Lower Extremities // Lecture 5 (Exam #1) Flashcards

• Atrophy
• Hypertrophy

Physical forces applied to the body as well as psychological, social, and emotional factors

Body+Tissues react to the stress forces placed on them in a predictable manner

Relative level of stress falls below the maintenance level

Duration and magnitude of the stress is progressively
increased

• History portion of clinical examination (patient describes what happened)
• Macrotrauma
• microtrauma

Occurs when a single force exceeds the
tissue’s failure point

Occurs with repeated submaximal forces over time, and the tissues are unable to adapt

• Longitudinal “tearing”
  stress
• Muscles, tendons,
  ligaments and fascia are
  prone
• Dynamic overload
  • Muscle is contracting
    eccentrically while an
    antagonistic force
    attempts to elongate
    the muscle.

1. tensile forces
2. compression forces
3. shear forces
4. torsion forces
5. direct blow

1. Muscles and tendons
2. Skin
3. Joint capsules
4. Ligaments
5. Nerve
6. Bursae

• Loss of motion
• Decreased strength
• Decrease volitional control
• Create joint instability

• Affects the muscle’s ability to generate or sustain tension
• Decreased force production
  • Secondary to pain

• Noncontact injuries of the
  musculotendinous unit
• Caused by
  • Tensile forces
  • Dynamic overload
    • Eccentric muscle contraction
    • (Example: Lowering a weight).

Inflammation of the
structures encased within
the tendon’s outer layer

• Degenerative condition
  • Little evidence of healing
• Most common at the bony attachment
• More prevalent than
  tendinitis (but often occur
  together)

• Repetitive tensile loading, compression, and abrasion of the working tendons
• insufficient rest periods = accumulation of themicrotrauma ==> tendon failure.

• A single force placed on the muscle, discrete tearing within the tendon or at the musculotendinous junction.
• area becomes the weak link
  • forces of otherwise normal
    activity are sufficient to cause further inflammation.

• redistribution of
  the forces around a joint, => new tensile loads, compressive forces, or wearing of the tendons.
• Ex. running on uneven terrain or using poor technique

• Soft tissue injuries resulting from direct blows
• Capillary bleeding and breakdown of hemoglobin
• Dark purple and blue
• Superficial bone contusions are more painful
• Eliminate underlying injuries
  • Fractures
  • Superficial nerve damage
• Treatment
  • Ice, gentle stretching, and padding

fluid-filled sacs that buffer tissues from
friction-causing structures to facilitate smooth motion

• inflammation of the bursae
• Caused by
  • Disease state
  • Increased stress
  • Friction
  • Traumatic force
• only palpable when inflamed

• Formation of bone within a muscle belly’s fascia
  • Occurs secondary to traumatic injury
• MRI—identifies intramuscular hematoma
  • Aspirate to restore function
• Commonly occurs in
  • Quadriceps femoris
  • Hip adductor group
  • Biceps brachii
• Can lead to compartment syndrome
• ROM is usually affected

• Result from trauma (contusions
  and fractures
• Considered medical
  emergency(absent pulse= immediate danger)

• exertional/recurrent
  compartment syndromes
• Occurs during exercise;
  muscles enlarge but
  compartment cannot expand
• Leg and forearm
  compartments common
  locations

• Pain, numbness, or paresthesia in the distal extremity

• Pain
• Pallor (redness)
• Pulselessness
• Paresthesia
• Paralysis

• Joint is forced beyond anatomical limits.
  • Stretching or tearing of ligaments or capsule
• Ligaments in capsule = produce more swelling.

1. First degree (little stretched, firm end-point, local pain+mild point)
2. Second Degree (partial tearing, joint laxity, softish, mod. pain+swelling)
3. Third degree (ruptured ligament, gross laxity, empty end point, complete loss of function)

• Disassociation of thejoint’s articulatingsurfaces
• Obvious deformity
• Open dislocation
  • Joint surfaces protrudethrough the skin.
• Joint reduction should beperformed ASAP

• Subtle chronic instability
• Joint surfaces that partially separate
• Joint that dislocates and spontaneously
  reduces

• Inflammation of a joint’s capsule
  • Secondary to existing inflammation thatspreads to the synovial membrane
    • Synovial membrane—membrane lining a fluid-filledjoint
• “Bogginess” within the joint
• Patient holds joint stressless position

• Result of bacterial infection on the skin’s connective tissue
• Immediately refer to a physician
  • Antibiotics
  • Possible hospitalization

• Edema
• Redness
• Tightening of the skin
• No outward leakage of pus

• Hyaline cartilage
• Found on the articular surface of bones (withstand compressive
  +shearing forces)
• Acutely injured or degenerative changes
• Irreversible, results in chronic joint pain

• Chronic joint pain
• Dysfunction

Result from trauma or softening of bone

• Affects patients younger than 15 years of age
• Adult—over 15 years of age

• Bony fragment—stable or free-floating
• Signs and symptoms
  • Pain
  • Loss of ROM
  • Decreased function
  • “Joint locking”

• Degeneration of a joint’s articular surface
• Osteoarthritis is most common type found in
  athletes
• Affects weight-bearing joints

• Autoimmune condition that affects the articular
  cartilage of multiple joints
• Joint appears to be hard and nodular

• (6 months–16 years of
  age)
• Unexplained joint pain and swelling
• Joint rashes and high fever

• Growth of extraneous
  bone at the site of
  stress
  • Stress reaction
  • Irregular forces
• Signs and symptoms
  • Painful
  • May limit movement

• Inflammatory condition
  involving a bone’s growth
  plate
  • Tightness of muscles or
    repetitive forces applied to
    the bone
  • Inflammation/separation of
    muscle and bone

• Muscular tissues fail
  to adapt to the new bone
  length
• apply increased
  stress to growth plate.

Fracture that fails to heal within 9 months of expected time required

Healed fractures that are in a medically
unacceptable position

• Tearing away of a
  ligament or tendon’s
  bony attachment
  • Forceful muscle
    contraction

• Obvious deformity
  • Tendon recoils
• Pain
• Tenderness

• Entrapment injuries
  
  • Common at ankle, elbow, wrist, and cervical spine
  • Entrapped by tissue or swelling

• Dysfunction
• Paresthesia
• Muscular weakness

• Trauma to nerves, arteries, and veins
• Caused by
  • Joint dislocations
  • Bony displacement
  • Concussive forces
  • Compartment syndromes
• Can lead to loss of affected body part or loss of function

• bone suspected to high, repeated submaximal stresses
• sudden changes to frequency, intensity, and duration

abnormally weak bones = subjected to normal forces