soft tissue disorders

Question 1

_____ refer to the stretching or tearing of the musculocutaneous unit; can be partial or full tears.

Answer 1

strains

Question 2

_________ is a more chronic condition with minimal or no inflammatory process detected histologically.

there are also changes at the cellular level showing expansion of local cells, thinner collagen fibrils, and inflammation

Answer 2

tendinosis or tendinopathy

Question 3

medical name for bruising

Answer 3

muscle contusion

Question 4

increased interstitial pressure with a closed myofascial compartment which compromises function

Answer 4

Myofascial Compartment Syndromes

Question 5

the earliest clinical symptom of compartment syndrome is _________ __________ than what’s expected

Answer 5

disproportionate pain

Question 6

partial disruption of the anatomic relationship within a joint is called ______. the joints at most risk are?

Answer 6

subluxation

GHJ
AC
SI
OA

Question 7

when should movement be done with care in Soft tissue injuries, when can you gradually progress, and what training starts 1st

Answer 7

• 3-7 days
• 7-10 days
• isometric

Question 8

T or F: you should stretch a recent soft tissue injury

Answer 8

F

Question 9

what type of load is advocated for in a soft tissue injury

Answer 9

eccentric

Question 10

bone formation in nonosseous tissues; benign condition

Answer 10

heterotopic ossification (HO)

aka myositis ossificans

forms in bruised, damaged, or inflamed muscle

Question 11

hallmark sign for HO

Answer 11

progressive loss of ROM
muscle pain
loss of motion
develops a hard-end feel after 3-6 mo

Question 12

in HO areas of calcification and bone spurs may progress to what

Answer 12

ankylosis

Question 13

T of F: you should forcefully stretch your HO pt

Answer 13

F: is could lead to muscle tears and you should use a more comprehensive approach

Question 14

two CT diseases at the same time or in different time frames

Answer 14

MCTD (mixed)
OCTD (overlapping)

Question 15

what population is most affected by CTD

Answer 15

adult women

Question 16

CTD is associated with what type of diseases

Answer 16

autoimmune- RA, SLE, polymyositis, dermatomyositis.

differential diagnosis is difficult

Question 17

clinical manifestations of OCTD

Answer 17

• rash, Raynaud, arthritis (SLE)
• scleroses (swollen hands, pulmonary interstitial disease)
• polyarthralgia
• RA in 75% of cases
• in 10% there is neuro issues
• trigeminal sensory affected in MCTD and OCTD

Question 18

disorder marked by diffuse pain and stiffness in multiple muscle groups that primarily affects the shoulder and pelvic girdle

Answer 18

PMR (polymyalgia rheumatica)

Question 19

15-20% of people with PMR also develop _______

Answer 19

giant cell arteritis
- a condition characterized by inflammation in the arteries of the head and neck

Question 20

most cases of PMR occur after age what

Answer 20

70 (FE>M)

Question 21

in PMR painful stiffness lasts more than _____ and are often ______

Answer 21

1 hour
bilateral

(shoulders, hips, LB, butt, neck, SCJ)

Question 22

what is the rapid breakdown of skeletal muscle tissue because of mechanical, physical, or chemical trauma? What is released?

Answer 22

Rhabdomyolysis

phosphokinase enzymes, myoglobin

Question 23

what can Rhabdomyolysis lead to

Answer 23

renal failure (accumulation of muscle breakdown products)

Question 24

T or F: exercising in hot and humid weather is a risk factor for Rhabdomyolysis

Answer 24

T

Question 25

clinical manifestations of Rhabdomyolysis

Answer 25

• excessive fatige, and inability to recover after a strenuous event
• myalgia and weakness
  -urine tea colored
  -massive skeletal necrosis
• reduced plasma volumes leading to shock and acute renal failure
• hyperkalemia (heart rhythm issues)

Question 26

nonspecific muscle weakness

Answer 26

myopathy

Question 27

CIM

Answer 27

critical illness myopathy (ICU stay induced myopatahy)

Question 28

hereditary myopathy

Answer 28

muscular dystrophy
congenital
myotonia
metabolic
mitochondrial
neurologic

Question 29

acquired myopathy

Answer 29

inflammatory
- idiopathic, RA, polymyositis, autoimmune diseases, HIV

Question 30

endocrine myopathy

Answer 30

diabetes
thyroid

Question 31

trigger points are associated with what?

Answer 31

myofascial pain syndrom

Question 32

what are trigger points

Answer 32

hyperirritable points in a taunt band of skeletal muscle that is painful on compression, stretch, overload or contraction of the tissue and responds from a referred pain that is perceived distant from the spot

Question 33

TrPs are classified as _____ when they cause spontaneous local and referred pain and as _____ when they cause only pain on stimulation

Answer 33

active
latent

Question 34

both types of TrP (active and latent) are known to cause hyperalgesia which implies…

Answer 34

nociceptors can make new effective connections with dorsal horn neurons

Question 35

TrPs follows the development of contracture muscle fibers or _________, which are the result of excess release of _____ and inhibition of ____

Answer 35

taunt bands
ACh
AChE

Question 36

Pelvic Floor Muscles superficial later (external)

Answer 36

external anal sphincter
bulbocavernosus and ischocavernous, and superficial transverse perineal muscles

Question 37

PFM second layer

Answer 37

sphincter urethra
urethrovaginal sphincter
(urogenital diaphragm for urinary continence)

Question 38

deep PFM layer

Answer 38

levator ani
- puborectalis
- pubococcygeus
- coccygeus
- ischococcygeous

supports pelvic viscera in M and FE

Question 39

coccygodynia (coccydynia) is …

Answer 39

pain related to the coccyx and the muscles attached

causes unclear but could be : MSK, trauma, childbirth, inflammation, referred pain, neoplasm, centralized pain syndrome

Question 40

MSK symptoms for coccygodynia can be

Answer 40

poor sitting posture
asymmetry in pelvis
hypermobility of sacrum
hook on end of coccyx (coccygeal spicule)
DDD