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MSK2 LEC > PRINCIPLES OF INTERVENTION > Flashcards

PRINCIPLES OF INTERVENTION Flashcards

1
Q

How many days does the acute stage of inflammation and repair last?

A

4-6 days unless insult is perpetuated

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2
Q

The body’s way of immobilizing a painful area

A

Edema/joint effusion, and muscle guarding

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3
Q

Occurs during any injury/insult caused by trauma, repetitive use, or chemical irritants to reinstate homeostasis

A

Acute stage of inflammation and repair

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4
Q

Proliferation, repair, and healing stage that lasts 10-17 days (14-21 days after onset of injury)

A

Subacute stage

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5
Q

May last up to _ weeks in tendons d/t limited circulation

A

6 weeks

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6
Q

Noxious stimuli are removed and capillary beds begin to grow into the area

A

subacute stage

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7
Q

Pain synchronous c encountering tissue resistance at the end of available ROM and occurs only when newly developing tissue is stressed beyond its tolerance

A

Subacute stage

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8
Q

Maturation & Remodeling stage which may last for 6 months to 1 yr depending on what type of tissue is involved and the magnitude of damage

A

Chronic stage

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9
Q

Scar retraction is completed by day __

A

21

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10
Q

May have contractures or adhesions that limit ROM c muscle weakness, limiting normal function

A

Chronic stage

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11
Q

Factors affect density and activity level of the fibroblasts in remodeling time

A

+ amount of time immobilized
+ stress placed on tissue
+ location of lesion
+ vascular supply

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12
Q

T/F: Tendons and ligaments have shorter healing time compared to muscle

A

False, muscles are more vascularized than tendons and ligaments, thus, making mm recovery time shorter

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13
Q

Difference between late subacute and chronic stages are

A
  • improvement in quality (orientation and tensile strength) of collagen
  • reduction of wound size during chronic stages
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14
Q

If there is a progressive loss of ROM due to stretching, what do you do?

A

do not stretch

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15
Q

Prolonged or recurring pain, and resulting limitations in activity & function occur as a result of stress being imposed on tissues that are unable to respond to the nature of the stress

A

Chronic inflammation

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16
Q

Tissue responses and characteristics during acute stage

A
  • vascular changes
  • exudation of cells and chemicals
  • clot formation
  • phagocytosis, neutralization of irritants
  • early fibroblastic activity
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17
Q

Tissue responses and characteristics during subacute stage

A
  • removal of noxious stimuli
  • growth of capillary beds into area
  • collagen formation
  • granulation tissue
  • very fragile, easily injured tissue
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18
Q

tissue responses and characteristics during chronic stage

A
  • maturation of connective tissue
  • contracture of scar tissue
  • remodeling of scars
  • collagen aligns to stress
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19
Q

Impairments during the chronic stage of tissue repair

A

-contracture & adhesions
-weakness, poor endurance & neuromuscular control
-dec functional usage of the involved body part
-inability to function as expected

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20
Q

Tissue responses and characteristics during the acute stage

A

vascular changes, exudation of cells and chemicals, clot formation, phagocytosis, neutralization of irritants, early fibroblastic activity

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21
Q

Removal of noxious stimuli, growth of capillary beds into area, collagen formation, granulation tissue, very fragile and easily injured tissue

A

Subacute stage

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22
Q

Absence of inflammation and pain after tissue resistance

A

clinical signs of chronic stage

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23
Q

Area at high risk for injury in a skeletal muscle

A

myotendinous junction

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24
Q

MOI for muscle injuries

A

high demand/impact activities d/t a significant force that can lead to muscle strain or contusion

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25
Tearing of a few muscle fibers with minimal loss of strength d/t pain
Grade 1/Minor
26
More damage to fibers c associated loss of contractile strength
Grade 2/moderate
27
Cross-sectional rupture c complete loss of contractile strength
Grade 3/severe
28
Phases of healing in muscle injuries
Destruction phase > Repair Phase > Remodeling Phase
29
Necrosis of contractile elements
Destruction Phase
30
Hematoma formation and inflammation
Destruction Phase
31
Fibrin and fibronectin form early linkages to provide support against contraction
Destruction Phase
32
Phagocytosis of nectrotic tissue
Repair phase for mm injury
33
Regeneration of contractile elements
Repair phase
34
Stimulation of myofiber formation and scar formation
Repair Phase
35
Needs at least 4-6 weeks for re-organization of tissue integrity and functional maturation
Remodeling Phase
36
Small injuries heal with ____ tissue while Large injuries heal with ____ tissue
Muscle; Scar
37
In muscle injury rehab, modalities may be used to
control inflammation, edema, and stiffness
38
Early activity is advocated to prevent adhesion formation. Active stretching is advocated for muscle injuries
First statement is true, second is false
39
How long should active stretching be postponed for post-injury?
3-7 days to prevent re-injury
40
Causes of tendinopathies
Repetitive motions/load, causing microtears abrupt, forceful contraction of the tendon's muscle
41
Tendons have ___ consistent blood supply compared to othe rtissues
Less
42
Most common tendon rupture alongside supraspinatus tendon
achilles tendon rupture
43
Healing process of tendinous injuries
Inflammatory > Proliferative repair > Remodeling > Scar formation
44
Healing process of tendon wherein collagen is produced
Proliferative repair
45
Healing process of tendon wherein realignment of collagen happens
Remodeling
46
Healing stage wherein there is decline of tendon metabolism and vascularity
Scar formation phase
47
Tendon healing phase where the faulty biomechanics and compensatory posture should be corrected
proliferative repair
48
healing phase of tendon which involves induction of fibrous repair
remodeling phase
49
_______ is important during the proliferative repair phase to correct faulty biomechanics and compensatory posture
patient education
50
Tissue strengthening for tendon injury begins at the
remodeling phase
51
MOI for ligament injuries
excessive lengthening
52
Most common injured ligaments
ATFL > ACL
53
microfailure c a few fibers in the part of the plastic range are ruptured
grade 1
54
only needs intervention and protection s surgery
grade 1 injury
55
Surgical intervention is dependent on pt's goal & instability present
grade 2
56
with moderate joint instability
grade 2
57
Significant joint laxity & involves surgical intervention
grade 3
58
Football, basketball, and soccer players, as well as skiers are most prone to this ligamental injury
ACL tear
59
Most common knee injuries sustained in sports
ACL Tear
60
Healing process of ligament injuries
inflammatory > regenerative > remodeling
61
ligament healing phase that involves fibroblast proliferation & collagen formation
regenerative phase
62
involves remodeling of the ligament & improved collagen alignment
remodeling phase
63
Stressing the injured ligament during regenerative & remodeling phases leads to
more organized collagen alignment
64
Common causes for bone pathology
direct trauma, overuse, aging & osteoporosis, cancer, other metabolic abnormalities
65
Types of complete fx
transverse, oblique, spiral
66
examples of segmental fx
avulsion
67
incomplete fx example
greenstick
68
healing process of bones
hematoma formation > cellular proliferation > callus formation > ossification > consolidation & remodeling
69
Phase wherein a fibrin meshwork is created
hematoma formation
70
the fibrin meshwork is the?
framework that the fibroblasts & capillary buds use to surround the bony ends of the fx
71
phase wherein the process and progression of forming a fibrocartilage collar around the site begins
cellular proliferation
72
phase wherein healing of the bone happens
callus formation
73
callus formation is slower in _____ patients compared to ____ and ____
geriatric; pediatric/adult
74
phase wherein osteoblasts continue to move into the site; cartilage is slowly replaced by bone
ossification
75
phase where callus is slowly reabsorbed and the bone remodels based on the mechanical stress placed on it
consolidation and remodeling
76
how long does consolidation and remodeling phase usually last
may take up to a year
77
_____ is required until evidence of callus formation is seen
immobilization
78
in fx, muscle atrophy is expected
true
79
presence of callus allows what
mobilization
80
what type of MD clears the patient for WB
orthopedic surgeon
81
Common cause of cartilage damage
overuse, trauma, degeneration from faulty biomechanics
82
Normal cartilage
grade 0
83
nearly normal c superficial lesions, soft indentations, fissures, or cracks which can be seen as a rough surface in macroscopy, and inhomogenous, high signal, and intact surface in MRI
grade 1
84
irregular surface defects c <50% of cartilage thickness seen in macroscopy
Grade II
85
ulceration, fissuring, fibrillation >50% of cartilage depth
grade III
86
full thickness chondral wear with exposure of subchondral bone
grade IV
87
What causes pain in cartilage damage
nociceptors in bone to bone contact are triggered which produces pain
88
the cartilage is highly vascular but receives nutrients via diffusion which greatly impedes its regenerative capacities
false, cartilage have no vascular supply
89
focus of rehabilitation in cartilage injuries
- restoring joint mobility - dec inflammation and pain - removing contributory factors such as faulty biomechanics, postural deviations, muscle activation dysfunction
90
nerves are directly injured from
too much compression/tension, laceration, stretch, electricity and radiation
91
nerves are indirectly injured by
poor circulation, temperature, chemicals
92
classification of nerve injuries according to seddon
neuropraxia > axonotmesis > neurotmesis
93
nerve injury with segmental demyelination which is due to mild ischemia from nerve compression or traction
neuropraxia
94
signs of neuropraxia
blocked or slowed action potential
95
signes of axonotmesis and neurotmesis
wallerian degeneration distal to lesion
96
loss of axonal continuity
axonotmesis
97
complete severance of nerve fiber usually from gunshot/stab wounds or avulsion rupture
neurotmesis
98
neurotmesis usual intervention
surgery
99
muscle affectation of neuropraxia
no muscle atrophy c temporary sensory loss
100
healing process of peripheral nerve injuries
acute > recovery > chronic
101
healing stage of nerves wherein healing and prevention of complications must be emphasized
acute phases
102
signs of re-innervation are usually seen in this stage
recovery phase
103
re-innervation potential peaked with minimal or no signs of neurological affectation
chronic phase
104
phase wherein the PT should focus on retraining and re-education
recovery phase
105
phase wherein the focus is training compensatory techniques
chronic phase
106
neural mobilization may be used to:
promote normal nerve gliding and prevent restrictions
107
rehabilitation phases
protection > controlled motion > return to function
108
rehab phase where the PT should control inflammation, facilitate wound healing, and maintain normal function in associated areas
protection phase
109
usual interventions during the protection phase of rehab
PRICES, selective rest/immobilization, Gr. I joint oscillations, passive movement, mm setting c caution, Gr. I-II distraction/glide, massage
110
contraindications for protection phase of rehab
stretching and resistance exercises
111
rehab phase wherein the PT should initiate and progress non-destructive exercises and restore mobility & function
controlled motion phase
112
usual interventions during controlled motion phase
AROM, multiple-angle submaximal isometrics, muscular endurance, stabilization exercises, functional training, hold-relax technique (stretching), gr III oscillations, GPS, massage
113
rehab phase where the PT should increase the pt's strength and flexibility
return-to-function phase
114
usual interventions of return-to-function phase
progressive stretching, cross-fiber massage, strengthening, muscular endurance training, aerobic exercises, specificity drills
115
precautions for controlled motion interventions
proper dosage of movement/activity, eccentric exercises in muscular injuries, heavy resistance exercises

MSK2 LEC (7 decks)

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