Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Skin MS: Week 6 > Soft Tissue Injury > Flashcards

Soft Tissue Injury Flashcards

(68 cards)

Start Studying
1
Q

What is soft tissue?

A

Articular cartilagen, tendon, ligament, fibrocartilage (i.e. meniscus, labrum), muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What can happed to articular cartilage?

A

Osteochondral defect, chondromalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What can happen to tendons?

A

Tenosynovitis, tendinopathy, tendon strain, tendon rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What can happen to ligament?

A

Sprain, tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can happen to Fibrocartilage?

A

Tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What can happen to muscle?

A

Strain, cramping, contusion, myositis ossificans, compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mechanisms of ligamentous injury

A

Repetitive stress (overuse), acute high-force injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ligament injury exam

A

Swelling, joint deformity, pain w/ palpation, ROM limited by pain (guarding), joint instability w/ stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Joint instability tests (ACL, UCL, ATFL)

A

Lachman, Pivot Shift (ACL)

Milk jug sign (UCL in thumb)

Ankle Anterior Drawer (ATFL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Valgus vs. Varus

A

It is determined by the distal part being more medial or lateral than it should be. Whenever the distal part is more lateral, it is called valgus. Whenever the distal part is more medial, it is called varus. Therefore, when the apex of a joint points medially, the deformity, if any, would be called valgus, as the distal part points laterally.

The L of “lateral” is also in valgus, but not in varus. When also remembering that the direction of the distal part is key: distal (more) lateral means valgus and distal (more) medial means varus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ottawa Ankle Rules

A
  1. Patient has pain in the malleolar zone (or under achilles)
  2. And any of the following: bone tenderness at the posterior edge or tip of the lateral malleolus or the medial malleolus or the inability to bear weight (four steps) immediately after injury and in the ER or physician’s office
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lateral condyle of tibia avulsion fracture on xray –>

A

ACL tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ligament Injury Tx

A
  • Relative rest
  • Immobilization (Brace, Splint, Cast)
  • Rehab of surrounding structures/PT
  • Surgical repair/reconstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Does torn ligament need surgery?

A

It depends! (Benefit vs risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Consequences of deficient ligament?

A

Early arthritis, secondary soft tissue injury, joint instability/disabilitiy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Surgical ligaments

A

–UCL thumb

–Scapholunate Ligament

–UCL elbow

–Glenohumeral*

–Coraco-clavicular

–ACL

–Tib-Fib/Syndesmosis

–ATFL

–Deltoid

–Lisfranc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Injury to tendon can involve

A

tendon, paratenon (more fibrous coating), tendon sheath (synovial membrane)

(or combination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

De Quervain’s Tenosynovitis

A

Tendon sheath swollen and inflammed as runs under extensor retinaculum (EPB and APL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Most tendon issues are not _____ but are ______

A

inflammatory

Usually degenerative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tendinopathy

A

Primarily degenerative (not inflammatory) - microtears

Activity-related pain (more repetitive us)

Focal tendon tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Tendinopathy Treatment

A

Pain relief (relative rest, activity modification, bracing, ice, acetaminophen, limited oral NSAIDs, topical NSAIDs, pertitendinous steroids)

Tendon restoration (Time 3-6 months, strengthening - eccentric, pro-inflammatory injections/procedures - prolotherapy/sugar,salt into tendon - PRP/platelet rich plasma injected - autologous blood - needle tenotomy, tendon debridement surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

_______ strengthening most effective for tendinopathy

A

eccentric most effective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tendon tearing predisposed by

A

Degenerative changes (age, maybe asymptomatic), malalignment, muscle imbalance, weakness, instabilty, inflexibility, glucocorticoids, fluorinated quinolones, inadequate blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tendon injury exam

A
  • Focal Pain
  • Swelling, contusion, muscle retraction/collection
  • Pain provoked with active motion

•Possibly loss of active motion

  • Passive motion may be limited by pain
  • Special Test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Special tendon injury tests
Empty Can – Supraspinatus Thompson’s Test – Achilles (squeeze calf --\> plantarflex) Hook Test – Distal Biceps (hook the tendon w/ finger)
26
Biceps supinate/pronate
supinate \*There are other flexors, but the supination will be why they need surgery
27
Proximal biceps tear vs distal
proximal biceps - not as big of a deal, usually long head --\> popeye deformity, but short head still intact - nonsurgical distal end - surgical
28
Nonoperative tendon tx
* Often spontaneously resolve (don't usually NEED surgery) * Time, relative rest, activity modification, immobilization * Physical Therapy, Eccentric strengthening * Anti-Inflammatories (pain relief) - NSAIDS, Ice, Corticosteroid injections * Pro-Inflammatories - Prolotherapy, PRP, Autologous Blood, Needle Tenotomy
29
Tendon surgery - questions to ask
* Can function be recovered without surgery? * If function is lost, will it be missed? * Complete ruptures/full thickness tears are susceptible to muscle retraction –Delaying surgery may make surgical procedure more difficult or impossible –Sometimes it’s urgent
30
3 (important) types fibrocartilage
Glenoid labrum Acetabular labrum Meniscus
31
Function of fibrocartilage
•Load bearing –Distributes load over broad surface area of articular cartilage * Shock absorption * Joint stabilization * Possibly joint lubrication * Loss of menisci alters the loading of articular cartilage * May increase the probability and severity of degenerative joint disease
32
Fibrocartilage injury
Tramautic tears - young/active, sudden change in direction Degenerative - aging, no specific injury, associated w/ age-related tissue changes (i.e. OA)
33
Fibrocartilage exam
Not very good - cannot reliably dx w/ exam Joint inspection typically normal **Joint line palpation - pain** Pain w/ movement Effusion not usually there (no vascularization)
34
Specific provacative tests for fibrocartilage
–Meniscus = McMurray’s Test –Glenoid Labrum = Obrien’s Test, Apprehension Sign, Anterior Load and Shift Test –Acetabular Labrum = FADIR Test/Impingement Sign
35
Imaging for fibrocartilage exam
Imaging important, US does not work (too far into joint) MRI (meniscus) MRI-arthrogram (glenoid and acetabular labrum) - contrast dye
36
2 important Glenoid labral tear
SLAP (superior labral): 2-10, biceps origin, athletes Bankart (anterior inferior dislocation): 3-6
37
Surgically urgent fibrocartilage tear (only one)
Bucket-handle meniscus tear ## Footnote Somewhat time-sensative. Loss of passive motion and inability to bear weight should raise suspicion. Limited opportunity for meniscus repair. cartilage moves into interchondylar notch
38
Fibrocartilage Injury Tx
* Benign Neglect, Watchful Waiting, Symptom Monitoring (unless bucket handle) * Repair - Vascular zone tears in young patients, Unstable flaps == Subluxates under condyle, Tear length \>1/2 meniscus length * Partial Meniscectomy * Meniscal Transplant
39
Big concern w/ skeletal muscle and injury
Generate heat --\> hyperthermia
40
Muscle strain
Powerful eccentric contraction Injury usally at muscle-tendon junction 2 joint muscles at highest risk strain = acute injury, immediate pain - soreness 24-48 hrs after exercise
41
Muscle strain prevention
* Flexibility * Warm-up - Temperature, Extensibility * Conditioning - Avoids fatigue * Strength - Able to absorb more energy
42
Muscle Strain Tx
* Rest * Ice * Compression * Elevation * NSAIDS * Mobilization * Rehabilitation
43
Muscle cramping = cause
uncertain dehydration electrolyte disturbances (salty sweaters, Na, Ca, Mg) Muscle fatigue
44
Most common muscle to cramp
Gastrocnemius
45
Medications associated given for muscle cramping
quinine sulfate (tonic water), chloroquine sulfate
46
Muscle contusions
* Direct trauma causing damage and partial disruption of muscle fibers * Intramuscular hematoma frequently results
47
Muscle contusions treatment
•Treatment generally includes rest, ice and early return to gentle motion Don't usually drain hematomas (could make it worse, will usually go away on its own - unless its the playoffs lol)
48
Muscle contusions characterized by
•Characterized by tenderness, swelling or palpable hematoma, limits in strength/motion
49
Myositis ossificans
* Complication of muscle contusions – 20% of quadriceps hematomas * Tissue calcification or ossification at the site of injury * May be prevented with NSAIDS * Usually seen on xray 2-4 wks after injury * May enlarge or be symptomatic for several months before stabilizing * Often resorbs with time * Surgical excision can be considered later if heterotopic bone remains symptomatic
50
Compartment Syndrome
* Rise in intracompartmental pressure above capillary pressure * Caused by muscle edema * If recognized early, incising fascia can restore circulation and function of the compartmental muscles and neurovascular components
51
Acute compartment syndrome
* Assoc with direct trauma to bone or soft tissue * Elevated compartmental pressure compromises tissue perfusion Surgical emergency - fasciotomy
52
Chronic compartment syndrome
* Diffuse, deep pain over anterior or lateral leg after period of exercise * Distal sensory changes often present * Resolves with rest * Can interrupt activity or reduce intensity of exercise * Diagnosed by elevated compartmental pressure testing - Resting vs Exercise stress testing Not really dangerous unless it doesn't go away
53
Chronic Compartment Syndrome
•Treatment –Relative rest, cross-training, activity modification –Physical therapy, biomechanical correction –Fasciotomy
54
Articular Cartilage
* Provides smooth surface for joint movement * Distributes the loads of articulation * Minimize stress on subchondral bone * Remarkably durable and wear resistant * Lacks nerve and blood vessels –Isolated injury unlikely to be detected at time of injury
55
Articular Cartilage Injury
Acute - tear, osteochondral defect Repetitive excessive loading - chondromalacia
56
ARticular cartilage injury
–Shaving – no resolution, possible worsening –Microfracture – Arthroscopic Abrasion –Cartilage Grafts - Autograft, Allografts – osteochondral fragment of any size, Chondrocyte – artificial matrix graft procedures
57
Chondromalacia
* Repetitive stress on joint * Muscle imbalance leading to uneven wear * Dislocation, fracture, trauma * Pain with squatting, kneeling, prolonged sitting, running, jumping and descending stairs or hills
58
Chondromalacia dx
–Pain with palpation over joint •Patellar compression test –Pain with joint movement –Effusion is possible –XR – may show joint malalignment –articular cartilage changes seen MRI or arthroscopy
59
Chondromalacia tx
–Ice, relative rest, acetaminophen, NSAIDS, steroid injections –Physical Therapy – muscle balance and joint stability
60
Bursa
* Fluid-filled, synovial-lined sac-like structure * Protect muscles and tendons from friction as they move over bones and other muscles * Serve as cushion between skin and superficial bones (superficial) or muscle - bone (deep)
61
Causes of bursitis
•Etiology –Direct trauma –Prolonged pressure –Overuse –Crystaline Arthropathy –Inflammatory arthritis –Infection (septic bursitis)
62
Common bursitis locations
•Common Locations –Subacromial space –Greater Trochanter –Olecranon –Prepatellar/infrapatellar –Iliopsoas
63
Bursitis diagnosis
* Boggy, warm, erythematous (superficial bursas) * Tender to palpation * Consider imaging to evaluate for local tendon tear (deep bursas) * Consider aspiration to rule out septic bursitis, inflammatory bursitis, crystaline bursitis
64
Bursitis tx
* Protection * Ice * NSAIDs * Steroid injection –Concern for introduction of infection with needle •Bursectomy
65
Scapholunate Dissociation
* Occurs after FOOSH * Mid-carpal pain * Watson’s Scaphoid Shift * Diastasis and/or abnormal scapholunate angle on xray * MRI arthrogram * Casting vs repair \*\*\* complication --\> SLAC wrist (need to make diagnosis quickly) --\> early arthritis and wrist fusion
66
FDP Rupture (Jersy Finger)
Flexor Digitorum Profundus - treat early to regain function in finger
67
Unhappy triad
Valgus stress - ACL, MCL, medial meniscus
68

Skin MS: Week 6 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions