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WEEK 4 Soft Tissue Disorders & Osteochondroses Flashcards

1
Q

What is the term for stretching & tearing of musculotendinous unit?

A

strain

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2
Q

Which tendon injury reflects a more chronic condition w/ minimal or no inflammatory process detected histologically?

A

tendinosis or tendinopathy

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3
Q

Changes w/ tendinosis or tendinopathy at the cellular level involve expansion of local cells & thinner _________ fibrils.

A

collagen

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4
Q

What is the term for bruising w/ intact skin?

A

muscle contusion

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5
Q

Myofascial compartment syndrome is when there’s increased ________ pressure within closed compartment –> compromising nerves, muscles, vessels.

A

interstitial

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6
Q

Where does myofascial compartment syndrome usually occur?

A
  • envelopes of lower leg
  • forearm
  • thigh
  • foot
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7
Q

What is the earliest clinical symptom of impending acute compartment ischemia?

A

disproportionate deep, throbbing pain

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8
Q

In severe compartment syndromes, which objective signs are visible?

A

swollen extremity w/ smooth, shiny, or red skin

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9
Q

What is the standard intervention of severe compartment syndromes?

A

surgical decompression

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10
Q

During adolescent growth spurts, the cartilage cells of ________ become more active & prone to injury.

A

physis

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11
Q

Where does osteochondritis dissecans happen?

A

articular surface

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12
Q

Where does osgood-schlatter disease happen?

A

apophysis

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13
Q

What is the term for partial disruption of anatomic relationship within a joint?

A

sublaxation

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14
Q

What joints are most at risk for sublaxation?

A
  • GH
  • AC
  • SI
  • AA
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15
Q

What joint does dislocation occur most often at?

A

GH

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16
Q

Where are congenital dislocations most freq seen at?

A

hip

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17
Q

Movement during the first ___-___ days should be done w/ care to avoid stretching injured muscle.

A

3-7

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18
Q

B/t ___-___ days, gradually progress to using injured muscle more actively.

A

7-10

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19
Q

What type of training should be done first? What should it progress to? What’s last?

A

isometric –> isotonic –> isokinetic

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20
Q

_________ contraction is advocated for chronic tendinopathies.

A

eccentric

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21
Q

What is the term for bone formation in nonosseous tissues (usually muscles & other soft tissue areas) after trauma?

A

heterotopic ossification

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22
Q

Where does myositis ossificans occur?

A

bruised, damaged, or inflamed muscle

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23
Q

What are the 2 most common presenting symptoms of HO?

A
  • muscle pain
  • loss of motion
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24
Q

What type of end-feel is seen in individuals 3-6 months in w/ HO?

A

rigid or abrupt w/ pain

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25
What sites are most affected by HO?
- hip - elbow - knee - shoulder - TMJ
26
What is the term for at least 2 connective tissue diseases @ same time or in diff time frames?
mixed connective tissue disease or overlap connective tissue disease
27
OCTD frequently includes overlapping features of which diseases?
- SLE - scleroderma - polymyositis
28
Who is predominantly affected by connective tissue disease?
adult women
29
What type of connective tissue disease has clinical & serologic characteristics of multiple autoimmune diseases?
undifferentiated
30
Which disease is present in 75% of cases of OCTD?
RA
31
A _________ sensory neuropathy appears to occur much more freq in MCTD/OCTB than in other rheumatic diseases.
trigeminal
32
What is the disorder marked by diffuse pain & stiffness in multiple muscle groups that primarily affects the shoulder & pelvic girdle?
polymyalgia rheumatica
33
The initial symptoms of PMR are subtle but a significant # of ppl w/ it also develop giant cell ________.
arteritis
34
At what age do most cases of PMR occur? Which gender?
over 70, women
35
PMR painful stiffness lasts more than ___ hour(s) in morning on arising.
1
36
The symptoms of PMR are often bilateral & (symmetric/asymmetric) affecting the neck, SC jt, shoulders, hip, low back, & buttocks.
symmetric
37
What is the rapid breakdown of skeletal mm tissue bc of mech, physical, or chem traumatic injury?
rhabdomyolysis
38
Injury in rhabdomyolysis results in release of _________ _________ enzymes, myoglobin, & other by-products into blood --> renal failure.
creatine phosphokinase
39
What is the change in urine color associated w/ rhabdomyolysis?
tea or cola colored
40
Injured muscle in rhabdomyolysis leaks _________ --> disruptions in heart rhythm.
potassium
41
What is the term for nonspecific muscle weakness secondary to identifiable disease or condition? What about if it's inflammatory?
- myopathy - myositis
42
What is the term for nonnecrotizing myopathy accompanied by fiber atrophy, fatty degeneration of mm fibers, & fibrosis that prolongs ICU stays?
critical illness myopathy
43
What are the 4 types of acquired myopathies?
- inflammatory - endocrine - associated w/ systemic illness - drug-induced or toxic
44
Myopathy has more (distal/proximal) muscle weakness while myositis has more (distal/proximal).
- pathy: proximal - sitis: distal
45
________-induced myopathy --> respiratory myopathy.
statin
46
What is the term for hyperirritable spots in a taut band of skeletal muscle that is painful on compression, stretch, overload, or contraction of tissue which usually responds w/ referred pain distal?
trigger points
47
TrPs are _________ when they cause spontaneous local & referred pain & __________ when they cause pain only on stimulation.
active & latent
48
Both active & latent TrPs can cause allodynia & primary & secondary hyperalgesia which implies that __________ fibers from TrP nociceptors can make new effective connections w/ dorsal horn neurons.
afferent
49
TrPs have been reported in all age groups except which?
infants
50
The current thinking & attention of TrPs has shifted more from mech factors --> __________ factors.
biopsychosocial
51
What should be the last step in physical examination process?
palpation of relevant muscles
52
What are the 3 criteria for identification of TrPs?
- taut band in relevant muscle - presence of TrP in band - referred pain
53
The most common metabolic & hormonal factors in myofascial pain are (hyper/hypo)thyroidism, gonadal hormone conditions, protozoal infections, & iron, mag, B12, D, estrogen, test deficiencies.
hypo
54
Possible side effects of meds such as w/ ________ drugs may induce widespread myalgias.
statin
55
What muscles are in the superficial layer of PF?
- external anal sphincter - sexual (bulbocav & ischiocav) - superficial transverse perineal
56
What muscles are in the urogential diaphragm (2nd layer) of PF?
- sphincter urethra - urethrovaginal sphincter
57
What muscles are in the levator ani (deepest layer)?
- puborectalis - pubococc - coccygeus - ishococc
58
Which layer participates in urinary continence? Which supports pelvic viscera?
- continence: 2nd - viscera: deep
59
Urinary or fecal incontinence & pelvic organ prolapse is due to (under/over)activity of PFM.
under
60
Obstructive voiding or defecation, dyspareunia, & pelvic pain is due to (under/over)activity of PFM.
over
61
What is the most common factor of underactivity of PFM?
birth-related trauma
62
What are the 2 categories of origin of dysfunction of overactivity of PFM? Which one has evidence said is the primary origin?
- tissue-based/nociceptive - neuropathic/central sensitization*
63
What is the term for pain related to coccyx & muscles attached there?
coccygodynia
64
What are the categories of causes of coccydynia?
- MSK - direct trauma (childbirth or fall) - inflammation - infections - referred pain from visceral sources - neoplasm - centralized pain syndrome
65
What is coccygeal spicule?
hook on end of coccyx
66
Sacral _________ is a rare, slow-growing tumor that should be considered in diff dx of coccygodynia.
chordoma
67
What is the term for where 2 pelvic sympathetic trunks converge ending in ganglion @ front of coccyx (which can cause chronic pain w/ overactivity)?
ganglion impar
68
What is the most susceptible area for osteochondroses?
epiphyses
69
What is the disorder of 1 or more ossification sites w/ localized subchondral necrosis followed by recalcification?
osteochondritis dissecans (OCD or OD)
70
In OCD/OD, piece of _________ cartilage & fragment of bone separate & pull away from underlying bone --> loose in joint.
articular
71
Where are the most common sites of involvement of OCD/OD?
concave surfaces of synovial jts: - medial femoral condyle - talar head - capitellum of humerus
72
OCD/OD is caused by repetitive __________ resulting in ischemia & disruption of subchondral growth.
microtrauma
73
What is the term for when pain is increased w/ passive knee extension & tibial IR & relieved w/ tibial ER?
wilson sign
74
What is the term for death of bone & bone marrow cellular components bc of loss of blood supply in absence of infection?
osteonecrosis (avascular/aseptic)
75
What is the most common site of osteonecrosis? What is the name for this?
femoral head (chandler disease)
76
What are other sites in which osteonecrosis is common?
- scaphoid - talus - prox humerus - tibial plateau - small bones of wrist & foot
77
What type of gait abnormality is seen w/ osteonecrosis in femur?
antalgic
78
What type of surgical interventions are done for osteonecrosis?
- core decompression - hemiarthroplasty - total jt replacement
79
What are other names for legg-calve-perthes disease?
coxa plana (flat hip) & osteochondritis deformans juvenilis
80
Legg-calve-perthes disease is epiphyseal aseptic necrosis of proximal end of __________.
femur
81
Who does legg-calve-perthes disease occur in the most?
boys b/t 5-8 yrs
82
Legg-calve-perthes disease has insidious onset w/ intermittent appearance of a limp on involved side & ________ pain w/ soreness, aching, & stiffness.
hip
83
Pain of legg-calve-perthes disease follows the path of which nerve?
obturator
84
What disease results from fibers of patellar tendon pulling small bits of immature bone from tibial tub (considered as tendinitis)?
osgood-schlatter
85
Which age groups in boys & girls is osgood-schlatter seen in? Who is it seen in more often?
- boys: 10-15* - girls: 8-13
86
What 3 abnormal alignment conditions can lead to osgood-schlatter?
- genu valgum - flat-footed - high-riding patella (patella alta)
87
Avulsion of _________ ossification center of tibial tub occurs when patellar tendon fibers pull fragments away from tibial epiphysis.
secondary

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