Lecture 1 Flashcards
(27 cards)
What is a grade 1 lateral ankle sprain?
Microspic ligament tear
- ligament is stretched
- no loss of function
- little to no bruising
- no/minimal point tenderness
- no joint laxity
- negative anterior drawer test
What is a grade 2 lateral ankle sprain?
Partial ligament tear
- incomplete tear
- some loss of function
- bruising
- moderate tenderness
- joint laxity
- positive anterior drawer test BUT negative talar tilt test
What is a grade 3 lateral ankle sprain?
Complete ligament tear
- RUPTURE
- bruising
- severe tenderness
- positive anterior drawer test AND positive talar tilt test
What are the 5 OTTAWA ankle rules?
- Distal fibula (palpate)
- Distal tibia (palpate)
- 5th metatarsal (palpate)
- Navicular (palpate)
- Weight bearing status (immediately can’t bear weight after injury)
What is the OARS sensitivity percentage ?
Very high, close to 100%
- this means the OTTAWA test will generate very few false negatives
What is the percentage of the OARS specificity?
Very low/poor, 26-48%
- this will generate A LOT OF FALSE POSITIVES
What is the negative likelihood ratio of OARS (NLR)
0.08
- NLR of 0.1 or less means that the test provides evidence that the test really is negative
What are the stages of tissue healing?
- Hemostatsis
- Inflammation
- Proliferation/repair
- Remodeling/maturation
In the stage of hemostatsis, what is being release to stimulate inflammation phase of healing
Pro-inflammatory cytokines (cellular signals)
In the stage of hemostatsis, what is being release that inhibits inflammation phase of healing and promote proliferate phase
Anti-inflammatory cytokines
What MSK tissues have best blood supply
Bone and tissue
What MSK tissue have the worst blood supply
Cartilage
Menisci
Tendons
What is the purpose of inflammation?
Clean up damaged tissue and prepare for scar formation
When does inflammation occur after an injury?
48-72 hrs
2-3 days
In the stage of inflammation, what is synchronized inflammation signaling?
Release of pro and anti inflammatory signals to inhibit inflammation response and promote optimal tissue growth
In the stage of inflammation, what duration is ideal for tissue healing?
Short
Prolonged will impair tissue healing
What are the 5 clinical signs of inflammation
- Redness
- Warmth
- Swelling
- Pain
- Loss of function
What are the 4 steps of inflammation (the four R’s)
Recognize
Recruitment
Removal
Repair
What are sentinel cells?
Monitor for cellular injury and/or harmful toxins
- macrophages, mast cells, fibroblasts, dendritic cells
What are the pro-inflammatory cytokines names?
- IL-1B (beta)
- TNF- a (alpha)
- IL-6
- IL-2
What are 3 major anti-inflammatory cytokines?
- IL-10 (inhibits pro inflammatory cytokines)
- IL-4
- IL-1ra (inhibits IL-1B)
When does the proliferation/repair stage begin?
Begin as early as 48 hrs and continues for 6+ wks
What is the immature collagen scar formation of the proliferation/repair stage
Cytokines stimulate the fibroblast to produce extracellular matrix and TYPE III COLLAGEN (immature collagen)
In what stage of healing does angiogenesis occur
Proliferation/repair stage
