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Semester 3 > Orthopedic pathology 1 (general terminology) > Flashcards

Orthopedic pathology 1 (general terminology) Flashcards

1
Q

orthopedic pathology

A

study of injuries to, or conditions involving the musculoskeletal system

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2
Q

Orthopedic Surgery

A

branch of surgery that deals with the correction of injuries or disorders of the skeletal system

associated muscles,
joints and ligaments

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3
Q

sprain

A

Overstretch or tear injury to a ligament

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4
Q

ligament function

A

Control ROM
Taut at end ROM
Relaxed in midrange

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5
Q

sprain cause

A

Related to sudden twist or pulling of joint beyond its normal ROM

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6
Q

sprain other cause

A

Congenital ligament laxity
Hypermobile joints

Biomechanical instability

History of Sprains

CT pathologies

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7
Q

more than once

A

History of Sprains

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8
Q

Signs symptoms

A

SHARP

Pain
Swelling
Bruising
Loss of functional ability
A “pop” when the injury occurs

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9
Q

sprain severity

A

Mild – with only slight stress to the ligament

Severe – with total separation of the ligament that supports a joint

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10
Q

grade 1

A

A minor stretch and tear to the ligament

No joint instability on passive relaxed testing

Minimal pain and swelling

No loss of functional ability – person can continue ADLs with some discomfort

Able to weight bear on the affected joint

Bruising is absent or slight

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11
Q

Able to weight bear on the affected joint

A

1

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12
Q

bruising 1

A

absent or slight

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13
Q

grade 2 sprain

A

Partial tearing of a ligament

Bruising

Moderate pain and swelling

Usually some loss of function - due to pain

Trouble bearing weight on the affected joint

*
Snapping sound and joint gives way at time of injury

Joint is hypermobile yet stable on passive relaxed testing

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14
Q

2

A

Usually some loss of function - due to pain

Trouble bearing weight on the affected joint

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15
Q

partial tear

A

2

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16
Q

3

A

Complete tear or rupture of a ligament or an avulsion fracture

Pain, swelling and bruising are usually severe

Unable to put any weight on the affected joint

*
Snapping sounds and joint gives way

Significant instability and no end point on passive relaxed testing

Chronic – painlessly hypermobile in the direction ligament is intended to check

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17
Q

complete teart, avulsion fracture also possible

A

3

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18
Q

unable to put any weight

A

3

adl affected

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19
Q

joint effusion

A

Occurs when injury is severe enough to inflame the synovium
Increased production of synovial fluid causing joint capsule to swell

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20
Q

knee effusion

A

water on the knee

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21
Q

water on knee cause

A

joint injury

arthritis

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22
Q

hemarthrosis

A

Bleeding into the synovial space

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23
Q

diagnosis of sprain, joint injury

A

x ray to rule out bone injury, fracture

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24
Q

why heal slowly?

A

igaments are moderately vascularized

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25
Q

adhesions during healing of ligament

A

Adhesions can form between the ligament and surrounding tissue that can limit ROM

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26
Q

SCAR TISSUE FORMATION TIME FRAME IN LIGAMENTS

A

Scar tissue in a ligament takes 6 weeks to develop – but a full 6 months to mature and provide maximum strength to the affected joint

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27
Q

6 weeks 6 months

A

6 weeks to develop, 6 months to fully mature, provide max strength

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28
Q

3 sprain

A

Usually surgically repaired or treated by a conservative approach of immobilizing the joint in a cast or strapping

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29
Q

future sprain

A

After a sprain of any severity an individual has an increased risk of having future sprains in the area (future instability)

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30
Q

common sprain location

A

Ankle
Lateral ligaments most likely in inversion sprain

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31
Q

most common in ank.e

A

anterior talofibular

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32
Q

least common ankle

A

calcaneocuboid

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33
Q

Calcaneofibular

A

also common

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34
Q

eversion sprain?

A

affects deltoid lig. (but they are quite strong, thus if they rupture, they tend to avulse the bone, i.e. medial malleoli of tibia)

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35
Q

eversion sprain?

A

deltoid ligament
anteiro psoteior tibiotalar

tibiocalcaneal

tibionavilcular

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36
Q

knee

A

PCL, ACL

MCL
m/c due to pronated feet and knees coming together
Cause: repetitive strain, trauma from lateral side of leg

LCL
force from medial side of leg

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37
Q

most common knee

A

MCL

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38
Q

terrible traid

A

When foot is fixed on ground, and knee is struck by a valgus force (medially directed), affects three structures:

medial meniscus, ACL and MCL

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39
Q

wrist

A

Palmar radiocarpal – m/c

Dorsal radiocarpal

Ulnar collateral

Radial collateral

Intercarpal ligamentm

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40
Q

most common wrist

A

palmar radiocarpal FOOSH

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41
Q

shoulder

A

AC lig joint

conoid lig, trapeziud lig (coracoclavicular ligs)t

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42
Q

treat sprian

A

RICE (outdated…)

ice for acute and subacute

heat/ice for flared up chronic or subactue

heat for dormant chronic, with pain but no inflammation

rest is okay, but must remain as active as possible to accelerate healing, increase circulation and homrones contributing to healing

elevation ???

compression ???

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43
Q

when surgery?

A

grade 3, immobilize/brace for … 10 weeks

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44
Q

how long immobilize brace?

A

10 weeks

6weeks scar tissue form

6 months scar tissue complete

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45
Q

strain

A

verstretch injury to a musculotendinous unit

of a muscle, tendon, their osseous attachment and the musculotendinous junction

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46
Q

acute chronic strain

A

ACUTE - caused by a sudden overstretching of the muscle or an extreme contraction of the muscle against heavy resistance

CHRONIC strains are usually the result of overuse – prolonged repetitive movement of the muscles and tendons

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47
Q

why chronic strain?

A

overuse

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48
Q

two mucsle ocntaction type

A

concentric eccentri

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49
Q

eccentric

A

can CREATE greater forces within the muscle than concentric contractions

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50
Q

which more likely result in strain?

A

ecentric

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51
Q

what else risk for strian?

A

Single, explosive muscle contractions, either eccentric or concentric, can also result in a strain

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52
Q

note

A

“The weakest link in the muscultendinous unit at the time of injury is the structure that is damaged”

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53
Q

why young more likely fracture than strain

A

developing bone weaker than ligament/tendon structure

and children muscles genreally cannot produce the amount of force required to strain muscle (e.g. like powerlifter)

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54
Q

most common strain? upper body

A

supraspinatus

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55
Q

which part of body more common

A

lower body more common than upper body

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56
Q

e.g. common

A

hamstrings @ origin (Isch tub?)

gastroc @ insertion (CALCANEAL TENDON)

QUADRICEPS – belly
(esp RECTUS FEMORIS)

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57
Q

most common quad

A

rectus femoris

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58
Q

adductors strain

A

most common near groin @ pubic tubercle

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59
Q

biceps brachii,w hich head

A

most common LONG HEAD

the way it cross GH jt to supragelnodi tubercle

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60
Q

neck most common

A

ANTERIOR SCALENE

Levator Scapulae

SCM

Longis Colli

Infra/Suprahyoids

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61
Q

cause strain

A

Sudden overstretching of the muscle

Extreme contraction of the muscle against heavy resistance

Overuse

Inadequate warm-up

Limited flexibility

Fatigue

Biomechanical imbalnces

History of previous strains

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62
Q

HISTORY OF STRAINS?

A

more common

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63
Q

limimted flexibility ?

A

nmore common

hypomobility

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64
Q

overuse

A

can also cause strain

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65
Q

signs symptoms

A

SHARP

Pain

Muscle spasm

Muscle weakness

Localized swelling

Cramping

Inflammation

Loss of muscle function

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66
Q

1 strain mild

A

Mild strain in which only some muscles fibers have been damaged

Mild pain at the time of injury or within the first 24 hours

Mild local swelling

Minimal loss of strength

Localized tenderness and pain occur when the tissue is stressed

Can continue ADLs

Usually heals in 2-3 weeks

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67
Q

1 how long heal

A

2-3weeks

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68
Q

1 adl

A

not really affected

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69
Q

1 strength

A

not really affected

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70
Q

1 tenderness?

A

mild local tenderness

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71
Q

grad e 2 moderate

A

Moderate strain with more extensive damage to the muscle fibers

Muscle is not completely ruptured

May or may not have a snapping sound

Palpable gap at injury site

Moderate edema, pain and tenderness

Difficulty continuing ADLs

Loss of strength

Usually heals in 3-6 weeks

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72
Q

2 heal time

A

3-6 weeks

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73
Q

2 loss of strength

A

yes

adls affected

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74
Q

2 gap @ site

A

yes

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75
Q

grade 3 severe

A

Severe strain injury with complete rupture of the muscle

can avulsion factr

Snapping sensation/sound

Palpable and visible gap

Severe pain, edema, heat, bruising

Can not continue ADLs

Typically involves surgical repair of the muscle

Healing period can be up to 3 months

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76
Q

healing time 3

A

up to 3 months

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77
Q

3 adls

A

no

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78
Q

3 SHARP, pain

A

Severe pain, edema, heat, bruising

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79
Q

3 gap

A

palpable AND visible

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80
Q

treatment 1-2

A

Rest and rehab, then maintain and increase ROM across a joint

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81
Q

rtreatment 3

A

surgery

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82
Q

contusion

A

crush injury to muscle

resultant bleeding into the muscle, skin and subcutaneous tissue.

bruising (ecchymosis) ranging from a local, minor discolouration to a large, debilitating area. It can track along the fascial planes to appear at a distant site.

Bruising is red, black and blue.

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83
Q

ecchymosis

A

a discoloration of the skin resulting from bleeding underneath, typically caused by bruising.

ekkhumonathai –> ekkhumosis
“FORCE OUT BLOOD, ESCAPE OF BLOOD”

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84
Q

cause contusio-n

A

contact sport

MVA

Fall

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85
Q

location contusion MOST COMMON

A

quadriceps “Charlie horse”

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86
Q

other contusion site

A

any muscle, and other structure E>g. bone

E.g.
Deltoid, triceps, biceps, brachialis

Dorsum of foot

Anterior tibia periosteum

Sacrum and Iliac crest

Greater trochanter

Olecranon

Palmar wrist – pisiform/hook of hamate

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87
Q

severity

A

mild contusion

moderate

severe

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88
Q

mild ocntusion

A

minor crush

minimal bleeding

minimal NO strength loss

minimal ROM loss

continue ADLs, minor discomofrt

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89
Q

mild adl

A

continue, mild discm

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90
Q

mild, srength ROM

A

minimal, no

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91
Q

mild symptoms

A

Minimal local edema

Tenderness at site
Minor discomfort

5-20% loss of ROM and minimal or no loss of strength

Can continue ADLs

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92
Q

moderate contusion

A

Moderate crushing of muscle with bleeding and swelling

Difficulty continuing ADL’s

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93
Q

moderate symtpoms

A

SHARP

Moderate local swelling

Heat and bruising present
Moderate tenderness

20-50% loss of ROM and moderate loss of strength

Pain is moderate

Difficulty continuing ADL’s

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94
Q

moderate pain, adls, strength

A

yes

ADL challenging

moderate strength loss

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95
Q

moderate rom loss

A

20-50% rom loss

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96
Q

severe contusion

A

Severe crushing of tissue

With rapid bleeding and swelling

Significant pain and muscle weakness

Unable to continue ADL’s

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97
Q

severe symptoms

A

Marked rapid local swelling with increased heat, edema and bruising

Severe pain at site

> 50% loss of ROM and functional loss of strength

Cannot continue ADL’s

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98
Q

severe contusion, pain, ADLs, ROM, strength

A

significant pain

more than 50 loss of ROM

loss of strength

cannot ADL, with extreme difficulty

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99
Q

treatment contusion

A

1st 24 hours critical

Control bleeding if severe

Avoid alcohol, stretching, heat, massage, activity, blood thinners

see doctor

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100
Q

hematoma

A

large area of local hemorrhage following a trauma

Pooling blood causes swelling and pain as it compresses nearby nerve fibers

More rapid swelling than edema due to arterial pressure

Pain increases with movement or if pressure applied to site

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101
Q

why pain hematoma

A

pooling blood compress nerve

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102
Q

why more swelling than edema (hematoma)

A

arterial pressure

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103
Q

why pain increase when pressure

A

more pressure on nerves, nociceptors

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104
Q

myositis ossificans

A

occasional complication

following HEMATOMA

blood within muscle CALCIFIES

fibroblasts replaced with osteoblasts (from nearby bone?)

–> 6 weeks to devleop

“Some of the bone may be slowly reabsorbed” (??)

“May have attachment to an existing bone or within the muscle itself”

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105
Q

myositis ossificans ..

A

Strength of muscle decreases

Spasms and local inflammation may occur in the affected muscle tissue

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106
Q

myositis ossificans, surgery

A

Is done if the calcification is found within the muscle

Is not performed when attached to a bone

“trauma from surgery will cause more bone formation”

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107
Q

myositis ossificans….

A

“Myositis ossificans occurs when bone forms where it shouldn’t, usually in your muscles or other soft tissues. Usually, myositis ossificans develops after a traumatic injury. Rarer hereditary types of myositis ossificans cause more severe symptoms. There’s no cure for these types of myositis ossificans.”

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108
Q

myositis”

A

inflammation and degeneration of muscle tissue.

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109
Q

cruciate and meniscal injuries

A

Prior to treatment it is important to distinguish between cruciate or meniscal injuries and collateral ligament injuries

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110
Q

cruciate ligamnets

A

These ligaments check motion at the knee and are most taut when the knee is in extension

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111
Q

form cross

A

.

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112
Q

cruciate ligaments inside joint capsule?

A

They are within the joint capsule but not within the synovium

ie within fibrous joint capsule/membrane

not synovila membrane of capsule

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Perfectly
113
Q

ACL function

A

Functions to prevent knee extension, anterior movement of the tibia on the femur AND**** internal tibial rotation

114
Q

acl which movement limit also?

A

INTERNAL TIBIAL ROTTATION

115
Q

ANTAGONIST muscle of acl

A

quadriceps

116
Q

acl injury cause

A

Blow to lateral knee,

forced hyperextension

with internal rotation of the tibia

blow to posterior tibia

117
Q

most common mechanism of acl injury?

A

BLOW TO LATERAL KNEE

118
Q

acl injury test

A

anterior drawer test

119
Q

PCL

A

Functions to prevent posterior movement of tibia on the femur and** internal tibial rotation

120
Q

PCL ALSO which rotation prevent

A

internal rotaiton of tibia

121
Q

pcl antagonist mucsle

A

hamstrings

122
Q

pcl stronger

A

than acl

less commonly injuryed

123
Q

pcl injury mechanisms cause

A

Blow to anterior tibia
(MVA (dashboard injury))

ALSO EXCESS HYPERextneisonp

124
Q

pcl test

A

posterior drawer

125
Q

cruaciate injyr managemnet

A

Depends on degree of instability and any associated injuries, demands places on the knee and time/cost involved in treatment

Conservative approach
Rest, anti-inflammatories, splint, remedial exercise

126
Q

surgery cruciate

A

Open or arthroscopic

Rupture may use the followin for reconstruction

Patellar tendon, IT band, gracilis, semitendinosus tendon

127
Q

which structurestissue is used for cruciate ligament reoconstruction

A

Patellar tendon,
IT band,
gracilis,
semitendinosus tendon

128
Q

crucaite rehbailitate

A

Keep moving
Knee brace – 18 months

aas much actiivty as possible to promote healing via vlood ciruclation increase, and hormone during exercise that influecen healing (E.g. testosterone)

129
Q

menisici

A

why?
shock absorption

add increased gliding between the femur and tibia

(reduce friction)

130
Q

what percentage of load is transmitted via menisci

A

30-55%

131
Q

menisci difference between anterior vs posterior side

A

MORE MOBILE anteriorly
less mobile posteriorly

thick convex outer edge –> “attached to the joint capsule”

“thinner concave inner edge unattached”

132
Q

which part of menisci avascular?

A

Middle and inner potions are avascular

133
Q

medial meniscus, shape, and attachments

A

forms semi circle

where attached?
periphery to joint capsule

“to the outer margin of the medial tibial condyle by the coronary ligament”

“To the MCL”

134
Q

which part of MCL most commonly injured?

A

POSTERIOR ASPECT

“Bucket handle tear”

(recall, anterior more mobile, posterior less mobile –> less mobile = more common to tear)

135
Q

lateral meniscus

A

almost complete circle

“Attached to Periphery to the joint capsule and tibia”

“No attachement to LCL”

“More mobile [overall] than medial one and therefore less prone to damage”

“It is moved posteriorly during knee flexion by the tendon of the popliteus muscle”

136
Q

medial vs lateral meniscus shape

A

medial is semi-circle

lateral is almost* complete circle

137
Q

lateral meniscus, popliteus

A

It is moved posteriorly during knee flexion by the tendon of the popliteus muscle

138
Q

meniscus, injury mechanism cause

A

Twisting injury while foot is weight bearing and anchored to the ground

139
Q

meniscus injuries, tests

A

Tests

Apleys Compression
McMurray Reduction Click
Apley’s distraction

140
Q

meniscus injury treatment

A

Rest, supports and remedial exercise

if severe, Surgery – open or arthroscopic

141
Q

different meniscal tears

A

longitudanl tear

radial tear

horizontal tear

bucket handle tear

parrot beak tear

flap tear

142
Q

meniscus injury and curicate lig injury, symptoms

A

SHARP

Pain, swelling and muscle guarding

Bruising or redness

Held in semi-flexed position due to swelling (reduce compression)

Have crutches, elastic bandages or splints to support joint

143
Q

cruciate, acute, symptoms

A

grade 1-2
continue adls

grade 3
total rupture
no ADLs

144
Q

cruciate, chronic, grade 2-3, acl/pcl

A

acl – no run forward

pcl – no squat
– no walk downstairs
– no run backward

145
Q

meniscal injury, sx, acute/chronic

A

severe acute
Knee may “give way”, buckle or lock

Pain on side with injury and with knee flexion

Tenderness at joint line

**
CHRONIC
Clicking sounds

Knee may lock if torn meniscus prevents knee motion

Return of acute symptoms with activity

146
Q

treatment, meniscal, curciate

A

Support, rest, exercise, medication, surgery

147
Q

complications,

A

Reflex Sympathetic Dystrophy Syndrome

Complex Regional Pain Syndrome

148
Q

”

A

“What is Reflex Sympathetic Dystrophy (RSD) Syndrome?”

“RSD is an older term used to describe one form of Complex Regional Pain Syndrome (CRPS).”

“Both RSD and CRPS are chronic conditions characterized by severe burning pain, most often affecting one of the extremities (arms, legs, hands, or feet).”

149
Q

cause “

A

some conditions that can trigger RSD are sprains, fractures, surgery, damage to blood vessels or nerves and certain brain injuries.

150
Q

mechanism “

A

“your sympathetic nervous system gets mixed signals. It turns on after an injury, but doesn’t turn back off. This causes a lot of pain and swelling at your injury site.”

151
Q

CRPS

A

“Complex regional pain syndrome (CRPS) is a form of chronic pain that usually affects an arm or a leg. complex regional pain syndrome (CRPS) typically develops after an injury, a surgery, a stroke or a heart attack. The pain is out of proportion to the severity of the initial injury.”

152
Q

spasm

A

Is an involuntary, sustained contraction of a muscle
Spontaneous motor unit activity

153
Q

cramp

A

Cramp
Is a common or lay term for a painful, prolonged muscle spasm

154
Q

Reflex Muscle Guarding

A

Describes a muscle spasm in response to pain
Functions to splint the area, reducing movement and preventing further injury
Guarding disappears when pain disappears

155
Q

why reflex muscle guard?

A

Functions to splint the area, reducing movement and preventing further injury

156
Q

when guarding go away?

A

Guarding disappears when pain (/injury) disappears

157
Q

intrinsic muscle spasm

A

viscious cycle ?

“The prolonged contraction of a muscle in response to the local circulatory and metabolic changes that occur when a muscle is in a continued state of contraction.”

158
Q

vicious cycle, intrinsic msucle spasm

A

pain –> tension –> lower circu –> more pain –> more tenson –> less circu –> more pain

159
Q

why poor circulation = pain

A

“Poor circulation can cause pain in the legs, feet, arms, and hands. Cold hands and feet may ache or throb, especially as they start to warm and blood flow returns.”

“Also, when the blood does not circulate correctly, oxygen and nutrients cannot reach tissues effectively, resulting in stiffness and cramping.”

160
Q

muscle tone

A

Is the resistance of a relaxed muscle to passive stretch or elongation

“Resistance of the muscles and connective tissue to palpation and the active, but not continuous, contraction of a muscle in response to the stimulation of the nervous system”

161
Q

hypotonia

A

Decrease in muscle tone

162
Q

Hypertonia

A

Increase in muscle tone

163
Q

muscle tension

A

Is a muscle held in a sustained contraction

164
Q

hypertonicity vs hypertonia ????

A

“Hypertonia of muscle: This term can refer to the same concept as hypertonicity, but it can also encompass a broader range of conditions involving increased muscle tone or tension. Hypertonia can include not only increased muscle tone at rest (hypertonicity) but also increased resistance to passive movement, spasticity, rigidity, or other abnormalities in muscle tone.”

FROM CHATGPT, may be incorrect

165
Q

hypertonicity (neurologists)

A

As the abnormally high tone usually seen with upper motor neuron disorders

166
Q

hypertonicty (osteopathic)

A

As an increase in tone that is present with painful, dysfunctional muscles

167
Q

tone associated neuronal disorders

A

spasticity

rigidity

168
Q

spasticity

A

Increased tone in response to stretch

Protective mechanism

Tries to keep muscle in it’s contracted state as it is being stretched to far

Looked after by GTO’s

169
Q

rigidity

A

Continuous contraction

170
Q

skeletal muscles

A

Fascicles, muscle fibers, myofibrils, thick and thin filaments, sarcomere

171
Q

muscle spindles

A

Major sensory organs of muscles

Aid in the control of muscle movements

Measure both the degree to which a muscle is stretched and the speed

172
Q

GTO

A

Are nerve receptors located in the tendons near their muscular attachments

Sensitive to tension in the muscle

They can inhibit contraction of a muscle protecting it from an overstretch injury

173
Q

causes (???) (hypertonicity, spasms, spasticity?)

A

Pain
Trauma, infection, inflammation

Decreased circulation
Guarding, lock of movement, pathology

Increased gamma neuron firing (MUSCLE SPINDLE)
From stress, anxiety, fatigue, overstretch

Chilling of muscle

Nutritional deficiency
Calcium, magnesium, Vit D, sodium, potassium, water, protein

Pathologies
Muscular dystrophy, tetanus, thrombus/emboli, vascular diseases, Buerger’s disease, DVT, Raynauds, medications

174
Q

buerger’s disease

A

Buerger’s disease (also known as thromboangiitis obliterans) affects blood vessels in the body, most commonly in the arms and legs. Blood vessels swell, which can prevent blood flow, causing clots to form. This can lead to pain, tissue damage, and even gangrene (the death or decay of body tissues).

175
Q

myofascial triggerpoints

A

Is a hyperirritable spot, usually within a taut band of skeletal muscle or its fascia

It is point tender on site, often exhibits a predictable pain referral pattern and causes shortening of the affected muscle

Healthy muscles do not contain trigger points

176
Q

TrP pathogenesis

A

not well known

“Believed that a taut band may be a contracture of muscle fibers that were damaged in the trauma that initiated the trigger point”

“Damage to SR allows calcium to spill out and cause an uncontrolled sustained contraction”

177
Q

when TrP commonly develop?

A

In physically active years or with bouts of extremely vigorous exercise – active TrP

Sedentary – latent TrP

178
Q

TrP development when sedentary (??)

A

Sedentary – latent TrP

179
Q

causes, etiology

A

idiopathic

180
Q

risk factors, TrP

A

Direct stimuli:
Trauma, muscle overload, fatigue, chilling of the muscle

Indirect stimuli:
Referred pain from other trigger points, referred visceral pain, emotional stress

Prolonged period where muscle is shortened

181
Q

TrP other factors

A

Mechanical stresses/postural imbalances

Muscle constriction – backpacks, purse

Nutritional/metabolic imbalances

Depression and anxiety

Infection/inflammation

Impaired sleep

182
Q

active vs latent TrP

A

.

183
Q

active Trp

A

Painful at rest and with movement of the muscle containing it

Prevents muscle from fully lengthening and decreases its strength

Tissue exhibits ischemia

Tender

When compressed – refers pain in a specific and predictable pattern

Pain felt with active and passive stretch
–> Protected from further lengthening by a muscle spasm

184
Q

active Trp palpation

A

Palpation produces a local twitch response and possible referred autonomic phenomena

185
Q

latent TrP

A

Produces pain only when palpated**

–> Same characteristics as active TrP

More common that active TrPs and can persist for years after initial injury

May revert to an active state by any referred pain, overuse, overstretching or chilling of the muscle containing it

186
Q

how does latent TrP become active?

A

referred pain,

overuse,

overstretching or

chilling of the muscle

187
Q

Trp other types, primary vs secondary, vs satellite

A

.

188
Q

primary trp

A

Directly activated by acute or chronic mechanical strain or overload of the affected muscle

189
Q

secondary trp

A

Activated VIA the overworked synergist or antagonist muscles

190
Q

satellite trp

A

Found in muscle that lies within the referral pattern of another trigger point

191
Q

myopathy

A

Any disease or disorder where the muscles do not work properly leading to muscular weakness

192
Q

myopathy, characteristic

A

muscle weakness

193
Q

inflammatory myopathy

A

Can include inflammatory myopathies (myositis), dystrophies, etc.

194
Q

congenital myopathy

A

A group of rare diseases that caues general muscle weakness and are seen from birth

195
Q

acquired myopathy

A

Non-specific muscle weakness secondary to some identifiable disease

196
Q

myalgia

A

muscle pain

A symptom of a variety of disorders that could lead to muscle pain

E.g. trauma, infection, metabolic disease, nutritional defect, etc.

197
Q

myotonia

A

Slow relaxation of muscles after contraction or electrical stimulation

Due to neurological pathologies

198
Q

myositis

A

inflammation of muscle

199
Q

infectious myositis

A

May be caused by bacteria, viruses, protozoa or worms

200
Q

immune myositis

A

Is myositis that is caused by immune mechanisms

201
Q

atrophy

A

atrophy

disuse atrophy

denervation atrophy

202
Q

atrophy?

A

decrease in size of body organ, tissue or part

203
Q

disuse atrophy

A

occurs because muscles are not being used

204
Q

denervation atrophy

A

occurs because the nerve supply to the muscle is disrupted or cut

205
Q

..

A

..

206
Q

bursiits

A

Inflammation of a bursa

207
Q

bursa

A

A small, flat sac lined with synovium

Reduces friction

Found between
skin and bone,
muscle and bone,
tendon and bone,
ligament and bone

208
Q

buritistis cause

A

Overuse of structures surrounding the bursa

Leads to excessive friction and inflammation of the bursa wall

Secondary to
Acute trauma, infection, OA, RA, gout

Contributing Factors
Muscle imbalances
Poor mechanics
Postural dysfunction (scoliosis)
Lack of flexibility

209
Q

contributing factors

A

Muscle imbalances (E.g. antagonists weaker than agonist)

Poor mechanics

Postural dysfunction (e.g. scoliosis)

Lack of flexibility

210
Q

bursitis lcoations

A

Subacromial (subdeltoid) bursa

Subscapular Bursa

211
Q

elbow burisitis

A

Olecranon Bursa
“student’s elbow”

212
Q

hip bursa

A

Trochanteric bursa

Iliopectineal bursa

Ischial busa

213
Q

knee bursae

A

Pes anserine bursa

Infrapatellar bursa

Prepatellar burse

214
Q

ankle bursa

A

Retrocalcaneal bursa

(“to reduce friction between the heel bone and the Achilles tendon”)

215
Q

bunion

A

.first MTP joint capsule

Formed by excessive bone growth (exostosis) (osteophytes)

a callus and an inflamed, thickened bursa developing over the joint

216
Q

bone spur, aka

A

exostosis –>ex, ostosis

aka OSTEOPHYTES

217
Q

bunion risk factor

A

Joint hypermobility
Poor biomechanics of first MTP joint

218
Q

bunion treatment

A

orthotics

changing footwear

surgery if severe

219
Q

baker’s cyst (other bursal injuries)

A

“Synovial cyst that usually appears at the lateral side of the popliteal space”

posterior knee –> lateral side (popliteal space)

220
Q

bursitis management

A

diagnosis:
Palpation,
ROM

(Special tests)
Ober’s test,
Faber test,
painful arc,
neer impingement tests

221
Q

bursitis acute, amnagement

A

rest

NSAIDs

ice (acute and subacute)

222
Q

preventative

A

Protections to more superficial bursa

Stretching and Strengthening of muscles crossing bursa

223
Q

tendinitis

A

inflammation of tendon

Is inflammation of a tendon
Resulting from mircoscopic tearing of the tendon fascicles due to overloading of the tendon

224
Q

tendinitis mechanism?

A

mircoscopic tearing of the tendon fascicles due to overloading of the tendon

225
Q

tendon shapes

A

Cord-like

Broad sheet – aponeuroses

226
Q

paratendon

A

Surrounds a tendon that moves in a straight line, houses blood vessels

“vascular”

227
Q

tendon sheath

A

Surrounds a tendon that crosses a bony prominence

Double layered, filled with synovial fluid

“avascular”

228
Q

why tendon sheath?

A

Surrounds a tendon that crosses a bony prominence

229
Q

tendon sheath synovial layer/fluid

A

Double layered, filled with synovial fluid

230
Q

tendinitis risk factors, cause

A

Chronic overload of the tendon
Leading to microtearing and an inflammatory response

231
Q

other risk factors, contributing factors

A

Muscle imbalances

Poor biomechanics

Lack of flexibility

Chronic degenerative changes in the tendon

Poor blood supply

Improper equipment or training errors

232
Q

tendinitis grade 1-4

A

Grade 1
Pain after activity only

Grade 2
Pain at the beginning of activity which disappears during activity

Grade 3
Pain at the beginning of activity, during activity and after activity

Grade 4
Pain with ADLs, pain continues to get worse

233
Q

paratendinitis

A

Inflammation of the paratendon or the tendon sheath

234
Q

paratendinitis aka

A

Tenosynovitis – inner surface irritation

Tenovaginitis – irritation and thickening of tendon

235
Q

tendinosis

A

Degenerative changes occurring with chronic overuse tendon injuries

No inflammation

236
Q

calcific tendinitis

A

aged 30-60

Esp @ ROTATOR CUFF MUSCLES –> E.g. esp SUPRASPINATUS

237
Q

calcific tendinitis mechanism

A

Tendon’s fibrocytes change to chondrocytes,

collagen disintegrates and calcific deposits accumulate in the cells

Deposits can be soft or hard

238
Q

calcific tendinitis locaitons (& tendinitis in general?)

A

Shoulder:

Supraspinatus tendon (MOST COMMON, b/c overhead activities)

Infraspinatus tendon
Subscapularis tendon

239
Q

tendinitis other locaitons

A

Biceps Long Head (just like strain)

240
Q

tendinitis vs strain (?)

A

“The way to distinguish between the two is that with a muscle strain, the pain is felt in the muscle itself, whereas in tendonitis, the pain is felt near where the muscle attaches to the bone.”

what if strain is near tendon??

strain may be referring to more substantial tearing/damage
vs.
microtearing of tendinitis

maybe repetitive use strains are structurally similar to tendinitis in some occasions (??)

241
Q

forearm tendinitis

A

common extensor tendon
(tennis elbow?)

common flexortendon (golfers elbow?)

241
Q

repetitive use strain @ tendon can include tendinitis, or tendinosis (?)

A

chatgpt

242
Q

wrist, tendinitis

A

abductor pollicis longus
extensor pollicis brevis

same tendons of DeQuervain’s Tenosynovitis

243
Q

knee, tendintiis

A

tibialis posterior tendon

Calcaneal tendon

243
Q

tendinitis management

A

rest, ice, NSAIDs (acute)

stretch, strengthen, modify activities/form/technique

Braces/taping
Steroid injections
Ultrasound
Laser therapy
Surgical repair (if severe)

244
Q

subluxation, dislocation

A

Dislocation
The complete dissociation of the articulating surfaces of a joint

Subluxation
is when the articulating surfaces of a joint remain in partial contact with each other

245
Q

about subluxation and dislocaiton

A

May occur at any joint
However some joints are more unstable due to their anatomical configuration\

246
Q

most frequently dislocation

A

GH

shallow glenoid fossa (despite glenoid labrum)

247
Q

other joints

A

AC joint (separated shoulder, esp advanced levels)

MCP joints, IP joints

248
Q

dislocations, complications, other damage

A

damage of:
Joint capsule,
surrounding ligaments,
tendons,
synovial sheaths,
articular cartilage,
contusion

nerves
bv

(bone) fractures

249
Q

sublux, dislocation, cause

A

Trauma – related sudden twist or wrench of the joint beyond its normal range of motion

250
Q

direct vs idnirect “

A

Direct – force to joint itself

Indirect – joint is the weak link in a closed kinetic chain

251
Q

” contributing factors

A

Pathologies:
RA, paralysis

Congenital ligamentous laxity

Previous dislocations (ligament and joint capsule structures become weaker)

252
Q

joint reduction

A

Tractioning of bones to bring surfaces back in contact

why no popping joint back in place?
can damage nerve/bv/other joint structures if is not tractioned first

253
Q

other treatment?

A

surgery if severe

brace/support

PT exercises:
ROM,
strengthening surrounding musclature to partially compensate for weakened joint capsule, and ligament structures (ease the load off those structures)

ice if acute/subacute (?)
NSAIDs “

increase circulation/hormones for healing maximum capacity via exercise however possible

254
Q

GH dislocation

A

most common anterior dislcation

255
Q

anterior GH dislocaiton AKA

A

subcoracoid disloaction

because GH head moves anterior and inferior, below where coracoid process is situated

256
Q

anterior dislocaiton mechanism

A

hyperextension (note anterior glide, posterior roll)

excess abduction with external rotation (again note anterior glide for ER)

257
Q

posteior dislocation GH

A

mechniams

flexion (p roll), adduction, and internal rotation (p roll)

258
Q

patella dislocaiton

A

esp laterally

mechanism?
external rotation of tibia/foot when knee is flexed

259
Q

lunate dislocation

A

FOOSH, wrist hyperextension

260
Q

elbow “

A

usually w/ fracture (of coronoid process?)

b/c HU jt is strong

ulna/radius displaced posteriorly

MOI
FOOSH
esp MVA (lots of force required for fracture)

261
Q

hip “

A

Femur is forced posteriorly by a direct impact to the knee

MOI
MVA

if accompanied by fracture, can be life-threatening (RBM, site of blood cell production)

262
Q

edema

A

Is a local or general accumulation of fluid in the interstitial tissue spaces

Result of altered physiological function in the body, not a disease itself

Used to describe the physical sign commonly linked to swelling or increased girth that accompanies the accumulation of fluid in a body part

263
Q

fibrosis

A

The formation or development of excess fibrous CT in an organ or tissue as a reparative or reactive process

264
Q

fibrositis

A

Inflammatory hyperplasia of white fibrous connective tissue, especially surrounding muscles, causing pain and stiffness

265
Q

hypermobility

A

Is an increased degree of motion at a joint

Can occur at one joint or several

Range from mild joint laxity to extreme mobility or even joint instability

Females>males
Children>adults
Asian>Africans>Caucasians

266
Q

hypermobility..

A

If one joint is hypermobile
It can result in compensatory weakness or hypomobility in another joint

267
Q

joint laxity, risk factor

A

Joint laxity may increase risk for

Sprains, tendinitis, osteoarthritis and entrapment neuropathies

268
Q

hypermobility causes, risk factors

A

Compensation due to hypomobility

Increased flexibilty

Hormonal influences

Joint trauma

Pathologies
Ehlers-Danlos Syndrome
Marfans Syndrome
RA

269
Q

hypermobility scale

A

Beighton scale
–> general measuring tool, diagnosis tool for hypermobility

getting 5 positives on a list of joints via measurement of ROM @ those joints
= positive for generalized hypermobility

270
Q

hypomobility

A

Is loss of motion at a joint, including the loss of normal joint play movements

Can be local or generalized

Joints on the dominant side of the body tend to be more hypomobile than those on the non-dominant side (e.g. Right?)

271
Q

hypomobility risk factor for

A

strained muscles,
nerve compression,
tendinitis

272
Q

hypomobility cause

A

Compensation due to hypermobility

Decreased flexibilty (no stretching with weightlifting, not moving joints through entire ROM on daily basis)

Intra-articular and extra-articular adhesions

Surgical fixations

273
Q

hypomobility via adhesions

A

Intra-articular and extra-articular adhesions

274
Q

hypomobility pathologies

A

Dupuytren’s contractures,

frozen shoulder

275
Q

hypertrophy

A

General increase in bulk of a part or organ, not due to tumor formation

Greater bulk through increase in size but not number of cells or other individual tissue elements

276
Q

muscle hypertrophy

A

The growth and increase of size of muscle cells

277
Q

muscle hyperplasia

A

Formation of new muscle cells

278
Q
A

Semester 3 (32 decks)

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