Chapter 4 Notes
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This 7 page Class Notes was uploaded by Danielle Francy on Monday September 26, 2016. The Class Notes belongs to KNES 315 at Towson University taught by Gail Parr in Fall 2016. Since its upload, it has received 2 views. For similar materials see Care and Prevention of Athletic Injury in Kinesiology at Towson University.
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Date Created: 09/26/16
Chapter 4 Notes Injury Mechanism and Classification of Injury Muscle Cramps and Spasms: ● Involuntary contraction. ● Cramp: ○ biomechanical imbalance (dehydration) associated with muscle fatigue ○ Painful ○ Types: ■ Clonic ● Alternating contraction/relaxation ■ Tonic ● Constant ● Spasm: ○ reflex reaction in response to trauma. Tendinitis: ● Inflammation of a tendon. ● Related to aging and degenerative changes. ● ****Anything ending in “-itis” is an inflammation. Myositis Ossificans: ● Calcium hardens and creates a new bone. ● Grows within the muscle . ● Hard to diagnose. Tenosynovitis and Myositis Ossificans: ● Inflammation of the tendon sheath. ○ Acute ■ Rapid onset, crepitus, local swelling . ○ Chronic ■ Same as acute, thickened tendon, nodule formation in the sheath. Overuse Injuries: ● Factors: ○ Intrinsic ■ From within ■ Ex: malalignment of limbs, muscular imbalances, other anatomic factors. ○ Extrinsic ■ External ■ Ex: training errors, faulty tech. ● Classification: 4 Stages are based on pain and dysfunction ○ Pain after activity only. ○ Pain during activity; doesn’t restrict performance. ○ Pain during activity; restricts performance. ○ Chronic, unremitting pain, even at rest. Diarthrodial Joints: ● Articulation of two bones ● Classified by structure and function ● Freely moveable joints ● Components: ○ Articular cartilage ○ Joint (synovial) activity ○ Synovial fluid ○ Reinforcing ligaments ■ Intrinsic or extrinsic Articular Cartilage: ● Ends of bones covered by hyaline cartilage. ● Solid type of connective tissue. ● More resistant to deformation than fibrous connective tissue and more resilient than bone. ● No blood supply; nourished by synovial fluid. Articular Capsule: ● Cuff of fibrous tissue ○ Primarily bundles of collagen. ● Primary function holds bones together. ● Muscle fibers Synovial Membrane: ● Inner layer of articular capsule ● Produces synovial fluid ○ Lubricate joint ○ Reduce friction ○ Nourish joint Ligaments: ● Bone to bone ○ Intrinsic or extrinsic ● Maintain anatomical integrity and structural alignment. ● Collagen and elastin intermixed (contain elastin-more elastic than tendons). ○ Viscoelastic ● Arrangement of collagen ○ Resists large tensile loads along the long axis of the ligament and smaller loads from other directions. ● Static stabilizers ● Fail in fast loading situations. ● Limited blood supply. Joint Cavity: ● Space-permits movement ● Filled with synovial fluid Classifications of Diarthrodial Joints: ● Plane ● Hinge ● Pivot ● Condyloid ● Saddle ● Ball-and-Socket Sprain: ● Injury to a ligament ● Comprises the ability of the ligament to stabilize the joint ● MOI: ○ Tensile force Dislocations and Subluxations: ● Joint forced beyond normal limits ● MOI: ○ Tension ● Dislocations: ○ Displacement and no return; bones stay out of place ● Spontaneous reduction ● Subluxations: ○ Partial displacement and return to normal ● Increased susceptibility for chronic or recurrent dislocations ● STS: ○ Pain ○ Swelling ○ Point tenderness ○ Deformity ○ Loss of limb ● Susceptibility for chronic or recurrent dislocations Osteoarthritis: ● Degeneration of articular cartilage ● STS: ○ Pain ○ Limited movement ● No definitive cause, rather, several contributing factors. ● Stronger muscles, stronger protection Bursitis: ● Inflammation of bursa ● Acute or chronic ● Fluid filled sac ● MOI: ○ Compression ● STS: ○ Localized swelling ○ Point tenderness ○ Warm to touch Anatomy of Bone: ● Primary constituents ○ Calcium carbonate ○ Calcium phosphate ○ Collagen ○ Water ● Structure ○ Diaphysis (shaft) ○ Epiphysis (long ends) ○ Membranes ■ Periosteum (covers the bone; life support system to bone) ○ Medullary cavity (old bone absorbed) ● Apophysis ● Bone growth ○ Longitudinal ■ Continues until epiphysis closes ○ Diameter ■ Continues until epiphysis closes ○ New bone formed via the periosteum; bone is resorbed around the medullary cavity. ■ Osteoblasts ● Form new bone ■ Osteoclasts ● Resorb bone ○ Composition ■ Cortical ● Compact bone tissue of high density (low porosity) ● Outside ● Can withstand greater stress but less strain ■ Cancellous ● Bone tissue of low density (high porosity) ● Inside ● Can tolerate more strain Stress fracture: ● MOI: ○ Repeated lower magnitude forces ○ Can become worse over time ○ Begins as a small disruption in the outer layers of cortical bone and ending as complete cortical fracture with possible displacement. Osteopenia: ● Reduced bone mineral density ● Predisposes individual to fracture ○ Particularly stress fractures ● Possible causes: ○ Amenorrhea, hormonal factors, dietary insufficiencies. Classification of Epiphyseal Injuries: ● Osteochondrosis of apophysis ● Idiopathic or traumatic avulsion fracture ● Ex: ○ Sever’s disease ○ Osgood-Schlatter disease Bone Injury: ● Fracture ○ Disruption in the continuity of bone ● Signs and Symptoms ○ Rapid swelling ○ Ecchymosis (black and blue color) ○ Deformity/shortening of the limb ○ Precise point tenderness ○ Grating or crepitus (rice krispies) ○ Guarding or disabilities ● Type of of fracture dependent upon: ○ Force applied ○ Health and maturity of the bone Anatomic Functions: ● Anatomic position ● Joint movement ○ Sagittal plane (front, back) ○ Frontal plane (left, right) ○ Transverse (cut in middle of torso horizontally) ● Directional terms ● Movement terms Mechanisms of Injury (MOI): ● How an injury occurs ● Components used to analyze MOI ○ Application of force ○ Tissue type ○ Severity of force Force: ● Push or pull acting on a body ● Causes: ○ Acceleration ○ Deformity ● Factors that determine injury: ○ Magnitude of force ○ Material properties of tissues involved ● Small load ○ Elastic response ● Large load ○ Plastic response ● Yield point ○ Load exceeds the ultimate failure point of the tissue resulting in mechanical failure. Anisotropic: ● Material is stronger in resisting force from certain directions than others. Mechanical Forces: ● Compression ○ Comes from the side ● Tension ○ Spreads vertically in both directions ● Shearing ○ Spreads left and right, horizontally Collagen and Elastin: ● Collagen ○ Primary component ■ Connective tissue ○ Protein substance ■ Strong in resisting tensile forces ○ Inelastic ■ But, wavy configuration allows for elastic type deformation or stretch. ● Elastin ○ Protein substance ○ Not as strong ○ Provides elasticity Injury Types: ● Acute ○ Single force ○ Definitive moment of onset ○ Macrotrauma ● Chronic ○ Repeated forces ○ More problematic over time (gradual onset) ○ Microtrauma ○ ‘-itis’ ***Ligaments do not contract ***Once a ligament is stretched beyond normal, it won’t come back ***Ligaments have more elastic because they have more ‘give’
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