnity
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14
Q

what are the basic principles of injury management?

A
  • minimise extent of intial damage
  • reduce associated pain/inflammation
  • promote healing of damaged tissue
  • maintain/restore flexibility, strength, proprioception
  • functional rehabilitation
  • assess and correct predisposing factors
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15
Q

What is the initial treatment for soft tissue injury?

A

Aimed at controlling the local inflammation

RICER?
R- rest
I - Ice
C - Compression
E - Elevation
R - ? Refer (rehab)

Avoid massage and alcohol in first 48 hours

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16
Q

What influences the prognosis of injury?

A
  • extent of injury
  • individual healing capacity
  • patients age/general health
  • previous function
  • goals
  • commitment/motivation
17
Q

what is the most common sporting injury

A

lateral ankle ligament sprain

18
Q

What history do you take for ankle injury?

A
  • establish mechanism
  • was there another player/force involved
  • sounds (pop/crack)
  • ability to weightbear
  • degree of pain, dysfunction, instability
  • initial management
  • investigations
19
Q

How do you assess an acute ankle in a physical examination?

A
  • Gait
  • AROM DF, PF, Inversion, Eversion
  • PROM = AROM
  • Palpation
20
Q

What are the ottowa ankle rules?

A

Inidcates when an xray is required

Is there pain in the malleolar zone and any of :

  • Bone tenderness posterior edge of the distal 6cm tibia

OR

  • bone tenderness at the posterior edge of the distal 6cm of fib

OR

  • inability to weighbear for 4 steps both immediately and at time of examination
21
Q

when dont ottowa rules apply?

A
  • pregnancy
  • intoxicated, uncooperative, altered LOC
  • other distracting injuries
  • Diminished sensation in legs
  • Gross swelling preventing palpation
  • Age less than 18
22
Q

How do you managemnt a lateral ankle ligament sprain?

A
  • reduction of pain and swelling - RICER
  • use ottawa rules
  • Gait aids as needed
  • Early controlled mobilisation
  • Restoration of range of movement
  • strength
  • proprioception
23
Q

what do you look at in the clinical presentation of a significant knee injury?

A
  • machanism of injury
  • severity of pain and disability at time of injury
  • presence and timing of swelling
  • degree of disability on presentation to you
24
Q

how does swelling help show you severity of knee injury?

A

Immediate swelling (0-2 hours) = usually a bleed - Haemarthrosis

Delayed swelling (6-24 hours)
= Effusion
25
Q

What sounds and sensations may indicate what unjury in a knee injury?

A
  • snap or pop = ACL
  • moved or popped = ACL or patella dislocation
  • Clicking or locking = meniscal
26
Q

what are the ottowa knee rules?

A

x ray is indicated when one of the following is present:

  • age over 55 or under 18
  • tenderness to fib head
  • tenderness over patella
  • inability to flex knee 90 degrees
  • inability to weight bear for 4 steps
27
Q

What arethe high index of suspicion rules for ottowa knee rules?

A
  • high speed injuries
  • children or adolescents
  • clinical suspicion of loose bodies
28
Q

what is the mechanism of injury for ACL rptures?

A
  • sudden change of direction
  • landing knee in hyperextension
  • landing and twisting
29
Q

what history will you see with an ACL?

A
  • landing from jump/deceleration/pivoting etc
  • sharp pain
  • often audible pop or crack
  • instability
  • locking
  • immediate onset of swelling (haemarthorosis)
30
Q

what mechanism can cause a medial collateral ligament rupture?

A

Valgus force to partially flexed knee from the lateral side

31
Q

what are the signs of meniscus injury?

A
  • gradual or delayed swelling
  • intermittent locking
  • restriction in range of motion
  • pain on weight bearing
32
Q

What do you see with patella disolcation?

A
  • acute mechanism (twisting and landing)
  • pops out
  • immediate pain and swelling
  • usually reduces spontaneously with knee extension
33
Q

whats the difference between a shoulder dislocation and sublaxation?

A

Dislocation = complete absence of continuity between the humeral head and the glenoid

Subluxation = partial discontinuity

34
Q

what do you have to be careful of with shoulder dislocations?

A

nerves running around humoral head

PAR3012 - Extended Care (12 decks)

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