Term
| Primary injuries are defined as what |
|
Definition
| injuries that are self-inflicted, caused by another individual or entity, or caused by the environment |
|
|
Term
| Primary injuries are split into what 3 categories |
|
Definition
acute
chronic
acute on chronic |
|
|
Term
| what is an acute on chronic injury? |
|
Definition
| acute flare up of a chronic injury |
|
|
Term
| Secondary injuries are defined as what |
|
Definition
| inflammatory response that occurs with the primary injury |
|
|
Term
| Healing abnormalities can be be d/t complicaitons such as (3) |
|
Definition
infection
compromised circulation
neuropathy |
|
|
Term
| 3 main phases of wound healing |
|
Definition
inflammatory
proliferative
remodeling |
|
|
Term
| 2 reactions within the inflammatory phase |
|
Definition
|
|
Term
| main funcitons of exudate during the inflammatory phase (3) |
|
Definition
provide cells capable of tissue reconstruction
dilute microbial toxins
remove contaminatns present in the wound |
|
|
Term
| Inflammation is mediated by what substances |
|
Definition
| chemotactic substances including anaphylatoxins |
|
|
Term
| role of anaphylaxtonxins during the inflammatory phase (2) |
|
Definition
| attract neutrophils and monocytes |
|
|
Term
| white bloods cells that bind to microorganisms, internalize them, and kill them |
|
Definition
|
|
Term
| white blood cells that develop into macrophages, and provide immunological defesnes against many infectious organisms |
|
Definition
|
|
Term
| what marks the end of the inflammatory process |
|
Definition
| complete removal of the wound debris |
|
|
Term
| how long can the inflammatory phase last |
|
Definition
| 1-6 days, longer than 6 months |
|
|
Term
| Common causes for a persistent chronic inflammatory response include (8) |
|
Definition
infectious agents
persistent viruses
hypertrophic scarring
poor blood supply
edema
repeated direct trauma
excessive tension at wound site
hypersensitivity reactions |
|
|
Term
| during the inflammatory phase there is pain when (3) |
|
Definition
at rest
with active motion
when specific stress is applied to the injured structure |
|
|
Term
| if the pain is severe enough during the inflammatory phase what will happen |
|
Definition
| loss of function, muscle guarding |
|
|
Term
| if there is constant pain regardless of rest or activity what is going on |
|
Definition
| there is an inflammatory process present |
|
|
Term
| characteristic changes of the proliferative phase (3) |
|
Definition
capillary growth
granulation tissue formation
fibroblast formation with collagen synthesis and increased macrophage and cell activity |
|
|
Term
| capillary growth during the proliferative phase includes what (2) |
|
Definition
| angiogenesis, neovascularization |
|
|
Term
| how long does the proliferative phase last |
|
Definition
| 5-15 days, often up to 10 weeks depending on the type of tissue and the damage |
|
|
Term
| remodeling phase of wound healing invovles what |
|
Definition
| conversion of the inital healing tissue to scar tissue |
|
|
Term
| how long can the remodeling phase last up to |
|
Definition
|
|
Term
| what collagen is being replaced by what during the remodeling phase |
|
Definition
| type 3 collagen being replaced by type I collagen |
|
|
Term
| only tissue in the body to be able to restore itself to its original state after damage |
|
Definition
|
|
Term
| imbalances in what during the remodeling phase may result in hypertrophic scarring or keloid formation |
|
Definition
| imbalances in collagen synthesis and degredation during this phase of healing |
|
|
Term
| why is a scar considered to be non funcitonal |
|
Definition
| lack of an elastic component making the scar more brittle and prone to breaking again |
|
|
Term
| if left untreated, how large will a hypertrophic scar or keloid formation be |
|
Definition
| less than 20% of its original size |
|
|
Term
| scarring that occurs in what line of force of a structure is less vulnerable to re-injury |
|
Definition
| parallel to the line of force |
|
|
Term
| Muscle injury can result from (6) |
|
Definition
excessive strain
contusions
excessive tension
lacerations
thermal stress
myotoxic agents |
|
|
Term
| injury which accounts for 90% of muscle tissue injuries |
|
Definition
|
|
Term
| strain refers to what tissue types |
|
Definition
|
|
Term
| sprain refers to what tissue type |
|
Definition
|
|
Term
| myotoxic agents which cause mm injury (4) |
|
Definition
local anesthetics
excessive use of corticosteriods
snake/bee venom
heavy dose antibiotics |
|
|
Term
| factors contributing to injury: (3) inadequate |
|
Definition
flexibility
strength or endurance
rehabilitation from previous injury |
|
|
Term
| factors contributing to injury: insufficient |
|
Definition
|
|
Term
| factors contributing to injury: dyssyngergistic |
|
Definition
|
|
Term
| what is dyssyngergistic muscle contraction |
|
Definition
| abnormal muscle activation |
|
|
Term
| factors contributing to injury: insufficient warm up refers to what |
|
Definition
| inappropriate warm up for the actvity to be done |
|
|
Term
|
Definition
| contusion to a muscle belly |
|
|
Term
|
Definition
intramuscular
intermuscular |
|
|
Term
| intramuscular hematomas are associated with what injury (2) |
|
Definition
|
|
Term
| which hematoma's size is limited by the muscle fascia |
|
Definition
|
|
Term
| what is an intramuscular hematoma |
|
Definition
| if the mm fascia is ruptured and the extravasated blood spreads into the interfascial and interstistal spaces |
|
|
Term
| contraindication for PT therapy with hematomas |
|
Definition
|
|
Term
| secondary condition as a result of a hematoma |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Describe a Grade I Muscle Strain |
|
Definition
a tear of a few muscle fibers with minor swelling and discomfort
associated with no or minimal loss of strength and restriction of mvmt
strong and painful
2-4 weeks for healing |
|
|
Term
| Describe a Grade II Muscle Strain |
|
Definition
Greater damage of teh muscle and clear loss of strength and some loss of function
Weak and Painful
4-6/8 weeks healing |
|
|
Term
| Describe a Grade 3 muscle strains |
|
Definition
tear extending across the whole muscle belly
characterized by severe pain or loss of function
presence of palpable and/or observable deformity
weak and painless |
|
|
Term
| the capacity of muscle for regeneration is based primarily upon what (3) |
|
Definition
type of injury
extent of injury
location of injury |
|
|
Term
| 3 healing phases in the healing process of an injured mm |
|
Definition
destruction phase
repair phase
remodeling phase |
|
|
Term
| what should the guiding factor be in treatment of a muscle injury |
|
Definition
|
|
Term
| principles for mgmt of mm injury: best course of treatment for muscle injury |
|
Definition
| controlled mobility and activity |
|
|
Term
|
Definition
| fibrous band of dense connective tissue that connnects bone to bone and which behave as a viscoelastic structures when exposed to stress |
|
|
Term
| ligament injuries are referred to as what |
|
Definition
|
|
Term
| how many grades of sprains are tehre |
|
Definition
|
|
Term
| Describe a Grade I sprain |
|
Definition
| painful, but do not have swelling or instability |
|
|
Term
| Describe a Grade II sprain |
|
Definition
marked swelling and pain
mild ligament laxity and jt instability |
|
|
Term
| Describe a Grade III sprain |
|
Definition
| complete disruption of the ligament with gross instability and laxity |
|
|
Term
| Ligament healing is dependent on what (4) factors |
|
Definition
anatomic location
presence of associated injuries
vascularity
function of the ligament |
|
|
Term
| difference between extraarticular and intra-articular ligament injuries |
|
Definition
extra-articular ligament tears that are comlete tears can heal together if they are immobilized correctly.
Intra-articular ligament tears will not |
|
|
Term
| Intraarticular ligament tears are limited by what |
|
Definition
| vascularity and synovial fluid which may hinder inflammatory phase |
|
|
Term
| 4 phases of extra-articular ligament healing |
|
Definition
hemorrhagic
inflammatory
proliferation
remodeling and maturation |
|
|
Term
| early intervention for ligament injury |
|
Definition
| early excercised ligaments stronger than those that are immobilized |
|
|
Term
| interventions for ligament injury: minimize what |
|
Definition
| periods of immobilization |
|
|
Term
| interventions for ligament injury: progressively... |
|
Definition
| stress while exercising caution relative to biomechanical considerations |
|
|
Term
| interventions for ligament injury: purose of low cyclical loads |
|
Definition
| promotes scar proliferation adn material remodeling making scar stronger and stiffer |
|
|
Term
| tendinitis implies what type of reaction |
|
Definition
| an inflammatory reaction to a tendon injury |
|
|
Term
| the term tendinitis implies an inflammatory reaction to a tendon injury, a microscopic tearing and inflammation of the tendon tissue commonly resulting from what |
|
Definition
| tissue fatigue rather than direct trauma |
|
|
Term
| How many grades of tendinitis |
|
Definition
|
|
Term
| Describe Grade I Tendinitis |
|
Definition
pain after activity
does not interfere with performance
generalized tenderness
resolves before next exercise session |
|
|
Term
| Describe Grade II Tendinitis |
|
Definition
Minimal pain with activity
Does not interfere with activity
Local tenderness |
|
|
Term
| Describe Grade III Tendinitis |
|
Definition
pain limits activity
disappears between sessions |
|
|
Term
| Describe Grade IV Tendinitis |
|
Definition
pain remains and seriously interferes with training
Pain, tenderness, crepitus, and swelling may be present |
|
|
Term
| Describe Grade V Tendinitis |
|
Definition
pain interferes with sports and ADLs
symtoms chronic or recurrent
Signs of tissue changes and altered muscle function |
|
|
Term
|
Definition
| no, but as long as it isn't painful its "okay" |
|
|
Term
| Grade IV, and V tendinitis tend to become more what |
|
Definition
| tendinosis (degenerative changes) rather than tendinitis (inflammatory) |
|
|
Term
| Inflammatory disorder of tissues surrounding the tendon such as the tendon sheath, usually the result of a repetitive friction of the tendon and its sheath (3) |
|
Definition
tenosynovitis
peritendinitis
paratenotitis |
|
|
Term
| example condition of tenosynovitis |
|
Definition
|
|
Term
| paretenonitis is common to what large tendon |
|
Definition
|
|
Term
| tendinosis refers to what |
|
Definition
| degenerative process of teh tendons |
|
|
Term
| tendinosis is characterized by the presence of what (3) |
|
Definition
presence of dense populations of fibroblasts
vascular hyperplasia
disorganized collagen/angiofibroplastic hyperlasia |
|
|
Term
| in tendinosis there is an absence of what cells |
|
Definition
|
|
Term
| tendinosis typical clinical finding |
|
Definition
|
|
Term
| mechanism for pain generation for tendinosis |
|
Definition
|
|
Term
| general term encompassing all tendon pathology types |
|
Definition
|
|
Term
| healign of ligaments and tendons can be broken down into ____ overlapping phases |
|
Definition
|
|
Term
| what are the 4 overlaping phases of tendon/ligament healing |
|
Definition
Hemoorhagic
Inflammatory
Proliferation
Remodling and maturation |
|
|
Term
| mgmt of tendonitis vs tendinosis: key to therapy for both |
|
Definition
| judicious application of force to encourage new collagen fibril alignment in directino of force is key |
|
|
Term
| mgmt of tendonitis vs tendinosis: key consideration for tendonitis |
|
Definition
|
|
Term
| mgmt of tendonitis vs tendinosis: key consideration in tendinosis rehab |
|
Definition
|
|
Term
| recommended tx for chornic tendinopathy |
|
Definition
|
|
Term
| viscoelastic structure with a very high tensile strength and is resistant to compressive and shearing forces |
|
Definition
|
|
Term
| Arthroscopic Grading System for Cartilage Defects was made by who |
|
Definition
| International Cartilage Repair Society |
|
|
Term
| Arthroscopic Grading System for Cartilage Defects: how many grades |
|
Definition
|
|
Term
| Arthroscopic Grading System for Cartilage Defects: Grade 0 |
|
Definition
|
|
Term
| Arthroscopic Grading System for Cartilage Defects: Grade 1 |
|
Definition
| cartilage has a soft spot or blisters |
|
|
Term
| Arthroscopic Grading System for Cartilage Defects: Grade 2 |
|
Definition
| minor tears visible in the cartilage |
|
|
Term
| Arthroscopic Grading System for Cartilage Defects: Grade 3 |
|
Definition
| lesions have deep crevices (more than 50% of cartilage layer) |
|
|
Term
| Arthroscopic Grading System for Cartilage Defects: Grade 4 |
|
Definition
| cartilage tera exposes the underlying (subchondral bone) |
|
|
Term
| Articular cartilage healing/treatment |
|
Definition
| capacity of articular cartialge for repair is limited |
|
|
Term
| INjuries of the articular cartilage that do not penetrate the subchondral bone become what |
|
Definition
|
|
Term
| injuries of the articular cartilage that do not penetrate the subchondral bone become necrotic and do not heal and usually progress to what |
|
Definition
| the degeneration of the articular surface |
|
|
Term
| why do articular cartilage injuries that penetrate the subchondral bone undergo repair? |
|
Definition
| d/t access to the bone's blood supply |
|
|
Term
| articular cartilage injuries that penetrate the subchondral bone and are repaired are usually characterized as (3) |
|
Definition
fibrous
fibrocartilaginous
hyaline-like cartilaginous |
|
|
Term
|
Definition
|
|
Term
| mgmt of cartilage injury: viscosupplemenation |
|
Definition
| intra-articular injections of hyaluronic acid |
|
|
Term
| mgmt of cartilage injury: supplementation |
|
Definition
| glucosamine and chondroitin |
|
|
Term
| mgmt of cartilage injury: surgical interventions (4) |
|
Definition
arthroscopic debridement
microfracture
autologus chondrocyte cell implantation
mosaiplasty |
|
|
Term
| mgmt of cartilage injury: what is more effective than arthroscopy for DJD of the knee |
|
Definition
| PT with frequent controlled exercise |
|
|
Term
| bone is better able to withstand _____ forces rather than _____ or ______ forces |
|
Definition
compressive
tensile
torsional |
|
|
Term
| if the adaptations of bone to stress do not occur fast enough, what happens to the bone |
|
Definition
| the bone is resorbed faster than it is replaced and bone strength is compromised |
|
|
Term
| If the adaptations of bone to stress do not occur fast enough, the bone is resorbed faster than it is replaced. Causes of decreased adaptation include (3) |
|
Definition
increase in the applied load
increase in the number of applied stresses
decrease in the size of the surface area over which the load is applied |
|
|
Term
| the striking feature of bone healing, compared to healing, is that repair is by _____ ______ not scar tissue |
|
Definition
|
|
Term
| Bone healing inolves a combination of ______ and _______ ossification |
|
Definition
intramembranous
endochondral |
|
|
Term
| 2 broad phases of bone fracture healing |
|
Definition
primary fracture healing
secondary fracture healing |
|
|
Term
| primary bone healing involves what |
|
Definition
| a direct attempt by the cortex to reestablish itself once it has become interrupted |
|
|
Term
| Secondary bone healing involves what |
|
Definition
| responses in the periosteum and external soft tissues with the subsequent formation of a callus |
|
|
Term
| the majority of fractures heal by what type of fracture healing |
|
Definition
| secondary fracture healing |
|
|
Term
| Immobilization: effects on cartilage |
|
Definition
|
|
Term
| Immobilization: effect on ligaments |
|
Definition
| decrease in the mechanical and structural properties of ligaments |
|
|
Term
| Immobilization: effect on bone |
|
Definition
|
|
Term
| Immobilization: effect on muscles |
|
Definition
| weakness or atrophy of muscles |
|
|
Term
| PT Rx of Ex to Promote Tissue Repair: Tendon Protocol |
|
Definition
| controlled loading of tendon after injury enhanced tissue healing |
|
|
Term
| PT Rx of Ex to Promote Tissue Repair: muscle protocol |
|
Definition
| after a brief period of scar formation and stabilization, controlled loading improved regeneration of myotubes and prevented atrophy of surrounding tissue |
|
|
Term
| PT Rx of Ex to Promote Tissue Repair: articular cartilage protocol |
|
Definition
| application of CPM (continuous passive machine) following cartilage transplant enhanced patient outcomes |
|
|
Term
| PT Rx of Ex to Promote Tissue Repair: Bone protocol |
|
Definition
| addition of cyclical compressive loading to healing bone tissue enhanced patient strength and ROM following immobilization periods |
|
|
