ATH_301_CH4

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itzlinds
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237051
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ATH_301_CH4
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2013-09-25 23:04:50
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Injury Pathology Nomenclature
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4: Injury Pathology Nomenclature
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  1. the tissues that form the human body react to the forces- stress- placed on them in a meaningful and predictable manner, as described by:
    the physical stress theory
  2. physical forces applied to the body, as well as psychological, social, and emotional factors are called:
    stress
  3. when the relative level of stress falls below the maintenance level, the tissues:
    atrophy

    example: long term immoblilzation of arm/leg; girth of immobilized limb is significantly less than a healthy limb
  4. when the duration and magnitude of the stress applied to the body are progessively increase, the tissues:
    hypertrophy

    increased muscle girth, increased bone mineral density, and strength
  5. the amount of tensile load specific tissues can tolerate before damage results is described by:
    stress-strain curves

    • tissue stiffness increases with age; a predisposing factor to soft tissue injry
  6. Continuation of a load may cause the tissue to rupture at its ultimate failure point, as described by:
    load-deformation curve

    • tissues have the ability to stretch/move; concentric/eccentric actions
    • tissues under a load stretch, break a little bit, then heal
    • if something is forced; tissues fail and ruptures
    • example: hamstring rupture; FOOSH
  7. a single force exceeds the tissues failure point:
    macrotrauma

    examples: FOOSH, contact, collisions, wrong step, falling
  8. the body recives repeated submaximal forces over time, and the tissue is unable to adapt:
    microtrauma

    examples: overuse, tendonitis, stress fxs, shin splints
  9. a longituduinal "tearing" stress on the structure is called:

    List the structures most prone to this stress:
    tensile forces

    most prone: muscle tissue, tendons, ligaments, fascia

    • muscle tissue: stretched beyond normal limits results in tearing
    • ligaments: overstretching of the structure (MCL)
    • muscle/tendon: occurs when the joint's normal range is exceeded; especially a muscle that crosses two joints (example: rectus femoris; crosses hip/knee)
  10. the muscle contracting eccentrically while an antagonisitic force attemtps to elongate the muscle:
    dynamic overload
  11. when stresses are applied at each end of a structure:
    compression forces

    Example: FOOSH
  12. stresses that occur perpendicularly across the long axis of a structure:

    results across a bone:
    results across a joint:
    shear forces

    • results arcoss a bone: transverse fx
    • results across a joint: disslocation
  13. stresses that occur as a result from twisting:
    torsion forces

    magnified by shoes that fix the foot more firmly to the ground
  14. a blow directly to a body part:

    results in:
    direct blow

    results in: contusions, fxs, possibily disslocations
  15. the group formed by a muscle and its tendons:
    musculotendinous unit

    • partial muscle/tendon tears: affect the muslces ability to generate or sustain tension
    • partial msucle/tendon tears: caused decreased force production
    • complete tears: inablility to create force
  16. noncontact injury of the musculotendionous unit caused by excessive tension within its fibers:

    caused by:
    strains

    caused by: tensile forces; dynamic overload; eccentricu muscle contraction
  17. the severity of a strain is based on the number  and extent of the fibers that have been traumatized: first degree strain
    • stretching of the fibers/damage to myofibrils, traumatizing less than 5% of teh musculotendinous unit
    • pain increases as muscle contracts, especailly against resistance; site of injury is point tender
    • swelling may be present; less if any at all
    • 24 hr - 2 week recovery time
  18. the severity of a strain is based on the number  and extent of the fibers that have been traumatized: second degree strain
    • involve the actual tearing of some muscle fibers/ fascia
    • more pronounced inflammatory response
    • pain increases as muscle contracts, espcially against resistance; site of injury is point tender
    • swelling
    • eccyhmosis may be present
    • 2-6 week recovery time (1 week of protection; then phase back strenght)
  19. the severity of a strain is based on the number  and extent of the fibers that have been traumatized: thrid degree strain
    • invloves the complete rupture of the muscle/blood vessels
    • total loss of fnx
    • palpable defect in the muscle
    • rapid obscured swelling
    • tissues become ischemic
    • ecchymosis is present
    • 8-12 week recovery
  20. gravity causes blood that has seeped into the tissues to drift inferiorly is called:
    ecchymosis
  21. "itis"
    inflammation
  22. inflammation of the structures encased within the tendon's outer layering:
    tendinitis

    • most commonly at the tendon's boney attachments
    • examples: patellar tendinitis (inflammation may be palpable); achilles tendon
  23. degeneration conditon of the tendon itself:
    tendinosis

    • more prevalent than tendinits (often occure together)
    • repetitive motion that has been happening for a long period of time
    • no time off from activity

  24. inflammation of the synoval sheath surrounding a tendon:
    tenonsynovitis

    • common in the hands/feet
    • adhesions; causing restricted movement of tendon within its sheath
  25. inflammation of tendons encased by pertendinous layer of thick tissue:
    peritendinitis

    • signs and symptoms are similar to tenditis
    • difference: more localized pain; crepitus
  26. the clinincal grading of tendinopathy is based on when symptoms occur: first degree tendinopathy
    marked by pain and slight dysfunction during activity
  27. the clinincal grading of tendinopathy is based on when symptoms occur: second degree tendinopathy:
    results in decreased function and pain during and after activity
  28. the clinincal grading of tendinopathy is based on when symptoms occur: thrid degree tendiopathy
    characterized by constant pain that prohibits activity
  29. capillary bleeding and the breakdown of hemoglobin provide the charactersitic inintal redness that gradually deepens to dark purple and blue, finally fading to yellow as the region heals:
    contusions

    • soft tissue injuries resulting from direct blows
    • superficial bone contusions are more painful
    • evaluations should eliminate fxs, and superficial nerve damage
    • treatment includes: ice, gentle stretching, and padding
    • example for quad: convince athlete to keep the leg bent at the knee so that the heel is close to the butt; the bend will prevent the blood from going inferior; return to play faster
  30. the formation of bone within a muscle belly's fascia:
    Heterotopic ossificiation (myositis ossificiation)

    • occurs secondary to injury such as deep contusion, multiple contusions, muslce strain
    • MRI - identifies intramuscular hematoma; aspirate to restore function
    • commonly occurs in: quadriceps femoris, hip adductor group, biceps brachii
    • can lead to compartment syndrom
  31. the cause of a disease (also the study of the causes of the disease):
    etiology
  32. fluid filled sacs that buffer tissues from friction-causing structures to facilitate smooth motion:
    • bursae
    • bursistis: inflammation of the bursae

    • bursae cannot be palpated unless they are inflammed
    • caused by: disease state, increased stress, friction, traumatic force
    • infection can occur; watch heat/redness
    • elbow/knee
    • treat the same way as tendinitis
  33. a joint is forced beyond its normal anatomical limits, resluting in the stretching or tearing of the ligaments, joint capsule, or both:
    sprain

    ligaments that are within the joint capsule or part of the joint capsule produce more swelling than ligaments that are outside the joint capsule (extracapsular)
  34. the degree of the sprain is based on the amount of laxity produced by the injury relative to the opposite limb: first degree sprain
    • ligament is strecthed with little or no tearing of its fibers
    • no abnormal motion is produced when the joint is stressed
    • normal firm end point is felt
    • local pain, mild point tenderness
    • slight swelling is present
  35. the degree of the sprain is based on the amount of laxity produced by the injury relative to the opposite limb: second degree sprain
    • partial tearing of the ligament fiber; results in joint laxity wehn ligament is stressed
    • a soft but definite end point is present
    • moderate pain
    • swelling
    • loss of the joint's function is noted
  36. the degree of the sprain is based on the amount of laxity produced by the injury relative to the opposite limb: thrid degree sprain
    • the ligament has been completely ruptured; causing gross joint laxity and instablility
    • an empty or absent end point
    • swelling
    • pain may be limited secondary to tearing of the local nerves
    •  complete loss of function to the joint
  37. the dissassoication of the joints articulating surfaces caused by forces that rupture many of the joints soft tissue restraints:
    joint disslocation

    • obvious deformity
    • assess distal vascular and nerve supply
    • open disslocations protrude through the skin
    • reduction should be performed by individuals who are trained ASAP
  38. subtle, chronic instablility, joint surfaces that partially separate, to a joint that dislocates and spontaneously reduces:
    joint subluxation

    • stretching/tearing of the joint capsule/ligaments and bony fxs must be suspected
    • 1st time subluxation should be evaluated by a physician
    • apprehension response: pt. displays anxiety or muscle guarding against a specific motion that may cause subluxation
    • may report the joint "giving away"
  39. inflammation of the joints capsule:
    synovitis

    • occurs secondary to existing inflammation that spreads to the synovial membrane
    • synovial membrane: membrane linging a fluid-filled joint
    • pt. tends to hold joint in a position that appleis the least amount of stress on the capsules fibers
    • pain occurs throughtout entire joint; aching at rest; increased with activity
    • "boggy" swelling
  40. bacterial infection on the skins connective tissue:
    cellulitis

    • signs/symptoms: edema, redness, tightening of the skin, no outward leakage of pus
    • immediately refer to a physican antibotics; possible hospitalization
  41. cartilage located on the articular surface of bones, especially suited to withstand compressive and shearing forces:
    hyaline cartilage

    • actutely injured or degenerative changes
    • irreversible
    • sigsn/symptoms: chronic joint pain, dysfunction
    • a # of surgeries on the knee; the cartilage is gone
  42. gradual softening of underlying bones
    osteochondral defects

    • partial-thickness: outer layer of the articular cartilage
    • full thickness: expose the underlying bone; symptomatic
    • juvenile (younger than 15)/ adult (older than 15)
  43. the boney fragemnt may be stable within the joint or free floating within the joint capsule:
    osteochordritis dessicans

    signs/symptoms: pain, loss of ROM, decreased fxn, "joint locking"
  44. local and temporary defeincy of blood supply caused by the obstruction of blood flow to a body area:
    ischemia
  45. the degeneration of a joints articular surface:
    arthritis

    • osteoarthritis is most common type found in athletes
    • affects weight bearing joints
    • chief complaint of pain during joint motion
    • chronic has unremitting pain, and  inablitily to function
  46. a systemic autoimmune condition that affects the articular cartilages of multiple joints:
    rheumatoid arthritis

    juvenile rheumationd arthritis: unexplained joint pain and swelling
  47. Salter-Harris Classfication of Epiphyseal injuries: type l


    fracture extends through the physis, seperating the two segments. common in infants
  48. Salter-Harris Classfication of Epiphyseal injuries: type II



    fracture starts through the physis and ends on the shaft, creating a displaced wedge
  49. Salter-Harris Classfication of Epiphyseal injuries: Type III


    the fx line extends perpendicullary through the joint surface and then transversely across the physis, resulting in partial displacement of the segment. growth of the involved phsis may be comprimsed.
  50. Salter-Harris Classfication of Epiphyseal injuries: type IV



    • similar to a type III fx; but the transverse fx line extends across the physis into the shaft.
    • surgical fixation is often required and physeal growth may be affected
  51. Salter-Harris Classfication of Epiphyseal injuries: type V



    • a crushing injury that compresses the physis.
    • if undetected avascular necrosis may occur and growth may be inhibited
  52. death of cells secondary to lack of an adequate blood supply
    avasuclar necrosis
  53. growth of extraneous bone at site of stress:
    exostosis

    • occurs as a stress reaction from injury or from irregular forces placed on the bone
    • signs/symptoms: painful, may limit movement
  54. an inflammatory condition involving a bone's growth plate:
    apophysitis

    • tightness of muscle or reptitive forces applied to the bone
    • muscles can result in inflammation/seperation of these areas from the rest of the bone
    • "growing pains"
  55. fractures that fail to heal within 9 months of the expected time required:
    nonunion fx
  56. healed fxs that leave the bone in a functionally unaccpetable position are called:
    malunion fx
  57. terminology used to describe the fracture location: diaphyseal fx


    involve only the bone's diaphysis and are assoicated with a good prognosis for recovery, barring any extenuating circumstances
  58. terminology used to describe the fracture location: Epiphyseal fx
    • fx line corssing the bone's unsealed epiphyseal line
    • can have long term consequences by disrupting the bones normal growth.
    • fx may mimic soft tissue injuries by resembling joint laxity during stress testing
  59. terminology used to describe the fracture location: articular fx
    • disrupts the joints articular cartilage
    • if improperly healed results in pain, decreased ROM, arthritis in the joints

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