Pathology of Injury Flashcards

1
Q

All injury happens because of ______.

A

trauma

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2
Q

What is trauma also known as? What is it?

A
  • MOI: mechanism of injury

- how did they get hurt

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3
Q

Define trauma. How does it help us?

A
  • Defined​ ​as​ ​a​ ​physical​ ​injury​ ​that​ ​is​ ​produced​ ​by​ ​an​ ​external​ ​or​ ​internal​ ​force
  • Gives​ ​you​ ​clues​ ​as​ ​to​ ​what​ ​might​ ​be​ ​hurt
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4
Q

What is a mechanical injury?

A
  • Force​ ​is​ ​applied​ ​to​ ​the​ ​body​ ​(int/ext)​ ​and​ ​that​ ​results​ ​in​ ​a​ ​disturbance​ ​of​ ​either​ ​structure (ex.​ ​Broken​ ​bone,​ ​torn​ ​skin,​ ​torn​ ​ligament)​ ​or​ ​function​ ​(ex.​ ​Can’t​ ​bend​ ​elbow,​ ​can’t​ ​touch toes​ ​etc.)
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5
Q

What is mechanical failure?

A
  • Point​ ​that​ ​injury​ ​happens,​ ​point​ ​where​ ​the​ ​body’s​ ​ability​ ​to​ ​withstand​ ​all​ ​forces​ ​is surpassed
  • May​ ​take​ ​several​ ​times​ ​to​ ​reach​ ​threshold​ ​or​ ​just​ ​once
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6
Q

What are the 5 types of tissue loading?

A
  • compression
  • tension
  • shearing
  • bending
  • torsion
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7
Q

Describe compression.

A
  • ​tissues​ ​get​ ​“squished”/shortened

- ex.​ ​fracture

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8
Q

Describe tension.

A
  • tissues​ ​get​ ​pulled​ ​apart

- ex.​ ​tears,​ ​strains

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9
Q

Describe shearing.

A
  • friction
  • forces​ ​aren’t​ ​balanced
  • ex.​ ​road​ ​rash,​ ​blisters,​ ​disc​ ​injuries
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10
Q

Describe bending.

A
  • bending​ ​where​ ​not​ ​meant​ ​to​ ​bend

- ex.​ ​strain,​ ​breaks,​ ​dislocate,​ ​tears

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11
Q

Describe torsion.

A
  • twisting
  • most​ ​disruptive
  • ​body​ ​is​ ​not​ ​meant​ ​to​ ​twist​ ​in​ ​those​ ​ways
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12
Q

What is the difference between traumatic and overuse injuries?

A
  • Traumatic:​ ​happens​ ​from​ ​1​ ​trauma​ ​or​ ​1​ ​MOI.
  • Overuse:​ ​happens​ ​from​ ​lots​ ​of​ ​micro​ ​traumas,​ ​generally​ ​ends​ ​in​ ​the​ ​word​ ​“…itis”​ ​(inflammation)
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13
Q

What is the musculotendinous unit?

A
  • Where​ ​the​ ​muscle​ ​becomes​ ​a​ ​tendon
  • Point​ ​of​ ​change​ ​in​ ​a​ ​structure
  • Point​ ​of​ ​weakness:​ ​place​ ​that​ ​trauma​ ​will​ ​hit​ ​first
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14
Q

Describe tendons.

A
  • Tissue​ ​that​ ​attaches​ ​a​ ​muscle​ ​to​ ​a​ ​bone
  • Most​ ​have​ ​tendons​ ​in​ ​each​ ​end
  • Also​ ​a​ ​point​ ​of​ ​weakness
  • Makes​ ​muscle​ ​smaller​ ​(concentrates​ ​down)​ ​so​ ​it​ ​has​ ​a​ ​small​ ​attachment​ ​space
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15
Q

Why is injury at the tendon rare? Where are we more likely to injure?

A
  • Generally​ ​double​ ​the​ ​strength​ ​of​ ​the​ ​muscle
  • More​ ​likely​ ​to​ ​have​ ​an​ ​injury​ ​at​ ​the​ ​musculotendinous​ ​unit​ ​or​ ​where​ ​tendon​ ​attaches​ ​to bone
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16
Q

Describe the aponeuroses.

A
  • Thicker​ ​band​ ​of​ ​tissue​ ​(not​ ​a​ ​muscle)​ ​that​ ​joins​ ​2​ ​structures​ ​together,​ ​generally​ ​bones
  • Helps​ ​disperse​ ​forces
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17
Q

Why is damage to the aponeuroses difficult to heal?

A

they do not have a very good blood supply

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18
Q

What are the 5 symptoms for every injury?

A
  • inflammation
  • redness
  • bruising
  • deformity
  • heat
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19
Q

Strains can only happen in ____ and _____.

A

muscles and tendons

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20
Q

Describe a grade 1 strain.

A

​-​ ​mild​ ​symptoms

  • No​ ​deformity
  • No​ ​loss​ ​of​ ​function
  • May​ ​have​ ​pain,​ ​but​ ​this​ ​is​ ​dependent​ ​on​ ​each​ ​person
  • Mild​ ​inflammation
  • Redness
  • Possibly​ ​mild​ ​bruising
  • Mild​ ​heat
  • Stretching​ ​of​ ​structure
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21
Q

Describe a grade 2 strain.

A

​-​ ​moderate​ ​inflammation

  • More​ ​redness​ ​and​ ​heat
  • Some​ ​bruising
  • Some​ ​deformity​ ​(can​ ​physically​ ​palpate​ ​it)
  • Some​ ​tearing​ ​of​ ​structures
  • Loss​ ​of​ ​some​ ​function
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22
Q

Describe a grade 3 strain

A

​-​ ​severe​ ​inflammation

  • Very​ ​red
  • Very​ ​bruised
  • Hot​ ​to​ ​the​ ​touch
  • Significant​ ​deformity
  • No​ ​function
  • Nothing​ ​attached​ ​=​ ​doesn’t​ ​hurt​ ​anymore
  • Feels​ ​like​ ​they​ ​“got​ ​shot,​ ​excruciating​ ​pain​ ​for​ ​5​ seconds,​ ​then​ ​no​ ​pain​ ​at all”
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23
Q

What causes muscle cramps?

A
  • Happen​ ​because​ ​of​ ​an​ ​external​ ​or​ ​internal​ ​force
  • Dehydration
  • Heat
  • Electrolyte​ ​imbalance
  • Lack​ ​of​ ​oxygen
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24
Q

What kind of pain does muscle cramps give? What can we do for someone feeling this?

A
  • Stabbing​ ​feeling,​ ​generally​ ​in​ ​1​ ​muscle​ ​group

- Massage,​ ​hydrate,​ ​get​ ​them​ ​air…​ ​nothing​ ​much​ ​else​ ​you​ ​can​ ​do​ ​for​ ​them

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25
Q

What is muscle guarding?

A
  • What​ ​your​ ​body​ ​does​ ​before​ ​or​ ​after​ ​it​ ​gets​ ​injured​ ​to​ ​help​ ​stabilize​ ​the​ ​area
  • “Stiff”​ ​feeling​ ​post​ ​injury​ ​~36​ ​hours
  • All​ ​muscles​ ​around​ ​injury​ ​spasm​ ​to​ ​try​ ​and​ ​protect​ ​it
  • Does​ ​not​ ​happen​ ​unless​ ​it​ ​is​ ​right​ ​around​ ​injury​ ​time
26
Q

What are muscle spasms?

A
  • Muscle​ ​guarding​ ​to​ ​a​ ​more​ ​extreme
  • Muscle​ ​is​ ​protecting​ ​itself​ ​from​ ​you,​ ​nothing​ ​to​ ​do​ ​with​ ​cramps
  • You​ ​did​ ​something​ ​muscle​ ​isn’t​ ​ready​ ​for
  • Common​ ​in​ ​leg​ ​muscles
  • Generally​ ​because​ ​load​ ​is​ ​too​ ​high
  • No​ ​injury​ ​yet
27
Q

What is muscle soreness?

A
  • Post​ ​workout:​ ​DOMS​ ​(Delayed​ ​Onset​ ​Muscle​ ​Soreness)
  • Workout​ ​=​ ​microtears,​ ​5​ ​symptoms,​ ​body​ ​is​ ​repairing​ ​itself​ ​=​ ​sore
  • Lactic​ ​acid​ ​for​ ​~12​ ​hours,​ ​then​ ​DOMS
28
Q

What can we do for muscle soreness?

A

Stretch,​ ​hydrate,​ ​nutrients

29
Q

What are contusions?

A

bruises

30
Q

Describe a grade 1 contusion.

A
  • ​surface​ ​bruise

- no​ ​damage​ ​except​ ​blood​ ​vessel

31
Q

Describe a grade 2 contusion.

A
  • deeper

- ​painful​ ​to​ ​contract​ ​muscle

32
Q

Describe a grade 3 contusion.

A
  • damaged​ ​tissues
  • lots​ ​of​ ​bleeding
  • ​specifically​ ​in​ ​quad
33
Q

What is atrophy?

A
  • loss of muscle

- typically in a cast

34
Q

What is contracture?

A
  • shortening of a muscle

- left in a bad position

35
Q

Name the 7 types of muscle injuries.

A
  • muscle strains
  • muscle cramps
  • muscle guarding
  • muscle soreness
  • contusions
  • atrophy and contracture
36
Q

Name some characteristics of tendon injuries.

A
  • Tend​ ​to​ ​be​ ​overuse​ ​injuries,​ ​tend​ ​to​ ​be​ ​more​ ​chronic
  • Takes​ ​longer​ ​to​ ​heal
  • 2​ ​places​ ​of​ ​weakness
  • No​ ​pain​ ​=​ ​want​ ​to​ ​return​ ​to​ ​activity
  • Twice​ ​as​ ​strong,​ ​twice​ ​as​ ​long​ ​to​ ​heal
37
Q

What is tendonitis?

A
  • breakdown of tendon
  • Tendon​ ​is​ ​getting​ ​inflammation
  • Painful​ ​to​ ​use
  • Continued​ ​use​ ​will​ ​lead​ ​to​ ​tendonosis​ ​(physical breakdown​ ​of​ ​tendon,​ ​irreparable)
38
Q

What are the symptoms of tendonitis?

A
  • pain​ ​with​ ​movement
  • ​low​ ​grade​ ​inflammation
  • warm​ ​to​ ​the​ ​touch
  • crepitus (“grindy”​ ​sensation)
39
Q

What is tendonosis?

A
  • Can’t​ ​fix​ ​it,​ ​physically​ ​breaking​ ​down
  • All​ ​we​ ​can​ ​do​ ​is​ ​try​ ​and​ ​slow​ ​it​ ​down
  • More​ ​inflammation,​ ​more​ ​pain,​ ​more​ ​grinding
  • May​ ​eventually​ ​rupture​ ​=​ ​surgical​ ​replacement
40
Q

What is tenosynovitis?

A
  • Sheath​ ​around​ ​tendon​ ​has​ ​injury,​ ​not​ ​to​ ​tendon
  • Same​ ​symptoms​ ​as​ ​tendonitis​ ​but​ ​happens​ ​to​ ​sheath
41
Q

What are myofascial trigger points?

A
  • Muscle​ ​knot​ ​located​ ​very​ ​close​ ​to​ ​a​ ​nerve
  • Activates​ ​nerve,​ ​travels
  • Most​ ​headaches​ ​are​ ​caused​ ​by​ ​these
  • Can​ ​massage
  • Injury​ ​and​ ​trigger​ ​point​ ​are​ ​different
42
Q

Name some characteristics of ligament injuries.

A
  • Ligaments​ ​can​ ​break​ ​down
  • Generally​ ​do​ ​not​ ​surgically​ ​repair​ ​ligaments,​ ​rest​ ​of​ ​the​ ​tissues​ ​need​ ​to​ ​make​ ​up​ ​for​ ​it
  • Ligament​ ​injury​ ​=​ ​sprain
43
Q

Describe the anatomy of ligaments.

A
  • Ligaments​ ​stabilize​ ​joints,​ ​holds​ ​2​ ​bones​ ​together
  • Ligaments​ ​have​ ​no​ ​elastic​ ​property,​ ​does​ ​not​ ​contract,​ ​only​ ​responsible​ ​for​ ​stability
44
Q

Describe a grade 1 sprain.

A
  • Mild​ ​inflammation
  • Mild​ ​redness​ ​and​ ​heat
  • No​ ​deformation
  • Stretching
  • Everything​ ​still​ ​attached
  • Function​ ​(may​ ​have​ ​pain)
45
Q

Describe a grade 2 sprain.

A
  • Moderate​ ​inflammation
  • Bruising
  • some tearing
  • Hot​ ​to​ ​the​ ​touch
  • Some​ ​loss​ ​of​ ​function​ ​(limping,​ ​pain)
  • Unstable
46
Q

Describe a grade 3 sprain.

A
  • Rupture
  • Really​ ​painful​ ​then​ ​no​ ​pain
  • Increased​ ​ROM​ ​@​ ​joint
  • Severe​ ​swelling
  • Severe​ ​heat
  • Severe​ ​bruising
  • Bones​ ​can​ ​be​ ​dislocated​ ​or​ ​broken
47
Q

What are dislocations?

A
  • something is fully out of place, even for a second

- common in shoulders, hips, fingers, knees

48
Q

What always accompanies dislocations?

A

ruptured​ ​ligaments,​ ​possible​ ​tears​ ​or​ ​strains​ ​of​ ​muscles,​ ​fractures

49
Q

What are subluxations?

A
  • Part​ ​way​ ​out​ ​of​ ​place
  • Same​ ​as​ ​dislocation​ ​but​ ​less​ ​severe
  • Commonly​ ​ribs,​ ​shoulder
50
Q

What is the most common type of fracture?

A

long bone fractures

51
Q

What is an avulsion fracture? Why is it different from every other fracture?

A
  • when​ a ​ligament​ ​attached​ ​to​ ​the​ ​end​ ​of​ ​a​ ​bone​ ​pulls​ ​a​ ​chunk​ ​of​ ​bone​ ​off instead​ ​of​ ​spraining
  • every​ ​other​ ​fracture​ ​occurs​ ​because​ ​of​ ​force​ ​on​ ​the​ ​bone.
52
Q

What are stress fractures also known as?

A

march fractures

53
Q

Where do stress fractures generally happen?

A

​weight​ ​bearing​ ​bones​ ​(ex.​ ​Tibia,​ ​metatarsals​ ​of​ ​foot)

54
Q

Why are stress fractures difficult to find?

A

Need​ ​40%​ ​damage​ ​to​ ​find​ ​in​ ​x-ray,​ ​need​ ​a​ ​bone​ ​scan

55
Q

What kind of injury are stress fractures?

A

overuse injury

56
Q

What physically happens in stress fractures? What kind of symptoms do they have?

A
  • Physical​ ​break​ ​in​ ​bone​ ​just​ ​at​ ​the​ ​edge

- Same​ ​symptoms​ ​as​ ​fractures

57
Q

Why healing typically difficult in stress fractures?

A

people assume they’re fine so they continue activity

58
Q

Describe epiphyseal injuries.

A
  • Epiphyseal​ ​plate​ ​is​ ​at​ ​the​ ​ends​ ​of​ ​bone
  • Bones​ ​grow​ ​from​ ​the​ ​end​ ​out
  • Don’t​ ​solidify​ ​until​ ​18-24​ ​years​ ​old
  • Fracture​ ​of​ ​these​ ​plates​ ​under​ ​18-24​ ​years​ ​old​ ​means​ ​it​ ​solidifies​ ​and​ ​does​ ​not​ ​grow
    anymore
  • Generally​ ​1​ ​bone​ ​stunted​ ​and​ ​not​ ​the​ ​other
59
Q

How do we avoid the damages from epiphyseal injuries?

A

need to continually re-break to allow growth

60
Q

Describe nerve injuries.

A
  • Nerves​ ​of​ ​body​ ​do​ ​not​ ​regenerate/grow

- At​ ​a​ ​certain​ ​point​ ​they​ ​are​ ​permanent

61
Q

What kind of pain is associated with nerve injuries?

A
  • Referred​ ​pain

- nerves​ ​will​ ​refer​ ​pain​ ​to​ ​other​ ​places,​ ​pain​ ​may​ ​be​ ​coming​ ​from somewhere​ ​else

62
Q

What is the technical name for bruising?

A

Ecchymosis