Lecture 5: Soft tissue

Question 1

_________ refer to stretching or tearing of the musculotendinous unit; they may be partial or full tears

Answer 1

strain

Question 2

_____________ reflects more of a chronic condition, with minimal or no inflammatory process detected historically. (tendon injury)

Answer 2

tendinosis / tendinopathy

Question 3

____________________ is when there is increased interstitial pressure within a closed myofascial compartment that compromises the nerves, muscles, and vessels within the compartment

Answer 3

myofascial compartment syndrome

Question 4

T/F: compartment syndrome may lead to ischemia and irreversible muscle loss and even potential loss of limb if untreated

Answer 4

true

Question 5

What is osgood schlatter’s disease?

Answer 5

when the patellar tendon is stressed on its attachment to the tibial tuberosity due to rapid growth or overuse???

Question 6

Which joints are most at risk for subluxation? (list 3)

Answer 6

glenohumeral, acromioclavicular, sacroiliac, and atlantoaxial

Question 7

What joint does dislocation occur at most often?

Answer 7

glenohumeral

Question 8

Which joint are congential dislocations most frequently seen at?

Answer 8

hip joint

Question 9

With soft tissue injuries immediate stabilization and early mobilization is important. Movement during the first ______ to _______ days should be done with care to avoid stretching the injured muscle.

Answer 9

3 to 7 days

Question 10

With a soft tissue injury you should begin with which type of training first?
a) isotonic
b) isometric
c) isokinetic

Answer 10

B) isometric

Question 11

Heterotopic ossification (HO) occurs most commonly after…………..

Answer 11

trauma! (ex: fractures, surgery such as THR, burns, amputations, SCI)

Question 12

__________- is bone formation in nonosseous tissues (usually muscles and other soft tissue areas); a benign condition of abnormal bone formation in soft tissue.

Answer 12

heterotopic ossification

Question 13

myositis ossificans forms bone in which type of tissue?

Answer 13

bruised, damaged, or inflamed muscles

Question 14

What is the hallmark sign of heterotopic ossification (HO)?

Answer 14

progressive loss of ROM at a time when trauma should be resolving

Question 15

Which sites are most affected by heterotopic ossification?

Answer 15

hip, elbow, knee, shoulder, and TMJ (think where trauma might occur)

Question 16

T/F: with heterotopic ossification you should forcibly stretch the muscle to make sure they do not lose ROM

Answer 16

FALSE; forcibly stretching muscles is contraindicated, instead do passive ROM

Question 17

T/F: heterotopic ossification can develop into ankylosis

Answer 17

true

Question 18

______________ refers to at least two connective tissue diseases occur at the same time or in different time frames

Answer 18

mixed connective tissue disease

Question 19

RA is present in ____% of cases of mixed connective tissue disease

Answer 19

75%

Question 20

MCTD is more common in which gender?

Answer 20

female

Question 21

Which cranial nerve is often involved in MCTD?

Answer 21

CN V: trigeminal sensory neuropathy

Question 22

___________ is a disorder marked by diffuse pain and stiffness in multiple muscle groups that primarily affects the shoulder and pelvic girdle musculature

Answer 22

polymyalgia rheumatica (PMR)

Question 23

T/F: polymyalgia rheumatica usually presents with asymmetrical muscle pain

Answer 23

false: bilateral and symmetric affecting the neck, sternoclavicular joints, shoulders, hips, low back and buttocks

Question 24

Which age group and gender does polymyalgia rheumatica occur in?

Answer 24

occur after age 70 and in women more than men

Question 25

__________________ is the rapid breakdown of skeletal muscle tissue because of a mechanical, physical, or chemical traumatic injury. This breakdown causes accumulation of by-products that can lead to __________ failure.

Answer 25

rhabdomyolosis; lead to acute renal failure

Question 26

Military recruits or marathon runners how have been exercising in hot and humid weather are at risk for _________

Answer 26

rhabdomylosis

Question 27

Name one mechanical, physical, and chemical cause of rhabdo

Answer 27

mechanical: crush injury physical: prolonged fever, excessive physical activity chemcial: medications, excessive alcohol use

Question 28

T/F: People with rhabdo may experience a change in color in the urine; it will be much lighter

Answer 28

false; People with rhabdo may experience a change in color in the urine; it will be much DARKER; this is an medical emergency!!!

Question 29

__________ is nonspecific muscle weakness secondary to an identifiable disease or condition

Answer 29

myopathy

Question 30

list one hereditary example of myopathy

Answer 30

congenital myopathy, muscular dystrophy, myotonia, metabolic myopathy

Question 31

List one acquired myopathy

Answer 31

anything from any sort of pathology (ie: idiopathic, RA, HIV, cancer, diabetes, thyroid, renal impairment, alcohol)

Question 32

What are two symptoms of myopathy?

Answer 32

- progressive PROXIMAL muscle weakness with varying degrees of pain - fever, fatigue, morning stiffness, anorexia

Question 33

Trigger points are classified as ________ when they cause spontaneous local and referred pain and as ________ when they cause pain only on stimulation

Answer 33

active; latent

Question 34

Both active and latent TrPs can cause ________ and primary and secondary hyperalgesia which implies that afferent fibers from TrP nociceptors can make new effective connections with neurons that normally process info from remote body regions

Answer 34

allodynia

Question 35

T/F: TrPs have been reported in all age groups

Answer 35

false; all age groups except infants

Question 36

What is an example of a mechanical or structural factor that could lead to TrPs?

Answer 36

forward head posture

Question 37

___________ should be the last step in the physical examination process of TrPs

Answer 37

palpation

Question 38

Where is myofascial compartment syndrome most likely to occur?

Answer 38

lower leg, forearm, thigh, and foot (fascia cannot give or expand)

Question 39

the term _________ is associated with prolonged stays in the ICU. There is nonnecrotizing myopathy accompanied by fiber atrophy, fatty degeneration of muscle fibers, and fibrosis.

Answer 39

critical illness myopathy