introduction

Question 1

2 factors determining injury

Answer 1

1. magnitude of force
2. material properties of tissues involved

Question 2

stress strain curve

Answer 2

for ligaments and tendons

elastic region: normal function w/o injury

plastic region: ligs/tens have inc risk of partial tear or rupture depending on tissue type

rupture point: complete tear

Question 3

factors of force

Answer 3

1. magnitude
   - size
   - direction of force: jt anatomy determines vulnerability
   - position of a limb/jt when stress is applied
   - AREA over which load is applied…dispersion
2. material properties
   - ability of tissue to withstand strain
   - musc vs bone

Question 4

tension vs shear

bending vs torsion

Answer 4

tension: stretch apart
shear: combination of compression and tension

bending: tension on one side, compression on other
torsion: twisting along longitudinal axis

Question 5

torque

Answer 5

depends on amount of force prod by muscle, and how FAR the muscle if from the origin

torque = force x moment arm

moment arm = perpendicular distance from force line to axis of rotation

Question 6

components of soft tissue

Answer 6

elastin: provides elasticity

collagen: mainly makes up skin, tendons, ligs
- some stretch, mainly inelastic
- strong in resisting tensile forces

Question 7

skin

Answer 7

dermis: has multidirectional force resistance
- arrangement makes resistant to shear, compression, tension

fibre types: elastin, collagen, reticular

injuries i.e. abrasion, laceration, burn, blister

main concern is INFECTION

Question 8

aniostropic

Answer 8

different response to loads from diff directions

many tissues are aniostropic

Question 9

systematic infection

Answer 9

spreads to other body parts, results in fever

Question 10

aponeuroses

Answer 10

connective tissues that connect muscle to other muscle or bone

flat, sheetlike

injury i.e. plantar fasciitis
MOI = overuse

Question 11

tendons

Answer 11

connect muscle to bone, are contractile

high collagen, low elastin

parallel fibre alignment allows unidirectional tension load
- 2x stronger than muscle

Question 12

viscoelastic

Answer 12

muscle is viscoelastic

time dependent elasticity….sustained force will result in inc musc stretch

Question 13

contusion

Answer 13

MOI = compression
S&S = bruising, acute onset, restricted ROM, swelling, nerve compression

ROM severity rating:
- 1st deg = mild/no restriction
- 2nd = noticeable
- 3rd = severe restriction

concern is secondary complications:
- compartment syndrome
- myositis ossificans

Question 14

sequelae

Answer 14

secondary complications, other body areas impacted by injury

Question 15

myositis ossificans

Answer 15

palpable lump, most common in quads

primary cause = repeated injury before healed
- can also be bcs of aggressive treatment in early healing

signs: light inc temp, pain after 1-2 treatments

detect via xray

risk factors: increased blood flow
- exercise
- heat
- massage
- severity and location of contusion

Question 16

strain

Answer 16

macrotrauma affecting muscle or tendon…usually indirect tensile forces

causes tearing of tissue and hemorrhage

MOI = acceleration, fatigue, weakness, instability
S&S = pain, sounds, colour
- tender, swelling, divot in tissue
- dec function and ROM, STRENGTH CHANGES

classification:
- 1st deg = few fibres torn, mild weak/loss function/defect/pain/ROM
- 2nd deg = nearly half torn, moderate
- 3rd deg = all fibres torn, severe (may not feel pain bcs detachment)

Question 17

what tissue tears first

Answer 17

muscle, because tendons are 2x stronger

Question 18

joint capsule

Answer 18

membrane enclosing jt, mostly collagen

fibrous connective tissue around synovial joint

holds bone in place, protects synovial membrane

synovial membrane: inner lining, secretes synovial fluid which gives nutrients and waste disposal

Question 19

ligaments

Answer 19

connect bone to bone
- collagen is parallel and interwoven, some elastin mixed
- can resist large tensile load along long axis (dec load other directions)

IDed according to:
- shape
- arranement w other ligs
- relation to jt
- function
- bony attachment

Question 20

sprain

Answer 20

joint injury, stretch or tear of LIGAMENT

MOI = tension, acute
S&S = SHARP, instability

Question 21

SHARP

Answer 21

helps ID signs of inflammation

swelling
heat: bcs inc BF
altered function
redness
pain

Question 22

benefits of inflammation

Answer 22

vital part of immune system’s resp to injury/infection

prostaglandins: create blood clots

clears necrotic cells and damaged tissues

nutrition to tissues and initiates repari

Question 23

dislocation and subluxation

Answer 23

dislocation = complete disarticulation of jt
subluxation = incomplete or partial dislocation of jt

MOI = tension
S&S = loss of limb function, deformity, swelling, pt tenderness

sequelae = reoccurance bcs overstretched capsule, instability

don’t “put” jt back in bcs could cause fracture, overstretching
- needs xray

Question 24

bursa

Answer 24

not rlly fluid filled sac, bt flat
- dec friction
- protect tendons from bony prominences

Question 25

bursitis

Answer 25

inflammation of bursa, can be acute or chronic septic vs aseptic MOI = compression S&S = aching/burning, disability, heat, crepitus - rebound pain: hurts when let go of squeezing

Question 26

parts of bone

Answer 26

diaphysis = shaft epiphysis = articulating ends metaphysis = neck b/w epi and dia periosteum = covering of bone - periostitis when musc attachments pull on covering, making inflamed `

Question 27

fractures

Answer 27

MOI = sudden injury i.e. fall, crush - can also be fatigue in overuse - usually break at weakest point w small diameter and vulnerability - or break at tendon/lig insertions bcs inc stress S&S = pain, swelling, GUARDING, spasm, crepitus, loss of power

Question 28

types of fractures

Answer 28

stress = chronic, aka incomplete fracture - weakness rather than thru bone depressed = dent, more often w flat bones i.e. skull, bone driven inwards transverse = straight line across comminuated = several pieces oblique = diagonal break, when torsion occurs when one end is fixed greenstick = incomplete, inc in kids bcs bones less likely to break impacted = bone driven into other bone, compression avulsion = lig or tendon pulls off bone spiral = s-shaped, torsion applied to fixed bone

Question 29

apophyseal injury

Answer 29

injuries to bone region where a tendon attaches - often young athletes - as athlete grows, tension of apophysis causes EXCESSIVE GROWTH i.e. bump below knee treatment is self-limiting, dec intensity self-resolving

Question 30

epiphyseal fracture

Answer 30

separation of epiphysis, growth plate injury determined via SALTER-HARRIS classification

Question 31

SALTER-HARRIS fractures

Answer 31

inc in severity as go down list, likelihood of impacting growth Separated: space b/w growth plate widens Above: fracture above growth plate Lower: below plate Through and through: travels thru metaphysis and epiphysis Rammed: epiphyses rammed against e/o (crush)