quiz #2- general treatment guidelines

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BPT
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72348
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quiz #2- general treatment guidelines
Updated:
2011-03-11 22:20:33
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hphp
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tissue healing
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  1. How is the severity of tissue injury measured?
    • grade I
    • grade II
    • grade III
  2. What are the characteristics of a Grade I tissue injury?
    • mild pain at time of injury or within 24 hours
    • mild swelling, local tenderness, and pain when tissue is stressed
  3. What are the characteristics of Grade II tissue injuries?
    • moderate pain that requires stopping of activity
    • stress and palpation increases pain
    • for ligaments, some fibers torn with increased joint mobility
  4. What are the characteristics of Grade III tissue injuries?
    • near complete or complete tear or avulsion with severe pain
    • stress to tissue is painless
    • if ligament then instable
  5. What are the three stages of healing?
    • Acute
    • Subacute
    • Chronic
  6. What are characteristics of the acute stage of healing?
    • vascular changes
    • exudation of cells and chemicals
    • clot formation
    • phagocytosis
    • early fibroblastic activity
  7. What is a clinical sign of the acute stage of healing?
    inflammation
  8. What are the goals during the acute stage of healing?
    • control inflammation and pain
    • decrease muscle guarding
    • maintain function of uninvolved areas
  9. What are common treatment tactics during the acute stage of healing?
    • PRICE
    • intermittent muscle setting
    • PROM within pain free ROM and outside plane of injury
    • massage with caution
    • modalities to decrease pain and swelling
    • gentle joint play
  10. What is a precaution and contraindication during the acute stage of healing?
    • precaution: no movement should increase pain or inflammation
    • contraindication: active movements at point of pathology
  11. What are characteristics of the subacute stage of healing?
    • removal of noxious stimuli
    • growth of capillary beds into area
    • collagen formation
    • granulation tissue
    • very fragile so easy to injure
  12. What are clinical signs of the subacute stage of healing?
    • decreasing inflammation
    • pain synchronus with tissue resistance
  13. What are the goals of treatment for the subacute stage of healing?
    • decrease pain and guarding
    • increase ROM and strength
    • muscle re-education
    • promote a functional, mobile scar
  14. What are the treatment methods in the subacute stage of healing?
    • decrease support from assistive devices
    • progress from low intensity --> sub-max isometrics at one angle --> sub max isometrics at multiple angles --> max isometrics at 1 angle --> max isometrics at multiple angles
    • progress from no motion -->short arc --> full ROM (then add mild resistance)
    • progressively lengthen injured tissue
    • joint mobilization with pain limits
    • deep friction massage
  15. What are precautions during the subacute stage of healing?
    • forceful manipulations
    • agressive stretching
  16. What are signs and symptoms of over activity?
    • increase pain
    • decreased motion
    • excessive fatigue
    • muscle spasm
    • loss of strength
    • increased swelling or inflammation
  17. What are characteristics of the chronic stage of healing?
    • maturation of connective tissue
    • contracture of scar tissue
    • remodeling of scar
    • collagens aligns to stress
  18. WHat are clinical signs of the chronic stage of healing?
    • absence of inflammation
    • pain after tissue resistance
    • function limited by muscle weakness, poor endurance or poor neuromuscular control
    • can last 6-12 months
  19. What are the goals of the chronic stage of healing?
    • increase strength and motion
    • normal muscle balance
    • pain frree
    • return to full function
  20. What are the treatment methods for the chronic stage of healing?
    • mobilize any adhesions
    • aggresive stretching and mobilizations
    • continue strength training
  21. What are indications for musculoskeletal surgery?
    • acutre traumatic rupture of muscle, tendon, ligament, cartilage
    • severe chronic joint destruction from RA, OA, or arthritis
    • correction of congenital or idiopathic defect
  22. What are some adverse effects of surgery?
    • intubation and anesthesia
    • risk for pulmonary infection
    • post-op infection or vascular disorders (DVT, PE)
    • delayed healing of soft tissue and bone
    • adhesions and contractures of soft tissue and joints
  23. What are some post-op problems?
    • pain
    • edema
    • increased risk for pulmonary or circulatory problems
    • increased risk for joint stiffness or loss of motion
    • increased risk of muscle atrophy
    • loss of strength and mobility
  24. What are some general guidelines for the healing process?
    • respect healing process
    • go from submax to max
    • no motion --> mid range --> full ROM
    • want to overload, NOT overwhelm

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