MS: Soft Tissue Dysfunction

Question 1

What are the fibrous components in extracelluar matrix?

Answer 1

collagen and elastin

Question 2

What are the ground structures for connective tissue?

Answer 2

glycoproteins and proteglycans, water

for joint lubrication

Question 3

What are the regions for stretching?

Answer 3

toe, elastic, plastic, failure

Question 4

What is creep in regards to viscoelasticity?

Answer 4

the ability to deform over time when a constant load is applied

in LBP pts making sure they get up every 30 mins to counteract creep

Question 5

What is stress relaxation in regards to viscoelasticity?

Answer 5

reduction in stress within a material over time as the material is subject to constant deformation

Question 6

What effects viscoelasticity?

Answer 6

1. immobilization- weakness of soft tissue
2. overuse- can’t adapt and build starts breaking down
3. hormones- low estrogen in females causes laxity in women
4. disease- lung and heart issues cause lack of O2 to tissue

Question 7

What is a strain?

Answer 7

acute injury to muscle or tendon

Question 8

What is a sprain?

Answer 8

injury to ligament of jt capsule

ex. dislocation, subluxation, instability

Question 9

What is the basic function of a tendon?

Answer 9

to be able to elongate (stretch) and sustain force (strength)

Question 10

what is a microstrain of tendon?

Answer 10

why is this tendon breaking down, possible over use?

Question 11

What is a macrostrain of tendon?

Answer 11

the tendon is torn

Question 12

What are healing factors of a tendon?

Answer 12

age

vascularity- for example supraspinatus and achilles have poor blood supply

comorbidities, auto immune meds

Question 13

What is tendinopathy?

Answer 13

a big subcategory, a general descriptors to include all pathologies that arise in and around tendons

Question 14

What is tendonosis?

Answer 14

the breakdown within the tendon likely due to ageing, microtrauma and vascular compromises

often palpable with no swelling but it is tender

Question 15

Would you use anti- inflammatory with pt with tendonosis?

Answer 15

No, b/c these will decrease blood flow to the area

goal of PT is to rebuild tendon, therefore you need swelling

Question 16

What is tendinitis?

Answer 16

overuse, or symptomatic degeneration of the tendon with vascular disruption and inflammatory repair

Question 17

Do you want to use anti- inflammatory meds with tendinitis patients?

Answer 17

Yes, to decrease blood flow to promote reduced swelling

use PRICE

Question 18

What is paratenonitis?

Answer 18

inflammation of the outer layer of the tendon, external architecture is affecting the tendon

ex. the sheath of tendon

Question 19

What is De Quervains disease?

Answer 19

AB Pl and Ext PL tendon sheaths

create a sandpaper effect during motion

Question 20

Treatment for tendonosis?

Answer 20

a lot of eccentric training to generate length and force

create microswelling

load and stretch tendon

Question 21

Treatment for tendonitis?

Answer 21

PRICE

concentric—–> eccentric

Question 22

Treatment for paratenonitis?

Answer 22

whats not efficient around the tendon and fix it

Question 23

What are primary stabilizers of a joint?

Answer 23

ligaments and capsule- 1st

muscles- 2nd

Question 24

What is a muscle strain?

Answer 24

results usually from a sudden stretch on a muscle that is actively contracting

Question 25

What is a 1st degree strain?

Answer 25

some stretching of the muscle fibers pain increases as muscle contracts slight swelling, pain at site of injury

Question 26

What is a 2nd degree strain?

Answer 26

actual tearing of some muscle fibers (5%-95%) same as 1st but Sx last longer bruising distal or at site of injury

Question 27

What is a 3rd degree strain?

Answer 27

complete rupture of muscle total loss of function, palpable defect in muscle less pain due to nerve endings death

Question 28

What is a 1st degree sprain?

Answer 28

ligaments stretched with little or no tearing of fibers less pain but jt feels unstable slight swelling, mild tenderness with firm end feel

Question 29

What is 2nd degree sprain?

Answer 29

partial tearing of ligament's fibers (5-95%) soft but definite end feel- loss of joint function (blood in joint) symptoms lasts longer than 1st degree

Question 30

What is a 3rd degree sprain?

Answer 30

complete rupture of ligament's fibers empty or absent end feel joint laxity or instability, complete loss of jt function severe swelling

Question 31

What are two forms of bursitis?

Answer 31

1. subcutaneous- can be large and not affect joint, not pain unless hit, swelling remains in sac (prepatellar, olecranon) 2. Bursa seperating tendinous or ligamentous tissue like in Pes Anserine often cause high pain with motion (system no effecient) Treatment- cortisone injection

Question 32

What is a peripheral nerve injury?

Answer 32

entrapment of nerves where symptoms are always distal sx: dull ache, weakness Ex: median, radian nerve

Question 33

What is a spinal nerve root injury?

Answer 33

pinching up root like C6 (radiculopathy) pain in a larger area, numbness distal with increased pressure, motor weakness, absent of reflexes (hypo-)

Question 34

what are spinal cord compression symptoms?

Answer 34

myelopathy- bilaterally UMN signs and symtpons- numbness distally, spasticity, HYPERreflexia, clonus (uncontrolled mvmt) balance and gait distubences, Babinski sign's sudden changes in bowel or bladder function

Question 35

What are examples of fibrocaritlage?

Answer 35

menisci, IV discs, pubic symphysis reduces friction

Question 36

What is articular cartilage?

Answer 36

aka hyaline any articular surface, strong tensile strength, flexible support Fx- absorbs and spreads load across jt surface, decreases friction doesn't heal well- due to little or no blood supply

Question 37

How does articular cartilage get nutrition?

Answer 37

provided by synovial fluid this is impt in rehab to promote synovial fluid to joint affected (bike, MET)

Question 38

What is Osteoarthritis (OA) or Degenerative Joint disorder (DJD)?

Answer 38

degeneration of articular cartilage and is most common musculoskeletal disorder

Question 39

What is the cause of DJD/OA?

Answer 39

still unknown: 1. genetic predisposition/ obesity causes articular cartilage defect/damage 2. posttraumatic- trauma or intra-articular cartilage fx disrupts AC 3. immobility or excessive loading can cause failure

Question 40

Signs and symptoms of OA/DJD?

Answer 40

joint pain, reduced motion, crepitus with motion, deformity (Wolff's law), muscle weakness synovitis can occur due to breakdown of jt surface severity depends on when pain occurs- after, during or before activity?

Question 41

PT management of OA/DJD?

Answer 41

meds- to reduce swelling PT- best response for joint conservation Surgery- clean it out or replace it