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Flashcards in Musculoskeletal injuries 1 Deck (246):
1

what is malfeasance

commits an act that is not their responsibility

2

what is misfeasance

commits an act that is their responsibility to perform but uses the wrong procedure or does the right procedure in an improper manner

3

what is nonfeasance

fails to perform their legal duty of care

4

what is malpractice

commits a negligent act while providing care

5

what is gross negligence

total disregard for the safety of others

6

what are the three types of force

compression/ tensile
shear
tension

7

what is a muscle contusion

a result of a sudden traumatic blow where a muscle is crushed (bruised muscle)

8

what is hematoma

bruising

9

what is the history of a muscle contusion

acute onset

10

what is the mechanism of injury of a muscle contusion

due to a compressive force

11

what is ecchymosis

bruising

12

why might ROM be affected with a muscle contusion

swelling and haemorrhage

13

what two types of injuries are graded

muscle contusion
muscle strain

14

what is a muscle strain

pulling apart, stretch, tear, rip of a muscle, tendon or fascia

15

what is the result of a passive force causing the muscle to length

muscle strain

16

what are the 3 properties of muscles

viscoelasticity
irritability
contractility

17

what is viscoelasticity

allows m. to return to stretch to greater lengths over time in response to a sustained tensile force
-extensibility -ability to stretch
-elasticity- ability to return to normal length

18

what is irritability

ability to respond to a stimulus
-electrochemical-nerve impulse
-mechanical-external blow

19

what is contractility

ability to develop tension
-isometric
-concentric
-eccentric

20

what is the history of a muscle strain

acute onset

21

what is the mechanism of injury for a m. strain

due to an overstretch or overload on the m.

22

how is the pain described for a m. strain

pain is localised over the injury, which tends to be at or near the musculotendinous junction

23

is there any visible deformity in a m. strain

can be evident in the m.

24

is there any decolouration in a m. strain

yes caused by blood pooling distal to the site of trauma

25

is there any m. weakness in a muscle strain

can be

26

what is a ligament sprain

disruption in the function or integrity of a ligament caused by a force that moves the bone apart

27

what is more elastic ligaments or tendons

ligaments

28

what is tendonitis

inflammation within the tendon or the tendon sheath

29

where does tendonitis occur

enthesitis (where muscle attaches to bone)

30

what is enthesitis

where the muscle attaches to the bone

31

what is the history or tendonitis

gradual onset of pain and swelling

32

what is tendinosis

tendonitis that lasts longer than 6 months

33

what is tendinosis caused by

micro tears in the connective tissue in and around the tendon

34

in tendinosis there is an increase in tendon repair cells and ________ ________ into the area

fatty infiltration

35

tendinosis results in a decreased _____ ____ and increased chance of ______ _____

tensile strength
tendon rupture

36

your tendon is replaced by _____ _____ it is not very designed to take on heavy loads

fatty globules

37

what is quick to heal tendinitis or tendinosis

tendinitis

38

what is common tendonitis or tendinosis

tendinosis

39

what is aggravated by exercise tendinosis or tendonitis

tendonitis

40

what does NSAIDS help tendinosis or tendonitis

tendonitis

41

what colour does tendinosis and tendonitis show up on the colour on an MRI

tendonitis- white
tendinosis- black

42

What is degenerative tendinosis or tendonitis

tendinosis

43

what usually feels better after proper training tendinosis or tendonitis

tendinosis

44

what hurts to move tendinitis or tendinosis

tendonitis

45

what responses well to ice and irritated by heat and vise versa tendinosis, tendinitis

tendinosis- irritated by ice and responds well to heat
tendinitis- responds well to ice irritated by heat

46

what are common sites for tendinosis and tendinitis

elbow, Achilles tendon and patellar tendon
may be caused by repetitive trauma or strain

47

what is the history or tendonitis

gradual onset

48

what is the mechanism of injury for tendonitis

due to overuse, repetitive stretch or overload

49

how is the pain described in tendonitis

localized throughout the length of the tendon on palpation

50

is there swelling in tendonitis

may range from minor to major and thickening of the tendon may be present

51

is crepitus present in tendonitis

yes

52

when does pain occur in tendonitis

in extreme ROM in passive and active movements

53

when does pain increase in tendonitis

during stretching and with resistance testing

54

what is bursitis

inflammation of the bursa the pocket of fluid within the synovial lining designed to decrease frictional forces between the tissues surrounding the joints

55

what are the 5 properties of a bursa

1- fluid filled sac
2- reduced friction
3- common sites- area of friction
4- characterized by a sudden onset of pain and swellings
5- common sites include the olecranon bursa of the elbow and the patellar bursa of the knee

56

what is the history of bursitis

sudden onset of pain

57

what is the mechanism of injury for a bursitis

due to a single traumatic compression or by repeated compression associated with over use of the joint

58

how is the pain described with bursitis

localized pain and warmth on palpation

59

is there swelling with bursitis

localized swelling and may be minor or major

60

what are the three phases on soft tissue healing?

acute inflammatory phase
proliferation phase
maturation phase

61

how long does the acute inflammatory phase take

0-6 days

62

how long does the proliferation phase

3-21 days

63

how long is the maturation phase

21 days-year

64

in what phase does: collagen remodeling and increase in tensile strength of scare occur?

maturation phase

65

in what phase does phagocytosis remove debris

proliferation phase

66

what are the 3 mass cells released in the inflammatory phase

heparin
histamine
bradykinin

67

what is heparin

thins the blood and prolongs clotting

68

what is histamine

promotes further vasodilation

69

what is bradyskinin

opens the blood vessel walls; causes pain

70

when does the proliferation phase start

day 6 or 7

71

what are the 4 classifications of bone injuries

fracture
stress fracture
dislocation
subluxations

72

the outer surface of the bone is made of ____ bone

cortical

73

the inner surface of the bone is made of ____ bone

cancellous

74

bone has a complex network of blood vessels and lymphatic vessels that form canals known as the ______ _____

haverisan system

75

what is the diaphysis

shaft of the bone

76

what is the epiphysis

located on the end of the bone

77

what kind of cartilage is on the epiphysis

hyaline cartilage

78

what are the 5 functions of bone

1. body support
2. organ protection
3. movement
4. a reservoir for calcium
5. the formation of blood cells (haemopoiesis)

79

what are the 5 mechanical forces affecting bone

tension
compression
shear
bending
torsion

80

what are the 3 ways fractures are classified

1. anatomical site
2. mechanism of injury
3. extent of the injury to soft tissues

81

what are the 2 types of fractures identified by anatomical site

avulsion fracture
epiphyseal fracture

82

what is a avulsion fracture

-tendon and ligament pulls a piece of bonce fragment off

83

what causes a avulsion fracture

s sudden, powerful twist or stretch, commonly occurs in the ankle

84

what is a epiphyseal fracture

growth plate fracture in the developing child that could result in a disruption of normal growth

85

what are the 3 fractures that are classified as mechanism of injury

traumatic
stress and fatigue
pathological

86

what is a traumatic fracture

caused by a direct blow or sudden force applied to the bone

87

what is a stress and fatigue fracture

caused by repeated stress on a bone

88

what is a pathological fracture

fracture to a bone that is already weakened. the bone may be weakened due to the presence of a tumour, osteoporosis or prolonged corticosteroid medication use

89

what are the two fractures classified by the extent of the injury to soft tissue

open/compound fracture
closed/ simple fracture

90

what is a compound fracture

there is communication of the fractured bone with the exterior of the body, may be contaminated and infected

91

what is a simple fracture

there is no communication of the fractured bone with the exterior of the body

92

what to look for when diagnosing a fracture [7]

-mechanism of injury
-snap or pop
-presence of nausea
-onset of swelling or bruising
-functional level
-crepitus
-intensity of pain

93

what tests are used to diagnosis a fracture

x-ray
CT scan
MRI
bone scan

94

what are the two most important factors when treating a fracture

reduction
immobilization

95

what needs to be reduced when treating a fracture

-may be required if fracture is displaced
- may be achieved manually or with surgical interventions

96

what is immobilization in regards to fracture treatment

decrease pain
not always necessary
must be aware of the negative affects

97

what is vikmann's contracture

negative effect of casting
-nerve and blood supply blocked

98

what is Volkmann's contracture also known as [2]

reflex sympathetic dystrophy sudeck's atrophy
complex regional pain syndrome

99

what is avascular necrosis

death of the bone due to a disruption of the blood supply to the area

100

prevention of function when in cast:

move joints above and below fracture site; increase circulation
perform isometric and isotonic exercises

101

prevention of function when out of cast

stretching and strengthening exercise of the affected joints
gradual return to normal functional activities and sports

102

what is a stress/fatigue fracture

a micro fracture that is secondary to repeated stress
starts small and gets larger if untreated

103

subjective history or a stress fracture

as per the diagnosis of fractures but the patient usually cannot report a single traumatic event causing the pain

104

objective physical assessment of a stress fracture

initially pain is present with activity but decreases with rest (early stages )
constant pain through the day and at night (later stage)

105

x-ray as a diagnosis test

a stress fracture is not visualized initially but may be present after one month post injury

106

bone scan as a diagnosis test

the most definitive diagnostic tools for stress fractures

107

what is a dislocation

complete displacement of the end of a bone from the joint usually injuring the joint capsule, ligament and the surrounding musculature

108

with dislocation is there a limited ROM

yes grossly

109

is there any deformity and swelling with a dislocation

yes

110

marked ______ impairment with dislocations

functional

111

what is the treatment for dislocations

-splint and immobilize the affected joint in position that it is found and seek medication attention
-reduction of the dislocation by the attending physician

112

what is subluxation

a partial displacement of the end of a bone from the joint , sleeping on your neck the wrong way

113

what are the three phases of fracture healing

acute inflammatory phase
proliferation phase
remodeling phase

114

how long is the acute inflammatory phase for fractures

4 days

115

how long is the proliferative phase for fractures

8-10 weeks in adults
4-6 weeks in children

116

how long does the remodeling phase take

1-2 years

117

in the proliferative phase in fractures how long does it take to form a immature form of bone

2 weeks in children
4 weeks in adults

118

what is a indication

a condition that could benefit from the use of a specific modality

119

what is a contraindication

a condition that is adversely affected if a particular modality is used

120

what is a electromagnetic spectrum

all modalities fall under electromagnetic spectrum (except ultrasound)

121

what is electromagnetic energy

therapeutic modalities are part of the electromagnetic

122

what are the two electromagnetic energy

ionizing range
non-ionizing range

123

what is ionizing range

can alter the components of atoms (radiation) not used by most healthcare professionals

124

what is non-ionizing range

incorporates ultraviolet, visible and infrared light used in management of musculoskeletal injuries

125

what is cryotherapy

multiple types of cold application including the use of ice cubes, cold gel packs, cold water

126

what spectrum does cold application fall under

infrared radiation spectrum

127

what is vasoconstriction [cryotherapy]

decreases capillary permeability, circulation and blood flow to the area

128

what is increases absorption [cryotherapy]

decreases the swelling and fluid already present in the tissue assisting with healing and absorption

129

what is decrease muscle spasm [cryotherapy]

as a result of the increased relaxation time and decreased conduction rate the muscle cannot contract as much and it is slower to contract when it does

130

what is decrease tissue O2 demand [cryotherapy]

reduction in tissue hypoxia
for heart surgery they induce hypothermia, controlling oxygen demands

131

what is the hunting response [cryotherapy]

cyclical period of vasoconstriction and vasodilation after the application of cold to an area

132

after 15 mins of icing application should be removed because it causes _______

hunting response

133

can use ice for the first ____ days of in injury

6

134

what is thermotherapy

application of heat to an area using hydro collator packs, moist towels, paraffin wax baths, whirl pool bath or other electrical modalities

135

indicators for use of cryotherapy

acute or chronic pain (12 week marker)
acute inflammatory
superficial first degree burns

136

indication for use of cryotherapy with exercise [3]

facilitate mobilization
relieve pain
decrease muscle spasticity

137

what are contraindications for the use of cryotherapy [7]

-hypersensitivity to cold
-circulatory or sensory impairment (hypertension/ diabetes)
-Raynaud's disease
-uncovered wounds
-nerve palsy
-certain arthritis (systemic lupus erythematous )
-Leukaemia

138

what are the effects of thermotherapy [5]

-analgesic and sedative effects
- increased circulation and hyperaemia
- increased cellular metabolism
- increase extensibility of connective tissues
-decreased muscle spasms

139

what are the indications for the use of thermotherapy [6]

-increased pain
-increased sub acute and chronic inflammation and ecchymosis
-increased muscle spasm and guarding
-decreased ROM
-joint contractures and scare adhesions
-wound healing and infection

140

what are the contraindications of thermotherapy [5]

-acute inflammation or injury
- circulatory impairment
- sensory impairment
- malignancy
- impaired thermal regulation

141

what is an ultrasound

uses high frequency sound waves to produce thermal and non thermal effects

142

what are the 7 thermal effects of an ultrasound

-increases the extensibility of the collagen
-increases circulation to the area
- increases the velocity of the sensory & motor neurons
-decreased muscle spasm
- decreases inflammation
- decreases pain
- increases enzymatic activity

143

what are the 6 non-thermal effects of an ultrasound

-increase cell membrane & vascular wall permeability through the production of cortisol
-increased blood flow
-protein synthesis
- decrease swelling
- mechanical disruption of the tissue causes the healing tissue to heal in a proper alignment
-micro massage

144

what are the 8 indications for the use of ultrasound

-increased pain
- increased inflammation and the presence of a hematoma
-increased spasticity and m. spasm
- decreased extensibility
-neuritis
-the presence of joint adhesions and contractures
- post acute myositis ossificans
-plantar warts

145

what are the 7 contraindications to the use of the ultrasound

-infection thrombophlebitis (acute inflammation of a vein)
- circulatory impairment
- sensory impairment
-malignancy
-over epiphyseal growth plates of children ( causes growth plate to fuse early)
- over a stress fracture
over the eyes, heart and genitals

146

what does TENS stand for

transcutaneous electrical nerve stimulation

147

what is transcutaneous electrical nerve stimulation

portable unit that applies a current to the skin via carbon electrodes that are placed over the painful site allowing pain control via a high frequency, low frequency and brief intense stimulation

148

what are the 3 effects of TENS

- pain relief in the body is based on the gate theory of pain
- large diameter nerves are stimulated and the pain impulse is modulated at the spinal cord level inhibiting transmission of this impulse to the brain
- pain relief via the production of endorphins

149

what is the 1 indications for TENS

increased pain

150

what is the 3 contraindications for TENS

-the presence of a pace maker
- placement in the abdominal and pelvis region of pregnant females
-pain of unknown origin

151

what does IFC stand for

interferential current

152

what is interferential current?

a current applied to the skin via paired carbon electrodes that are positioned perpendicular to one another creating a pattern of interference that targets both the sensory and motor neurons

153

what are the 7 effects of IFC ( outcome of the molality )

- 2 generators with quadripolar electrodes arrangement and AC current
-decreased pain
- decreased both acute and chronic swelling
- decreases m. spasm
- increases circulation to the area
- strengthen weakened m.
-increases cellular activity thereby facilitating the healing process

154

what are the 4 indications for the use of IFC ( what patients experience)

- increased pain
- increased acute and chronic swelling
-increased m. spasms and guarding
-may assist in chronic wound healing

155

what are the 4 contraindications for the use of IFC

-the presence of a pace maker
- placement in the abdominal and pelvic region of pregnant females
- thrombophlebitis
- pain of unknown origin

156

what is electrical neuromuscular stimulation (EMS)

the electrical current stimulates the peripheral nerve and elicits a m. contraction

157

what are the 6 effects of electrical neuromuscular stimulation

-decreases pain
- decreases inflammation
- decreases m. spasm
- maintains m. strength and size during period of immobilization
- re-educate m.
-increases circulation to the tissue

158

what are the 6 indications for the use of EMS

-increased pain
- increased acute and chronic swelling
-increased m. spasms and guarding
-during periods of immobilization to prevent m. atrophy
-decreased range of motion and strength
-peripheral nerve injuries

159

what are the 5 contraindications for the use of EMS

- the presence of a pace maker
- placement in the abdominal and pelvic region of a pregnant women
-thrombophlebitis
-malignancy
- superficial skin and lesions and abrasions

160

what is a dynamic muscle contractions

a muscle contraction in which the muscle alters its length

161

what is isometric contraction (first exercise to use on a rehab program )

a muscle contraction in which the internal force developed by the m. neither the lengthens nor shortens the m.

162

what is concentric contractions

a contraction in which the internal force generated is greater than the external forced applied so that the m. activity shortens (lifting a weight)

163

what is a eccentric contraction

a contraction in which the external force applied us greater than the internal force generated. the m. is allowed to lengthen while still maintaining tension, the . contraction acts as a braking force.

164

what is the most common injury for children

soft tissue injuries

165

what age range is it most common for a child to obtained a soft tissue injury

10-18

166

what is the mechanism of cartilage injuries in children

compressive and tensile force

167

what is apophyseal avulsion

suddenly applied forces to the bone may cause the apophyses to become partially or completely separated from the bone

168

what is Osgood schlatters disease

developing ossifications center in the tibial tuberosity may be avulsed and replaced by fibro-cartilaginous material

169

what is the mechanism of injury to Osgood schlatters disease

repetitive strain of the quadriceps

170

when do they have pain with Osgood schlatters disease

until they stop growing approx. 18

171

what are the 6 signs and symptoms of Osgood schlatters disease

- pain localized over the tibial tubercle
- swelling over the patellar tendon
- pain increases with activity and decreased with rest
- usually present bilaterally
- more common in males between the ages 11-15
-x-rays show regularity of tibial tuberosity

172

what is the treatment for Osgood schlatters disease

rest from painful activities
restore strength and flexibility to lower extremity m.

173

what is calcaneal apophysitis

- inflammation of the calcaneal apophysis (insertion of Achilles, plantar fascia and short m. of foot

174

what are the 5 signs and symptoms of calcaneal apophysitis

-localized pain on the calcaneal apophysis
- pain increases on palpation and with activity and decreased with rest
- more common in males
- more common between ages 11-15
-x-rays reveal sclerosis and irregularity of apophysis

175

what is the 7 treatments of calcaneal apophysitis

- heel lifts
- ice and rest
- casting (only way to make the child rest)
- orthotics
- proper athletic shoes
- stretching of gastrocnemius and soleus m.
- strengthening of lower extremity m.

176

what is sinding Larsen Johansson disease

occurs at the proximal end of the patellar tendon
in adults this is known as patellar tendonitis

177

what is sinding Larsen Johansson disease called in adults

patellar tendonitis

178

what are the 8 signs and symptoms of sinding Larsen Johansson disease

-pain over the distal pole of patella
- palpable prominence edvident
- pain increases with activity and decreases with rest
- higher location than Osgood schlatters disease
- common in females between 8-13
- common males 10-15
- bilateral involvement usually
- x-rays reveal irregularity of fragmentation of the inferior part of the patella

179

what is the treatment for sinding Larsen Johansson disease

same as for Osgood schlatters disease:
rest from painful activities
restore strength and flexibility to lower extremity m

180

what is osteochondritis dissecans

- the articular cartilage may separate from the surrounding bone and form a loose body
- segment of subcondral bone undergoes avascular necrosis and ischemia
- associated with physical activity, repetitive micro trauma and high level sports in young athletes

181

what is legg calve perthes disease

avascular necrosis of the proximal femoral epiphysis
needs surgical intervention

182

what are the signs and symptoms of legg calve perthes disease [4]

- pain in the groin, anterior thigh and knee
-antalgic gait pattern
- decreased hip abduction, extension and external rotation
- more common in males between the ages 3-8

183

what is the treatment for legg calve perthes disease

-immobilization in an abducted position in non weight bearing immobilization may last 1-2 years
- surgery to prevent further deformity of the femoral head

184

what is plastic deformation

- growing bone is less mineralized than mature bone and has the capacity to bend rather than break and stay that way

185

what is a torus fracture

- caused by a longitudinal force along that shaft of a long bone resulting in a compressive force on the distal end of the bone
- damages growth plate

186

what is green stick fracture (unique for children )

the tension result in the bone bending at each end but the fracture is not complete

187

what is a hip pointer

- contusion type if injury
- blow localized to the ASIS or AIIS
-possible causes may include a direct blow to the area or a force contraction of the muscles attaching to the region
- involved the Sartorius, rectus femoris or abdominal m,

188

what is consider grade 1 hip pointer

- normal gait pattern and posture
- slight pain on palpation
- little or no swelling
- full ROM of the lumbar spine and hip

189

what is consider grade 2 hip pointer

- antalgic gait pattern with shorten swing phase
- patients stands in flexed and side flexed towards the side of injury
- pain on palpation
- visible swelling and bruising
- active lumbar spine and hip flexion
-ROM decreased and painful
- pain and weakness with resistance testing
- positive Thomas test

190

what is considered grade 3 hip pointer

- pain with coughing sneezing or laughing
- severe pain, swelling and bruising (must role our a fracture or a eruption of m. or ligament )
- all other findings as per grade 2

191

what is the treatment of the hip pointer

-rest, ice, compress and elevate the area
- crutches for walking
- non steroidal anti-inflammatory mediations (NSAIDS)
- TENS, IFC and ultrasound
- protective pad over area
- stretch and strengthen the appropriate m.

192

what is NSAIDS

non steroidal anti-inflammatory mediations

193

what is trochanteric bursitis

inflammation of the trochanteric bursa of the hip

194

what causes trochanteric bursitis [2]

1.direct blow to the lateral aspect of the hop resulting in bleeding into the bursa
2. excessive friction or shear forces from the tensor fascia latea m. gluteus max m. or the iliotibial band

195

what is burning or aching pain over or posterior to the greater trochanter a sign of

trochanteric bursitis

196

with an individual with trochanteric bursitis what might a person report with movement

snapping sensation in hip region

197

what movements would someone with trochanteric bursitis report pain with

active flexion, abduction and internal rotation of the hip, (tensor fascia lata m.) and extension and external rotation of the hip

198

what test would someone with trochanteric bursitis report pain with

resistance testing

199

what are the 9 treatments of trochanteric bursitis

-ice
-protected rest
-NSAIDS
-electrical modalities such as ultrasound and interferential current
-no compression because that is the while cause of bursitis
-stretching of the tight m.
-determine the potential cause of this problem and modify
-aspiration of the bursa
- surgical removal of bursa

200

what is snapping hip syndrome

intra articular and extra articular causes

201

what are the two extra articular causes of snapping hip syndrome?

external
internal

202

what is external articular cause of snapping hip syndrome

ITB or gluteus max. snapping over greater trochanter during hip flexion---> TROCHANTERIC BURSITIS

203

what is internal articular cause of snapping hip syndrome

iliopsoas snaps over structures deep to musculotendinous unit -->ILIOPSOAS BURSITIS

204

what is the intra articular causes of snapping hip syndrome

lesions of the joint-->LABRAL TEAR
usually occurs when an individual externally rotates and flexes the hip joint

205

what does the Ober's test for?

snapping hip syndrome,
ITB when it gets tight can cause the noise

206

what are the 3 treatments for snapping hip syndrome

-NSAIDS
-stretching of the tight structures and strengthening of the week m. involved
-alter the biomechanics and technique of the activity

207

what is the most commonly strained m. in the body

hamstrings

208

in what phase of knee flexion is someone likely to strain their hamstrings

initial swing phase

209

true or false a strength imbalance of the quads and hams can cause a hamstring strain

true

210

injury occurs when the hamstrings _____ a forceful contraction of the quad m.

decelerates

211

what is the history of a hamstring m. strain

poor posture, inflexibility and m. imbalance

212

how is antalgic gait pattern a result of a strained hamstring

inability to fully extend the knee at the heel strike

213

increase pain with hamstring strain with ___ hip flexion and knee flexion

active

214

increase pain with hamstring strain with _____ hip flexion and knee extension

passive

215

what is the treatment phase 1 for hamstring strain

-protected, rest, ice, compression and elevation
-NSAIDS
- use of crutches if an antalgic gait patterns is evident

216

what is the treatment phase 2 for hamstring strain

-electrical modalities such as ultrasound and EMS
-slow, pain free and gradual stretching program
-being gentle isometric strengthening exercises

217

what is the treatment phase 3 for hamstring strain

-progressive stretching and strengthening exercises
-sport specific exercises that involve rapid stops, starts and directional changes
- focus on the prevention of future injury

218

what is a quadriceps m. contusion

result of a direct blow to the quad m.

219

what is the most common sit for a quad contusion

anterolateral aspect

220

in what injury is the severity almost always underestimated

quad m. contusion

221

bruising and swelling over the anterior thigh
antalgic gait pattern are signs of what?

quad m. contusion

222

with a quad m. contusion you have pain with ___ hip extension and knee flexion and pain with _____ hip flexion and knee extension

passive
active

223

what is myositis ossificans

a direct blow to an area causes a deposition of bone within a m.

224

true or false may need surgery with myositis ossificans

true

225

what is medial collateral ligament MCL sprain caused by

an abnormal valgus force

226

what is the valgus stress test looking for?


tests for MCL sprain

227

what does the patellar apprehension test

patellar dislocation

228

what does the Thomas test look for

hip pointer

229

what does the resistance test detect

m. contusions (quads)
trochanteric bursitis

230

hat does ober's test detect

snapping hip syndrome
ITB friction syndrome

231

what does the valgus test detect

MCL sprain

232

what does the figure 8 test detect

if someone is ready to go back to sport after an MCL sprain

233

what does varus stress test detect

LCL sprain

234

what does anterior drawer test detect

ACL sprain

235

what does posterior drawer test detect

PCL sprain

236

what does posterior sag test detect

PCL sprain

237

lochment test detect

ACL sprain

238

what does McMarry's test detect

meniscal sprain

239

what does Apley's test detect

meniscal sprain

240

what are the 9 elements in the acute inflammatory phase in the soft tissue healing

- blanching of the skin as the site does not bleed immediately
-vasoconstriction (first 10mins to try and coagulate)
-platelet reaction in which the clot is formed by celling combining with one another to form a mechanical plug to seal ruptured vessel
-coagulation cascade affects clot formation
-followed by increase in blood flow for the next 5-60 minutes
-redness, heat, swelling, pain and loss of function is evident with an increase in blood flow to the area
-chemical and cellular events occur in which macrophages and neutrophils and various kinins released in the area
- mass cell release (heparin- thins the blood and prolong clotting; histamine- promotes further vasodilation; Bradykinin- opens blood vessel walls and causes pain)
- the length of the acute inflammatory phase is approx. 0-6 days

241

what are the 7 elements in the proliferation phase in the soft tissue healing

- starts on day 6 or 7
- before any repair can occur the debris must be removed by phagocytosis
- Angiogenesis occurs in which new blood vessels are formed
- fibroplasia occurs in which type 1 and 3 collagen is laid down forming a mass of immature connective tissue
-the generation of new epithelial tissue occurs as a result of these processes
-overlap between the acute inflammatory phase and proliferation phase
-lasts approx. 3-21 days

242

what are the 5 elements in the maturation phase in the soft tissue healing

- scar tissue formation in the region occurs, the scar tissue is fibrous inelastic and nonvascular as compared to the original tissue
-collagen remodeling and the increase in tensile strength of scar occurs
-early mobilization insures that the collagen fibres are laid down in proper orientation along the lines of habitual stress
-return to normal histochemical activity occurs
-last from 21 days to 1 year post injury

243

what are the 4 elements in the acute inflammatory phase in fracture healing

- damage to the periosteum and the surrounding soft tissues results in massive bleeding into the area
-the formation of hematoma results
-vasodilation, edema formation and histochemical changes as per soft tissue occurs (mass cells)
- lasts approx. 4 days

244

what are the 5 elements of the proliferation phase in fracture healing

-also known as the repair and regenerative phase
- osteoclasts resorb the damaged bone
- osteoblasts lay down new bone trying to bridge the gap where the fracture was
-osteoblasts la down a matric which forms a callous. this matric becomes impregnated with calcium and form an immature form of bone. the process takes approx.. 2 weeks in children and 4 weeks in adults
- radiological union occurs in approx. 4-6 weeks in a child and 8-10 weeks in an adult

245

what are the 2 elements of the remodeling stage in fracture healing

-strengthening of the bone and reshaping
-takes 1-2 years to complete

246

what are the 5 effects of cryotherapy

-vasoconstriction
-increases absorption
-decreases muscle spasms
- decreases O2 demands
-Hunting Response