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MIDTERM Flashcards

1
Q

what is the ultimate goal of treating an injury

A

promote a strong, mobile scar
pain free ROM

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2
Q

5 signs of inflammation - SHARP

A

swelling
heat
altered function
redness
pain

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3
Q

what is the point of the healing process

A

restore integrity of the tissue

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4
Q

what is mature collagen repair called

A

scar tissue

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5
Q

what is primary / first intention healing

A

some tissue loss

wound edges are approximated

healing is efficient, only small amounts of collagen produced

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6
Q

what is secondary/second intention healing

A

extensive tissue loss/large area affected

wound edges aren’t easily approximated

healing takes longer through extensive re-epithelization

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7
Q

acute timeline

A

moment of injury –> 3-4 days

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8
Q

symptom picture of acute

A

redness
swelling
heat
pain
loss of function
muscle spasm/guarding
black, blue purple bruising

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9
Q

what causes swelling

A

fluid leaking into interstitium due to increased permeability of blood vessels

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10
Q

treatment goals in acute stage

A

limit inflamm. process

reduce pain/swelling

decrease SNS firing

prevent re injury

protective spasms are reduced but not removed

compensatory structures are addressed

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11
Q

early subacute stage timeframe

A

within 2 days of injury –> 3 weeks

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12
Q

symptom picture of early subacute

A

less signs of inflammation
decreased swelling
less pain
muscle spasm diminished

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13
Q

what is the primary process of early subacute stage

A

filling damaged area with new tissue

regeneration begins in this stage if necessary

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14
Q

when does re-epithelization happen

A

only applies if the skin is damaged

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15
Q

treatment goals for early subacute

A

decrease inflammation, pain, swelling and spasms

maintain available ROM and strength

peripheral tissue to injury can be treated

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16
Q

what is different from acute tx vs early subacute tx

A

you can start working on tissue proximal to injury site

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17
Q

granulation tissue is part of any tissue repair where first/second intention healing

A

true

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18
Q

what is neuroangiogenesis

A

new blood vessels develop from venues at the edge of an injury

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19
Q

what is granulation tissue

A

vascular CT

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20
Q

in acute stage:
initial vasoconstriction is followed by what

A

vasodilation

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21
Q

what happens in acute stage briefly

A

vasoconstriction followed by vasodilation

swelling caused by fluid leaking into interstitium

platelets cause coagulation

leukocytes go to injured site and clean

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22
Q

subacute time frame

A

within 2 days up to 3 weeks up to 6 weeks

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23
Q

timeline of late subacute

A

2-3 weeks post subacute stage

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24
Q

what happens in late subacute stage

A

blood vessels that developed w neoangiogenesis retract***

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25
what can wound contraction result in
deformation of tissue and possible dysfunction
26
describe what happens in scar remodeling
reshaping, reorganizing, healing as collagen is broken down, new collagen is synthesized cross links develop strength increases
27
timeline for chronic
2-3 weeks post injury --> 1-2 years
28
describe reflex muscle guarding
response to pain/injury acts to splint, reduce movement and prevent further injury can result from referred pain guarding stops when pain is relieved
29
describe intrinsic muscle spasm
self perpetuating pain spasm cycle indirect or direct trauma increase in SNS due to not knowing why mm is spasming RESTRICTS MOVEMENT OF JOINT IF CROSSED BY MUSCLE circulatory stasis, metabolite build up
30
what is tone
resistance of a relaxed muscle
31
what is tension
increase in tone in mm that tend to shorten
32
what causes muscle contraction
filaments move past each other, pulling on actin, repeated actions produce muscular contraction
33
muscle spindle and golgi tendon transmit proprioceptive info from muscles to the CNS to allow proper functioning
true
34
where are muscle spindles found where are golgi tendons found
muscle belly tendons
35
what do muscle spindles do\ what do they measure
major sensory organs that aid in control of movement measure muscle stretch / speed
36
causes of muscle spasms (6)
pain circulatory stasis increased gamma firing chilling of muscle impaired nutritional supply lack of vit d
37
symptom picture of spasms
pain within muscle due to ischemia and retention of metabolites spasm/hypertonicity decreased ROM of joint crossed by shortened affected muscle antagonist/synergists muscles are affected
38
what does an acutely spasmodic spasm feel like
firm dense congested
39
what is the texture of a intrinsic spasm
hard fibrous
40
describe abrasion
superficial wound w ragged edges extremely painful
41
how does a muscle spasm occur
an action potential stimulates release of calcium --> initates mm contraction when action potential stops, calcium is recovered and mm contraction ceases in a spasm, the contraction continues
42
define laceration
increased tissue loss w ragged edges
43
define incision
clean approximated edges from sharp object
44
define puncture
clean edges w small entry point
45
define animal bite
combo of laceration, crush, puncture
46
what happens within a short amount of time in first intention healing, then what happens later on
thin layer of fibrin, basis for a clot of laid down re-epithelization is complete in 2-3 days site is closed to bacteria over 10-14 days fibroblasts and collagen add strength
47
what happens in second intention healing
if dermis is affected moisture allows better healing
48
describe superficial burn (1st degree)
affects epidermis prolonged low heat or quick exposure to high heat redness/pain mild edema within week epithelium sloughs off healing is rapid, no scar tissue but discoloration may occur
49
describe partial thickness (2nd degree burn)
goes into dermis blistering increased edema, risk of infection, decreased pain due to nerve damage new layer of skin as a barrier within 14-21 days , deeper burns in 21-35 days good functional return, minimal scar tissue deeper= contracture, fibrosis, joint mob restrictions
50
full thickness (third/fourth degree) burn
affects down to subcutaneous down to muscles, bone, tendon burns look waxy, dry, white or charred painless = nevre damage re-ep is not possible because of tissue damage skin grafts needed
51
what is hypertrophic scar tissue
fibres organizing into adhesions w reduced elasticity combined w contraction of myofibroblasts causes "heaped up" tissue AKA tissue appears heaped up
52
goal for working with scar tissue
mobility return strength improve tissue health
53
where is the area of a trigger point
the motor point where nerve stimulation initiates a contraction in a small, sensitive bundle of muscle fibres that in turn activates the entire muscle
54
what causes a trigger point
calcium and ATP on myofascial tissues that have been stressed that causes the tissue to shorten producing taut band/nodule
55
localized uncontrolled metabolic activity in area and localized acidic fluid environment does what
makes the nerve endings hyperirritable resulting in TP pain
56
3 perpetuating factors of TP development
reflexive mechanical systemic
57
reflexive perpetuating factors TP's
skin sensitivity joint / visceral dysfunction vasoconstriction nerve segment
58
mechanical perpetuating factors
gait distortion immobilization vocational stress restrictive clothes furniture
59
systemic perpetuating factors
enzyme dysfunction metabolic / endocrine dysfunction chronic infection dietary insufficiencies psychological stress
60
what is an active trigger point
PAINFUL ALL THE TIME / AT REST prevents mm from fully lengthening tender on palpation referred pain in a specific pattern when mm is lengthened to point of pain a protective mm spasm occurs
61
on an active TP what can palpation produce
a local twitch response and possible referred autonomic phenomena
62
what is a latent trigger point
produces pain only when palpated more common than active can persist for years all other characteristics of active may occur w latent
63
primary trigger points
activated by acute or chronic mechanical strain or overload of affected muscle
64
secondary trigger point
activated in the overworked synergist or antagonist muscles
65
satellite trigger points
found in muscles that lie within the referral pattern of another trigger point
66
who invented trigger points
travell simons
67
what is panniculosis
thickening of subcutaneous tissue granular feel
68
what is a jump sign
when pain is intense enough to cause client to jump

FCA (6 decks)

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