Ephe 344 Joint & Ab Injuries

Front 1

Diarthroidial / Synovial joints (5)

Back 1

1. Freely moveable joints supported by ligaments

2. Enclosed by a thick fibrous capsule, intra- and extra-capsular ligaments limit accessory movements

3. Capsule lined with synovial membrane

4. Articulating bone surfaces covered with hyaline cartilage

5. Joint spaces contain synovial fluid

Front 2

What determines the type of movement at a joint? (1)

Back 2

The shape of the joint surface

Front 3

How is stability determined at a joint?

Back 3

By the congruency of the articulating surfaces

Front 4

What type of joint is the shoulder and the stability of it?

Back 4

Shallow ball and socket

Poor static stability relies on dynamic stability (i.e. muscles)

Front 5

What type of joint is the hip and the stability of it?

Back 5

Deep ball and socket

High static stability

Front 6

What type of joint is the knee and the stability of it?

Back 6

Hinge joint

Poor static stability, relies on substantial ligament and muscle control

Front 7

Most common joint injuries? (4)

Back 7

Dislocation / subluxation (deformity)

Joint Sprains (ligament, capsule)

Bursitis (trauma / overuse)

Cartilage (pop or locking and give way)

Front 8

Joint dislocation - difference between complete and partial?

Back 8

Complete - dislocation, luxation (fully out)

Partial - subluxation (pops out and pops back in on its own)

Front 9

What joints are more susceptible to dislocations? Fractures?

Back 9

Highly mobile joints to dislocation (shoulder, patella)

Highly stable joints to fractures (ankle, fingers, hips)

Front 10

Dislocation results in

Back 10

Damage to the surrounding joint capsule and ligaments

Possible osteochondral fracture and or chondral lesions

Front 11

How to recognize a dislocation? (5) Subluxation? (3)

Back 11

Dislocation - deformity, loss of function, hemorrhage, pain, loss of strength

Subluxation - history, pain, may strain muscle or sprain ligaments stabilizing joint

Front 12

How to manage dislocations / subluxations (5)

Back 12

Stabilize with splint

Ice

Refer

Do not relocate

Assess strength and ROM

Front 13

Joint sprain grade 1 (6)

Back 13

- Traumatic injury to the joint capsule involves intra and extra capsular ligaments

- Joint loaded in tension / shear

- May only be a few fibers damaged

- 0 instability, 0 haemarthrosis

- Full ROM, function

- Pain at end range and palpation

Front 14

Moderate Grade II Joint Sprain (6)

Back 14

- Large number of fibers damaged

- Disruption of joint capsule

- Slight instability

- Restricted ROM

- Haemarthrosis (bleeding in joint spaces)

- Loss of function

Front 15

Grade III Joint Sprain

Back 15

- Gross instability

- No end feel with accessory movement

- Empty end feel

- Haemarthrosis

- Gross loss of function

Front 16

Joint Capsule is made up of? (5)

Back 16

Blood vessels and nerves

Synovial membrane

Joint ligaments

Intra-capsular

Thickenings on inside of capsule provide aditional strength in certain direction

Front 17

Function of joint capsule and ligaments

Back 17

- Stabilization, prevent abnormal and excessive movement when bony configuration is insufficient to provide adequate stability

- Movements beyond normal, passive range

Front 18

What happens when tension is placed on the ligament (role of proprioception)

Back 18

Reflexive muscle contraction prevents overstretching of ligaments

Front 19

Inadequate ligaments? (role of proprioception)

Back 19

- abnormal joint movements, excessive mechanical stress, excessive joint wear

Front 20

Flexibility training (role of proprioception)

Back 20

stretched ligaments and/or capsule, decreased ligament stability, abnormal movements between joint surfaces

Front 21

What is the articular disc?

Back 21

An additional fibrocartilaginous disc between the articular surfaces

(knee - menisci)

Front 22

Function of articular disc?

Back 22

Improve congruity between joint surfaces, increasing stabilization

Absorb shock

Spread compressive load

Front 23

Bursa, what is it and its function, how you can injure it, and what an injury looks like? (4)

Back 23

Fluid filled sac that decreases friction between muscle / tendon and bone

Overuse or trauma

Swelling, pain, loss of function

Front 24

Where are the major bursa located?

Back 24

Knee, hip, elbow, shoulder

Front 25

Treatment for bursitis?

Back 25

Tests for imbalances that may be the cause

History of repetitive tasks

Ice, progressing activity, correct imbalances

Front 26

From what do abdominal injuries occur and what are they? (2)

Back 26

They are superficial muscle injuries or deeper internal organ injuries

Direct force to the anterior, lateral, or posterior abdominal wall

Front 27

Is the level of pain and the reaction to palpation indication of the severity of the injury?

Back 27

NO

Front 28

When do you assume internal trauma and hemorrhage?

Back 28

After a blow to the abdominal with hypovolemia and tachycardia

Front 29

What is hypovolemia and tachycardia?

Back 29

Hypovolemia - decreased blood volume

Tachycardia - Increased resting HR

Front 30

Liver contusion from what, what ribs, what quadrant, where is pain referred to?

Back 30

Direct blow to right side lower ribcage

Maybe fractures to 7, 8, 9th ribs anterior or lateral

Right upper quadrant

Pain referred to right shoulder / scapula

Front 31

Liver contusion symptoms? (4)

Back 31

Hypovolemic shock, cardiac distress, shortness or breath, tachycardia

Front 32

Spleen injury, what ribs, what quadrant, pain referred where? onset of pain?

Back 32

9th and 10th ribs, left upper quadrant, pain to left shoulder region, onset 1-2 hours

Front 33

Symptoms of ruptured spleen and factor to consider?

Back 33

Hypovolemic shock, cardiac distress, tachycardia, careful with athletes recovering from mononucleosis

Front 34

Kidney contusion: what area, what ribs, what kind of blow?

Back 34

Lower flank area (lumbar), ribs 11 and 12, relatively soft blow

Front 35

Symptoms of kidney contusion?

Back 35

contusion, hematuria, hypovolemic shock, cardiac distress, tachycardia, deep abdominal breathing and resulting flank pain

Front 36

Bowel rupture: common or rare? From what kind of injuries? Vulnerable when?

Back 36

Is rare from blunt trauma, usually from penetrating injuries, vulnerable if disturbed with food contents

Front 37

Bladder contusion: blow to where, occurs when, pain in what quadrant, what symptoms? When is it a bladder rupture?

Back 37

Blow to lower quadrant when bladder distended with urine, pain in lower quadrant, hematuria, hypovolemic and cardiac distress

Bladder rupture - urinary urgency but unable to void

Front 38

Scrotal contusion: from what, when is their rupture? When to refer?

Back 38

Direct blow to testicles contusion or rupture

Rupture and massive swelling requires surgery

refer if increasing or unresolved pain after 15 minutes

Front 39

Rectus abdominus hematoma: how to tell?

Back 39

Rapid onset of pain and hematoma

Maybe visible swelling

Disabling pain and muscle spasm

Have to sit, SOB,

Front 40

Managing a rectus abdominus hematoma

Back 40

ice and rest, avoid exertion

Front 41

Hernia, what is it, result from, how to treat it?

Back 41

Protusion of abdominal viscera through portion of abdominal wall

From violent activity or strain

Pressure and seek medical attention

Front 42

Hernia signs and symptoms: (4)

Back 42

- Previous history of a blow or strain to groin area

- Bulge in lower abdomen

- Superficial protrusion in the groin area that is increased by coughing or exertion

- Weakness and pulling in groin

Exercise not effective at reducing