By Monica Kesson MSc Grad Dip Phys MCSP Cert Ed Cert FE, Elaine Atkins DProf MA Grad Dip Phys MCSP Cert FE
ISBN-10: 0750655631
ISBN-13: 9780750655637
A realistic textbook on orthopaedic drugs, this whole reference resource offers the main up to date principals and perform in orthopaedic drugs for college kids, postgraduates scholars and scientific practioners.* New color structure * Evidence-based technique * Injection thoughts and handbook innovations incorporated * largely illustrated
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Extra resources for Orthopaedic Medicine: A practical approach (2nd Edition)
Sample text
Therefore tissues which are subjected to high tensile forces, such as tendons and ligaments, have a low proteoglycan concentration (Levangie & Norkin 2001). The concentration of GAGs present in tissues is related to their function and gives connective tissue structures viscous properties. More water is associated with a higher GAG concentration and rabbit ligamentous tissue has a significantly greater water content than that in rabbit tendinous tissue (Amiel et al 1982). This increase in GAG and water content alters the viscoelastic properties and may provide the ligament with an additional shock-absorbing feature that is unnecessary in most tendons.
In late arthritis, bony changes may occur, leading to a genuine hard end-feel and crepitus associated with advanced arthritis, as well as that arising from involuntary muscle spasm and capsular contracture. An abnormal springy end-feel is associated with mechanical joint displacement, usually a loose body. The sensation imparted to the examiner is one of not quite getting to the end of range, with the joint springing or bouncing back. It is similar to the sensation of trying to close a door with a small piece of rubber or grit caught in the hinge which causes the door to spring back.
The involuntary muscle spasm, in protecting the painful, inflamed joint, prevents the use of the painful range of movement and if the range of movement is underused it will become limited. In arthritis, the individual joints resent some movements more than others, hence the capsule contracts disproportionately, making some movements more limited than others and giving rise to the characteristic pattern of limitation. For example, in the study conducted by Eyring & Murray the position of minimum pressure for the elbow was found to be between 30° and 70° of flexion.
Orthopaedic Medicine: A practical approach (2nd Edition) by Monica Kesson MSc Grad Dip Phys MCSP Cert Ed Cert FE, Elaine Atkins DProf MA Grad Dip Phys MCSP Cert FE
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