Year 1 exam Flashcards
What are the distinguishing factors between myogenic and arthrogenic injuries
Arthrogenic:
- Tendons are likely to be injured after a period of unloading followed by excessive load, or excessive loading alone
- Location, i.e at a joint? at a site of arthrogenic structures?
Myogenic:
- over work or over stretching
- bruising location, swelling, when is pain reproduced?
What are the different categories of muscle injury? What are the tissues made of in muscles?
Grade 1 - minor number of fibres torn
Grade 2 - Minimal to moderate number of fibre gears
Grade 3 - severe to complete muscle tear
Muscles are made of myofibers which are the contractile element, and connective tissue which binds muscle cells together
What are the categories of ligament injuries and their signs?
Grade 1 - Tearing a few fibres (normal ROM on clinical testing)
Grade 2 - Considerable proportion of fibres torn (increased laxity, but end point)
Grade 3 - Complete tear (excessive laxity, no firm end point)
What are the stages of bone healing?
0-7 days = Haematoma & Inflammation
7-21 days = Catilaginous callus
3-7/16 weeks = Bony callus and cartilaginous remnants
7/16-months/years = remodelling
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for Achilles tendinopathy
Time scale: function improves within 8-12 weeks depending on extent
Common MOI: overloading or rapid increase in activity
Treatment modality: Ice to reduce swelling and pain, eccentric soleus/ gastroc strengthening
Objective test: palpation (positive = pain, thickening, heat) or ROM (positive = reduced plantarflexion)
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for ACL
Time scale: grade 1 = 2-4 weeks, grade 3 = much longer scale due to required surgery
MOI: valgus stress to lateral knee, or twisting motion when knee is slightly flexed, rapid deceleration
Treatment modality: RICE: rest until able to weight bear, ice: NICE suggest 20 mins every 2-3 hours, Compression: helps with stability and swelling, Elevation: aids with lymphatic drainage
Objective test: Anterior drawer, lachman’s test
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for ATFL sprain
Time scale: Grade 1 = 2-3 weeks, grade 2 = 4-6 weeks, grade 3 = up to 12 weeks
MOI: Landing on a plantarflexed/ inverted foot
Treatment: first reduce swelling and inflammation using RICE principles, next restore ROM, finally restore strength endurance and proprioception, then progress to functional exercises
Objective test: Positive anterior drawer test, pain on plantarflexion/inversion
Give a time scale for recovery, common mechanism of injury, treatment modality for fractured neck of femur
Time scale: will need surgery, so there will be a period of immobilisation, dynamic hip screw needs 3 months before and vaguely intense exercise, rough timescale is 4-6 months
MOI: most commonly from falls, osteoporosis, balance issues, reduced bone density
Treatment: ROM improvement after period of immobilisation due to stiffness, muscle atrophy due to compression and lack of activity, balance and proprioception work
Give a time scale for recovery, common mechanism of injury, treatment modality for fractured neck of humerus
Time scale: 4-6 months depending on fracture
MOI: Common from falls, reduced bone density, previous fractures
Treatment: NICE shows that physio 2 weeks after immobilisation shows best results, ROM, strengthening and potentially some balance work if falls was the issue
Give a time scale for recovery, common mechanism of injury, treatment modality for fractured ulna
Timescale: non-surgical means cast for 4-6 weeks, if surgical, no weight bearing for 6 weeks
MOI: contact sports e.g. rugby, falls, reduced bone density
Treatment: ROM, muscle strength, balance
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for MCL
Time scale: Grade 1=1-3 weeks, grade 2= 4-6 weeks, grade 3=6+ weeks, longer without surgery
MOI: Valgus stress when leg is locked in extension
Treatment: Ice immediately and throughout recovery, strengthening, flexibility, balance, later in recovery process massage can be helpful to prevent the ligament sticking to the bone
Objective test: Positive valgus stress test, Reduced ROM of extension, brushing/ swelling
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for meniscus injury
Time scale: 6-8 weeks
MOI: medial injury = extension/ lateral rotation, lateral = extension/ medial rotation (more common)
Treatment: RICE, improve ROM, muscle strengthening, agility work
Objective test: Positive McMurray’s, pain on Apley’s test, tenderness on joint line
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for muscle contusion/ haematoma
Time scale: 2-6 weeks depending on severity
MOI: Results from a direct blow, common in VM
Treatment: Ice and compress at early stages, stretching and strengthening muscles, early activation of area i.e. gentle stretching within 48 hours
Objective test: Decreased PROM/ pain, observable swelling/ bruising, decreased strength
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for muscle sprains
Time scale: depends on extent and location of injury (calf = 6-8, hamstring = 3-8, quad =2-8 weeks)
MOI: low strength in muscle, muscle tightness, not warming up, poor fitness and conditioning, high intensity activities
Treatment: control of hemorrhage, restore pain free ROM, functional rehab, gradual return to activity, Ice 3-4 times a day for recommended time of product, strengthening after ROM restored
Objective tests: Pain on muscle contraction, pain on palpation, reduced ROM, reduced strength
Give a time scale for recovery, common mechanism of injury, treatment modality and objective test for patellar tendinopathy
Time scale: 3-6 months rehab
MOI: common in sports involving a lot of jumping, increased risk in male undergoing growth spurt
Treatment: RICE for pain and swelling, relative unloading of tendon, corrective biomechanics, eccentric based exercise program, some evidence for dry needling to break up degenerative structures
Objective tests: Tenderness of patellar tendon, pain on resisted knee extension, localised thickening or nodules
