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Clinical Pathophysiology > Disease, MSK Inuries, Overuse Notecards > Flashcards

Disease, MSK Inuries, Overuse Notecards Flashcards

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2
Q

Disease

A

a structural or functional change within the body judged to be abnormal

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3
Q

Etiology

A

study of causes of disease

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4
Q

Pathogenesis

A

the sequence of events that leads from cause to structural and functional abnormalities and finally manifestation of disease

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5
Q

Diagnosis

A

process of assigning a name to patient’s disease

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6
Q

Syndrome

A

a cluster of signs and symptoms commonly encountered with more than one disease

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7
Q

symptoms

A

evidence of disease perceived by the patient

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8
Q

signs

A

physical observations made y the person who examines the patient

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9
Q

Types of Disease

A

Structural (organic)–observable abnormalities (rheumatoid arthritis)

Functional Disease–disturbance of function without any observable lesion (mental illness)Acute (short time period)Chronic (long time)

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10
Q

Disease Statistics: Epidemiology Terms (6)

A
  1. Mortality Rate: death rate measured as number of people dying in a given time period (# per 100,000)
  2. Morbidity-frequency of disability within a given population (not lethal)
  3. Co-Morbid (presence of one or more disordersIncidence (newly diagnosed in a given time period)
  4. Prevalence (# or proportion of persons with disease at any given time)
  5. Prognosis (expected outcome)
  6. Incidence–number of newly diagnosed cases
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11
Q

Causes (10)

A
  1. Hereditary/Developmental
  2. Physical Injury
  3. Infectious Disease
  4. Immunological/inflammatory
  5. endocrine
  6. neoplastic
  7. nutritional
  8. psychological
  9. iatrogenic
  10. idiopathic
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12
Q

General Healing Time: Tendon

A

3-4weeks (tendonitis)

5 weeks-6mos (lacerations)

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13
Q

General Healing Time: Muscle

A

0-3 days (DOMS)
0-14 days (grade 1)
14 days-3mos (grade II)
3 weeks-6mos/year (grade III)

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14
Q

General Healing Time: Ligament

A

0-3 days (grade I)
3weeks-6mos/year (grade II)
5-7weeks–2years (grade III)

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15
Q

General Healing Time: Ligament Graft

A

2months-2years

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16
Q

General Healing Time: Bone

A

3-4weeks-3/6mos

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17
Q

General Healing Time: Articular Cartilage Repair

A

7 weeks-2years

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18
Q

Soft Tissue Injury

A

disruption in structural integrity of either skin, fascia, muscle, tendon, ligament

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19
Q

Epidemiology of soft tissue injuries

A

20% of all in sports will sustain soft-tissue injuries every yearin UK (9.8million) new exercise-related soft-tissue injuries per year (ages 16-45)

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20
Q

Stages of Soft Tissue Healing (under optimal healing conditions)

A
  1. Inflammatory phase (acute)–0-6 days
  2. Proliferative Phase (sub-acute)–3-20days
  3. Remodeling/maturation phase (chronic)–day 9 and beyond
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21
Q

Inflammatory Phase Responses and purpose (4)

A

Hemostatic
Vascular
Cellular
Immunological

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22
Q

I: Vascular Phase Response (steps and signs)

A
  1. transient vasoconstriction2. followed by vasodilation (inc blood flow, hydrostatic pressure, permeability of small vessels) redness, swelling, warmth, pain, loss of function
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23
Q

I: Edema

A

blood volume and pressure increase, outward filtration increases, (inflamed edema)

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24
Q

I: cellular response

A

luekocytes (attracted by chemical mediators)neutrophils (rid area of bacteria and debris by phagocytosis)Monocytes (large macrophages)

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25
Q

I: Hemostatic Response (very early)

A

platelets aggregate, deposit fibrinFibrin forms a lattice for clot formation

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26
I: Immune Response
cellular and humoral fators(leukocytes, lymphocytes, enzymatic proteins)
27
I: Clinical consideration
protection phase, control pain/swelling, maintain mobility, patient education
28
I: Physical agents
cryotherapy, compression, electrical stimulation, non-thermal ultrasound
29
Proliferative Phase Responses and Purpose
1.new blood vessels (endothelial buds)2.new connective tissue (fibroblasts)3.granulation tissue (bight pink combo of CT and blood vessels)4. wound contraction(make the repair tissue viable and re-establish tensile strength)
30
P: Clinical considerations
controlled motion (everything is fragile)look for restricted range and infection
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P: Treatment Goals
promote healingprogressively restore soft tissue/muscle/joint mobilitystrengthen involved areasintegrity and function of related areaspain and swelling control
32
P: Physical Agents
Transition to heating modalitieselectrical simulation
33
Remodeling Phase: Responses and Purpose
1. Scar maturation2. Remodeling through collagen turnover (Wolff's)3.
34
R: Clinical Considerations
(pain, adhesions/contractures, muscle weakness, decreased activity)1. improve quality of the collagen and dec size of wound2. progressive activity and functional return3. healing may continue for 18 months
35
R: Treatment goals
soft tissue mobilitystrengthen supporting and related musclesdevelop muscular endurancedec painprogress functional independence balance-agility-speed
36
R: Physical Agents
Heat and Stretchsuperficial v deep heatultrasound vs diathermycryotherapy after activityelectrical stem
37
Baylor Progression Model (9 steps)
1. pain mgt2. motion3. motor control4. strength5. propiception6. endurance7. power8. skilled activity9. full activity
38
Common MSK Injuries
strainspraindislocationsubluxationmuscle/tendon/ligament teartendonopathysynovitiscontusionbursitis
39
Contusion
sudden/severe compressive forcehematomamyositis ossificans
40
Strains
---musculo-tendinous unit---(load forces, repetitive forces, strength imbalance, lack of flexibility)
41
Strains Grades I
I---localized pain, mild swelling, minor loss of function & ROM, minimal structural damage (2-22 day recovery)
42
Strain Grades II
partial tear with palpable defectloss of ROM/functionswelling/ecchymosispain and tenderness (20-90 day recovery)
43
Strain Grades III
complete tear with palpable defectsignificant pain/swelling/ecchymosissevere loss of ROMmay require aspiration/surgery(50-180 day recovery)
44
Overexertion Muscle Injuries
Acute muscle soarnessDOMSMuscle Cramps
45
Chronic Muscle Injuries
Myositis/FasciitisEctopic Calcifications (myositis ossificans/calcific tendinitis)
46
Tendon Injuries
(limits exceeded/repeated microtrauma)Tendinitis (is an observation, not same a tendinopathy/tendinosis)Tenosynovitis
47
Synovial Joint Injuries
Sprains (acute, ligaments, capsule)Synovitis (acute)Dislocation/Subluxation/Diastasis (acute)Chronic synovitis/capsulitis/bursitisosteochondrosis
48
Sprain (stretching/tearing of ligaments/capsule) Grades 1+:
minimal loss of structural integrity/motionlittle to no swellingminimal ecchymosislocalized tendernessmay need protection but prognosis is good
49
Sprain Grades 2+:
significant structural weakeningsome abnormal motion solid end-feel to stress(increased swelling and ecchymosis)(effusion)(modified immobilization and protection)
50
Sprain Grades 3+:
effusion w/ hemarthrosisprolonged protection and surgery considered
51
Dislocations
total disunion between articular surfaces
52
Subluxation
partial dislocation
53
Diastasis
Disjointing of 2 bones parallel to one anotherrupture of solid joint
54
Osteochondrosis
aseptic necrosis to epiphysistrauma to loose articular cartilage(apophysitis: osgood schlatters)
55
Injury Defined
nonfatal traumatic wounds or other conditions of the body caused by external force or exposure or non-traumatic physiological harm or loss of capacity caused by continued or repeated neuromusculoskeletal stress or strain
56
Overuse Injury Defined
repetitive microtrauma during exercise, sports, military training or operations(remember to also consider psychosocial issues)
57
Development of Overuse Model
normal (stress), normal (tissue)----okabnormal, normal, inflamenormal, abnormal, inflameabnormal, abnormal, inflame
58
Common Examples of Overuse MSK Injuries
tendinosis, tendinopathy, tenosynovitis, muscle strains, anterior knee pain, back pain, lower leg pain, bursitis
59
Etiology Factors of Soft Tissue Injuries (5)
frequencyintensitydurationtypeprinciple of transition
60
Broad Treatment for Overuse Injuries
pt educationpain modulationcorrect problemsactivity modulationactive rest
61
Types of Bone Stress Injury (BSI)
Reaction: inc osteoclastic and osteoblastic activity at site of stress may produce periosteal reaction (pain only with Run, Jump, March)Fracture: visible crack through the cortex
62
Common BSI SItes
sacrum, pubic rami, femoral neck, femoral shaft, tibia, metatarsals, calcaneus
63
BSI Pathophysiology
muscle fatigue, bone deformation, microvasculature compression, dec in O2 perfusion causes local ischemia
64
BSI RIsk Factors
agegenderracelow bone densityless lean body masslow fitness levelfemale triadlow-fat dietmenstural disturbanceage of menarchecalf girth
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Objective Signs of BSI
Antalgic gaitlocal edemapoint tendernesslimited functionspecial tests
66
BSI Imaging
X-rayBone Scan--positive withn 12 hours (no sign of healing)MRI---the best
67
Healing Times
IPR: 2-5mosTibial: 4-8 weeksMT: 4-6weeksFemoral: 4-8 weeksFemoral Neck: 6-12 weeksTreat by time, symptoms, healing on X-ray
68
BSI Management
RESTremove stressexercise to maintain cardiovascualrSafe return to previous activitytime for bone maturity to catch up
69
Progressive Treatment Principles for BSI
early detectionRICEcasting if neededpain medsambulation aidsmodify activityclosed chain exerciseslow aerobic exercise progression
70
BSI: Military Implications
shortest to tallest in marching formationtall road guards
71
Preventing BSI
softer surfaces, reduce marching speed, interval training
72
Rhabdomyolysis
breakdown of striated muscle fibers usually in response to intense prolonged vigorous exercise(excretion of myoglobin in the urine)
73
Etiology of Rhabdo
drastic exercise changegenetic dispositionperformance enhancing substances
74
Signs of Rhabdo
muscle weaknessswellingurine discolorationmuscle sorenessserum creatine kinase(CK)death from renal failure
75
Rhabdo Treatment
Acute--call docF/U: ice, fluid replacement threapy, monitor closely

Clinical Pathophysiology (1 decks)

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