soft tissue disorders

Question 1

strains

Answer 1

stretching or tearing of the musculotendinous unit

Question 2

tendinosis/tendinopathy

Answer 2

chronic condition of the tendon with minimal or no inflammation histologically

Question 3

what does the tissue of a tendon with tendinopathy look like (2 main things)

Answer 3

• expanded local cells
• thinner collagen fibrils

Question 4

muscle contusion

Answer 4

• bruising with intact skin
• incites an inflammatory response
• sometimes causes hematoma formation

Question 5

Myofascial Compartment Syndromes

Answer 5

Increased interstitial pressure within a closed
myofascial compartment

(compromises nerves, muscles, and vessels)

Question 6

where do myofascial compartment syndromes typically occur (4)

Answer 6

within “envelopes” of lower leg, forearm, thigh, and foot

Question 7

which soft tissue injury can cause ischemia and irreversible muscle loss

Answer 7

myofascial compartment syndromes

Question 8

osteochondritis dissecans and osgood schlatter disease both cause damage to what soft issue structure

Answer 8

growth cartilage

Question 9

4 joints most at risk for subluxation

Answer 9

glenohumeral
acromioclavicular
sacroiliac
atlantoaxial

Question 10

dislocation

Answer 10

complete loss of joint integrity coupled with significant ligamentous damage

Question 11

where does the most common joint dislocation occur

Answer 11

glenohumeral joint

Question 12

what is the most common CONGENITAL dislocation location

Answer 12

hips

Question 13

what type of training should occur first when dealing with a soft tissue injury

Answer 13

ISOMETRICS!!

it aligns the fibers and is the least forceful contraction to begin with

Question 14

what type of exercise is advocated for chronic tendinopathies

Answer 14

eccentric contractions

Question 15

after the pt can do isometric + isotonic exercises without pain… what type of training is next?

Answer 15

isokinetic with minimal load

Question 16

heterotopic ossification (OH)

Answer 16

bone formation in nonosseous tissues like muscles and other soft tissues

Question 17

myositis ossifications form in….

Answer 17

bruised, damaged, or inflamed muscles

Question 18

hallmark sign of heterotopic ossification (OH)

Answer 18

pain + progressive loss of ROM at a time when posttraumatic inflammation should be resolving

Question 19

5 sites most common for heterotopic ossification (OH)

Answer 19

hip
elbow
knee
shoulder
TMJ

Question 20

2 types of connective tissue diseases

Answer 20

mixed connective tissue disease (MCTD)
overlap connective tissue disease (OCTD)

Question 21

connective tissue diseases have features of many ___________ disorders

Answer 21

autoimmune

Question 22

___________ combines features of SLE, scleroderma, polymyositis, and polyarthralgias

Answer 22

OCTD

Question 23

what autoimmune disease is present in 75% of OCTD cases

Answer 23

RA

Question 24

polymyalgia rheumatica (PMR)

Answer 24

diffuse pain and stiffness in multiple muscle groups

Question 25

what muscle groups are typically involved in PMR

Answer 25

shoulder muscles pelvic girdle muscles

Question 26

painful stiffness lasting longer than ______ in the morning indicates PMR

Answer 26

1 hour

Question 27

PMR: unilateral or bilateral?

Answer 27

bilateral and symmetric

Question 28

rhabdomyolysis

Answer 28

the rapid breakdown of skeletal muscle tissue resulting in release of creatine phosphokinase enzymes, myoglobin, and other TOXIC BY PRODUCTS

Question 29

accumulation of muscle breakdown by-products is dangerous to which body system?

Answer 29

RENAL SYSTEM

Question 30

military recruits + marathon runners who have been exercising in hot and humid weather are more susceptible to _________

Answer 30

rhabdomyolysis

Question 31

physical rhabdomyolysis causes

Answer 31

prolonged high fever hyperthermia excessive physical exertion

Question 32

mechanical rhabdomyolysis causes

Answer 32

crush injuries burns compression compartment syndrome

Question 33

chemical rhabdomyolysis causes

Answer 33

medications excessive alcohol electrolyte abnormalities infections

Question 34

tea colored or cola soft drink colored urine indicates....

Answer 34

severe rhabdo + need to go to emergency room

Question 35

what ion is released by injured muscles that can cause fatal disruptions in heart rhythm?

Answer 35

POTASSIUM --> hyperkalemia

Question 36

critical illness myopathy (ICM) is associated with....

Answer 36

prolonged stays in ICUs

Question 37

trigger points (TrPs)

Answer 37

hyperirritable sports in a taut and of skeletal muscle painful on compression, stretch, contraction, etc.

Question 38

active vs latent trigger points

Answer 38

active: spontaneous local + referred pain latent: causes pain only on stimulation

Question 39

allodynia

Answer 39

normally non-painful stimuli (light touch, pressure, or temp) trigger intense pain

Question 40

what 4 micronutrients could be involved in myofascial pain like TrPs

Answer 40

iron magnesium B12 D

Question 41

what layer of the pelvic floor are the levator ani muscles in?

Answer 41

3rd layer (deepest)

Question 42

symptoms of underactive pelvic floor

Answer 42

urinary/fecal incontinence pelvic organ prolapse absent/weak pelvic floor contraction

Question 43

symptoms of overactive pelvic floor

Answer 43

obstructive voiding/defecation dyspareunia pelvic pain nonrelaxing pelvic floor muscles

Question 44

what is the most common cause of an underactive pelvic floor

Answer 44

birth-related trauma

Question 45

what should the treatments of overactive pelvic floor be targeted toward

Answer 45

hypersensitive nervous system

Question 46

coccygodynia

Answer 46

pain related to the coccyx and the muscles attached to it

Question 47

sacral chordoma

Answer 47

rare, slow-growing tumor that presents with neurologic symptoms as well as pain similar to coccygodynia