Lecture 2 Flashcards
1
Q
What are 3 mechanical forces that contribute to soft tissue injuries?
A
- compression
- tension
- shear
2
Q
What is the load deformation curve in tissue injuries?
A
- expresses the change that can occur in human body tissues as load is applied over time
3
Q
What are 4 curves within the load deformation curve in tissue injuries?
A
- elastic region
- yield point
- plastic region
- failure point
4
Q
What is the elastic region in the load deformation curve?
A
- The material properties of any structure will suffer structural change when force is applied to it
- This change may be temporary (as long as the load is applied) or it may be permanent
- the Elastic region is considered that zone where while the load is applied, it may change shape & as soon as it is removed, it returns to its original state
5
Q
What is the yield point in the load deformation curve?
A
- when a load on any material overcomes the ability of elastic change
- the structure is said to have reached its yield point or elastic limit
6
Q
What is the plastic region in the load deformation curve?
A
- structural change will remain in the material even after load has been removed
7
Q
What is the failure point in the load deformation curve?
A
- When a load reaches the ultimate failure point on the deformation curve, complete failure for the structure has been reached
- In the body this would mean a fractured bone or ruptured muscle, ligament, etc
8
Q
What is the classification & mechanisms of injury?
A
- The sport participant is susceptible to various forces both internally & externally produced
- i.e., inappropriate muscle contraction causing a quadriceps strain versus being hit in the thigh by an opponents knee
- Both cause damage to the muscle but the mechanisms are quite different
9
Q
What is a primary injury?
A
- Results from trauma/stress directly imposed on the body as a result of athletic activity
10
Q
What are 4 types of primary traumas?
A
- direct
- indirect
- acute trauma
- overuse micro trauma
11
Q
What is direct/indirect trauma?
A
- direct: injury resulting from a direct impact
- indirect: did not directly witness or experience a traumatic event themselves
12
Q
What is acute trauma?
A
- a single, sudden, and short-lived traumatic event that occurs unexpectedly (can be direct or indirect)
13
Q
What is overuse micro trauma?
A
- small, often undetectable injury to a muscle, tendon, or bone that occurs due to repetitive stress over a prolonged period
14
Q
What is secondary injury?
A
- Refers to problems that may arise from Improperly cared for initial injuries
- Most often, when return to activity was too soon after the injury, when adequate healing did not occur
- I.e., Joint Instability, Muscle Weakness
15
Q
What is skin trauma?
A
- any type of injury directly on the skin
- the skin It is connected to muscle fascia by the hypodermis (a loose connective tissue)
- This loose connection allows the underlying muscle to contract without noticeably pulling the skin
- This layer is important regarding scar tissue formation & potential adhesions
16
Q
What are the 2 layers of the skin?
A
- epidermis: closely packed epithelial layer
- dermis: deeper layer irregular connective tissue
17
Q
What are the 5 functions of the skin?
A
- protection
- temperature regulation
- excretion
- sensation
- vitamin D production
18
Q
How does the skin protect?
A
- Barrier to micro-organisms & other foreign substances
- Decrease ultraviolet penetration
- Thickens (ie. callous with increased friction)
19
Q
How does the skin regulate temperature?
A
- Under stress capillary dilation, increases heat loss
- Evaporation of perspiration cools body
- Conversely capillary constriction conserves body heat
20
Q
How does the skin excrete?
A
- Nitrogenous waste & sodium leave the body in the perspiration
21
Q
How does skin produce sensation?
A
- Special receptors in the skin provide body with much information about the environment: i.e., temperature, light touch, pressure, pain
- Nervous system responds according to the message it receives from the afferent system. The response is usually motor or efferent
22
Q
How does the skin produce vitamins D?
A
- sunlight UV rays with sterols in the skin combine to form vitamin D
23
Q
What are 7 types of main traumas?
A
- burns
- blisters
- abrasions
- contusions
- lacerations
- incisions
- avulsions/degloving
24
Q
What is a burn?
A
- Results when the skin receives more energy than it can absorb without injury (i.e., heat, chemicals, electricity)
25
What is a blister?
- the development of fluid within or below the epidermal layer as a result of excess friction whereby the dermal & epidermal layer separates
26
What is an abrasion?
- a wound that results when the epidermal layer has been scraped or rubbed off
27
What is a contusion?
- compression (blunt force) trauma to the epidermal/dermal tissue
28
What is a laceration?
- a wound were the skin has been irregularly torn
29
What is an incision?
- a skin wound where the cut is clean (i.e., surgical cut)
30
What is an avulsion/degloving?
- a wound where the skins hypodermal layer has been separated from the muscle
31
What are 3 types of nerve injures?
- neuropraxia
- axonotmesis
- neurotmesis
32
What is neuropraxia?
- A blunt trauma which causes a concussion of the nerve causing transient physiological change
33
What is axonotmesis?
- Severe blunt trauma or stretch; axon damage is evident
- sensory or motor degeneration may occur
- Recovery of the nerve is slow - approx. 1mm/day
34
What is neurotmesis?
- Injury resulting when the structure of a nerve is destroyed by actual division or by severe scarring
- causes sensory or motor degeneration & loss
- Recovery of the nerve is possible in the peripheral system if sutured appropriately
35
What are 4 sensory changes? What do they do?
- Hypoesthesia: Decreased sense of touch
- Hyperesthesia: Increased sense of touch; pain
- Parasthesia: Numbness, prickling, tingling or burning; stinger
- Anaesthesia: Total absence of sensation
36
What is a muscle strain?
- an injury to the muscle tendon unit
- result of a sudden intense contraction or abnormal stretch of the affected muscle
- Severity is classified in degrees & may range from a slight stretch to a complete rupture of a muscle or tendon
- When a muscle is damaged, its ability to cause movement or exert force against a resistance is diminished
37
What are 3 types of strains?
- 1st degree
- 2nd degree
- 3rd degree
38
What is a 1st degree strain?
- a mild muscle injury where only a few muscle fibers are stretched or torn (i.e., pulled muscle)
- Findings: Mild point tenderness, Able to move joint through near full range, mild muscle spasm, minor swelling, can exert force against resistance, still strong & causing slight discomfort
39
What is a 2nd degree strain?
- a moderate level of muscle injury, where a significant number of muscle fibers are partially torn
- findings: moderate muscle spasm, diffuse pain & swelling, increased pain with movement, moderate loss of strength & function
40
What is a 3rd degree strain?
- a complete rupture of a muscle or tendon
- findings: Severe pain, swelling, disability & muscle spasm (may be painless), May be unable to move the associated joint, A deflect or divot may be felt in the muscle belly or tendon, If the muscle belly is involved the torn strip may contract & produce a noticeable bulge
41
What are 3 types of muscle traumas?
- strains
- contusions
- cramps & spasms
42
What is a contusion?
- The result of a direct blow to a muscle or bone causing tissue damage & resulting in bleeding or ecchymosis (bruising/ discolouration)
43
What is the severity of a contusion?
- The severity of the injury is dependent upon the magnitude of the impact & the amount of tissue damage
- commonly discussed as mild, moderate or severe
44
What are 3 types of contusions?
- mild or 1st degree: Knee flexes past 90 degrees
- moderate or 2nd degree: Knee flexes between 45-90 degrees
- severe or 3rd degree: Knee flexes <45 degrees
45
What are cramps & spasms?
- an uncontrolled contraction of a muscle or muscle group; Common in the calf & hamstrings
- can cause Extreme fatigue with accumulation of metabolites, Extreme levels of exercise before proper conditioning is achieved, Inadequate blood supply Electrolyte & mineral imbalances
46
What are heat cramps?
- profuse sweating during exercise, where there is undue stress on the muscles, it can lead to fluid imbalances which can cause general cramping in the stomach muscles, legs & arms
- These cramps serve as a warning to impending heat exhaustion or heat stroke
47
What is Myositis?
- an inflammatory condition within a muscle or muscle group where calcification (calcium build-up) of tissue occurs
- Generally occurs when a muscle injury such as a contusion is not cared for properly
48
What are 4 common causes of Myositis?
- Severity of initial contusion or early re-injury of unprotected muscle
- Continuing to play after an injury has occurred
- Early massage of the injured area
- Early application of heat
49
What is tendinitis/tenosynovitis?
- Inflammation of a tendon unit
- It may sometimes be caused by sudden trauma but in most cases the injury is a result of overuse
- Tendonitis is a progressive injury, As the condition becomes worse, pain & disability increases
50
What are the 3 phases of Tendonitis?
- Phase 1: Athlete complains of some pain following activity
- Phase 2: Athlete complains of some pain during & after activity but is still able to compete at their normal level
- Phase 3: Athlete is unable to compete at level to which he/she has pain all the time
51
What is tendinosis?
- Not inflammatory in nature, but rather a degenerative progression
- tissue deteriorates over a period of time from previous injury or traumatic events
- Repeated injury leads to poor re-vascularization & chronic fibrotic inelastic tissue repair
52
What is tendonopathy?
- Implies a change in the structural matrix of the tendon
- The tendon has lost its normal sheen & appears as an opaque substance that has very little resemblance to the healthy tissue
53
What is a sprain?
- An injury to a ligament
- Ranges from partial tearing to complete rupture of the fibres of the ligament
- Once damaged, ligaments become lax & no longer prevent unwanted joint motion as readily as prior to the injury
54
What are 3 types of sprains?
- 1st degree (mild)
- 2nd degree (moderate)
- 3rd degree (severe)
55
What occurs during a 1st degree sprain?
- Mild Ligament Stretch
- Sharp pain initially but mild overall
- Minimal swelling, Point Tenderness, Ligament Laxity, Loss of strength/function
56
What occurs during a 2nd degree sprain?
- Partial Ligament Tear; Severe pain
- Moderate swelling, Point Tenderness, Ligament Laxity, Loss of strength/function
57
What occurs during a 3rd degree sprain?
- Complete Ligament Tear; Severe pain (may be absent in some (cases due to nerve conduction loss)
- Severe swelling, Point Tenderness, Ligament Laxity, Loss of function
- moderate loss of strength
58
What is a fracture?
- A break in the continuity of bone
- may be caused by direct trauma, by twisting due to a severe muscle spasm, or by disease that results in de-calcification (osteoporosis) & weakening of bone
59
What are 2 forces that can cause fractures?
- Bending - Involves compression & tensile stress
- Torsion - shear force internally on the bone around a neutral axis
60
What are 5 types of fractures?
- closed or simple fracture
- open or compound fracture
- incomplete fracture
- complete fracture
- salter/harris fracture
61
What is a closed or simple fracture ?
- a fracture where the skin remains intact
62
What is an open or compound fracture?
- a fracture where the skin is broken by the damaged bone
63
What is an incomplete fracture? What are 5 types of incomplete fractures?
- The bone has not fractured through the shaft or body (only one half of the bone is broken)
- greenstick, impacted, stress (hairline), buckle, penetrating are all types of incomplete fractures
64
What is a complete fracture? What are 3 types?
- The bone is completely broken, there is separation between the bone segments
- spiral, oblique, transverse are all types of complete fractures
65
What is a salter/harris fracture?
- Fracture types involving the epiphyseal plate (growth plate) at the ends of long bones in children.
- Classified numerically as Salter I to V with the ascending numbers corresponding to severity & specific X- Ray result
66
What is a salter I fracture?
- A fracture of the growth plate without injury to the bony metaphysis or epiphysis
- When un-displaced these fractures are rarely evident on X-ray
- True Salter I fracture rarely affect growth
- Immobilization is necessary though, until clinical union is evident
67
What is a salter II fracture?
- Transverse fractures of the growth plate which has split obliquely into the metaphysis
- This fracture is readily evident on x-ray treatment & prognosis is the same as Type I
68
What is a salter III fracture?
- Transverse fractures of the growth plate which have split obliquely into the epiphysis
- This fracture is more likely to lead to growth arrest
69
What is a salter IV fracture?
- These fractures extended axially into the bony metaphysis & epiphysis
- Great danger for growth arrest exists
70
What is a salter V fracture?
- Crush type of fracture involving the growth plate
- Clinically not distinguishable from a Type IV, Prognosis is not very good
- Bone growth arrest is usually imminent, Growth plate has fused with the metaphysis
71
What are undisplaced/displaced fractures?
- If the bone remains aligned it is known as an un-displaced fracture
- If mal-alignment occurs, the fracture is a displaced fracture
72
What is a dislocation?
- The complete displacement of a bone from a joint
- there must be damage to the joint capsule & severe damage to the ligaments (3rd degree sprain)
- Dislocations must be reduced by a physician, DO NOT attempt to reduce a dislocation
- They should be treated with the same care & immediate attention given to fractures
73
What is a subluxation?
- May refer to partial or incomplete dislocation
- the dislocation that spontaneously reduced itself
- The athlete will give a history of feeling "something pop out” & then back in right away
74
What is bursitis?
- The inflammation of a burial sac
- A bursa may become inflamed as a result of a direct blow or overuse (most common)
75
What is capsulitis?
- An inflammatory condition of the capsule (most often in shoulder) where there is painful restriction of both active & passive movements
- Characteristics signs are an atraumatic insidious onset of shoulder dysfunction & immobility:
- Decreased external rotation
- Decreased abduction
- Decreased forward flexion
