Deck 9: Ligament Healing

Question 1

In which phase of the ligament repair process does type III collagen transform to type I collagen,improving the stiffness of the ligament and increased tensile strength of the repair tissue?

A) Phase I
B) Phase II
C) Phase III
D) Phase IV

Answer 1

Phase IV

Question 2

What is the remodeling and maturation time for a ligament?

A) 4 weeks
B) 3 months
C) 6 months
D) 1 year

Answer 2

1 year

Question 3

Adhesion formation,active shortening of ligaments,deterioration in ligament strength,loss of bone,and weakening of cartilage and tendons can result from which physical therapy intervention?

A) Immobilization after injury
B) Active strengthening exercises
C) Isometric exercises in the initial healing period
D) Weight-bearing exercises in the initial healing period

Answer 3

Immobilization after injury

Question 4

Your patient has a grade III injury to a ligament.Which of the following actions will most likely be taken for this patient?

A) The ligament sprain will be treated with protective bracing and progressive rehabilitation
B) The ligament will be treated with protective bracing and appropriate strengthening to provide dynamic muscular strength
C) The patient will require surgical repair of the ligament
D) The patient will be treated with a knee support and physical therapy during the healing process

Question 5

Which is the correct order in which ligaments heal?

A) Remodeling,proliferation,inflammation,hemostasis
B) Hemostasis,inflammation,proliferation,remodeling
C) Inflammation,hemostasis,proliferation,remodeling
D) Hemostasis,inflammation,remodeling,proliferation

Question 6

Which heals faster with remobilization and exercise?

A) Ligament
B) Ligament-bone insertion complexes
C) Both at the same pace over time
D) Neither after injury

Question 7

In the therapeutic considerations during stages of ligament healing,what is the treatment for days 3-14?

A) RICE,pain management,and weight bearing as tolerated
B) RICE,active progressive motion,and protected active resistance exercise
C) RICE,low-load static stretches,full-weight bearing,isokinetic exercise
D) Prolonged low-load static stretching,and isokinetic and isotonic exercise

Question 8

If a patient has an isolated grade III medial collateral ligament (MCL)tear,which of the following actions would most likely be taken?

A) Surgery to repair the ligament
B) Protective bracing and comprehensive and progressive rehabilitation
C) Light brace support of the joint and crutch walking
D) None of the above

Question 9

When beginning progressive resistance exercises after MCL sprain,where would you place resistance (a weight)during adduction exercises?

A) At the ankle
B) Below the knee
C) Above the knee
D) Higher on the thigh

Question 10

If a patient has a grade III anterior cruciate ligament (ACL)tear,which of the following actions would most likely be taken?

A) Surgery to repair the ligament
B) Protective bracing and comprehensive and progressive rehabilitation
C) Light brace support of the joint and crutch walking
D) None of the above

Question 11

Which of the following influences the characteristic behavior of ligament substance?

A) Collagen composition
B) Proteoglycans and actions between the extracellular matrix and ground substance
C) Orientation of fibers
D) All of the above

Question 12

What is the effect of continuous passive motion (CPM)on the joint versus immobilization?

A) Immobilized joints produce adhesions and scar tissue
B) Both are excellent methods of healing ligaments
C) Joints that have CPM applied show no adhesions and well-organized longitudinally oriented collagen fibers
D) A and C

Question 13

In which phase of the repair process do the ends of the ligament retract and a hematoma forms between the damaged ends of the tissues?

A) Phase I
B) Phase II
C) Phase III
D) Phase IV

Question 14

Which condition is NOT required for a ligament to properly remodel or heal?

A) Torn ligament ends being in contact with each other
B) Progressive,controlled stress applied to the healing tissues to orient scar tissue formation
C) Complete immobilization during the healing process
D) Protection against excessive forces during the remodeling processes

Question 15

What happens to the ligament-bone complex during immobilization?

A) It remains unchanged during immobilization
B) It has some reduction in strength,which quickly returns after therapy begins
C) The ligament-bone insertion site becomes osteoporotic with bone resorption and reduced strength
D) The bone remains strong while the ligament repairs itself

Question 16

In the therapeutic considerations during stages of ligament healing,what is the treatment for days 60-360?

A) RICE,pain management,and weight bearing as tolerated
B) RICE,active progressive motion,and protected active resistance exercise
C) RICE,low-load static stretches,full-weight bearing,isokinetic exercise
D) Prolonged low-load static stretching,and isokinetic and isotonic exercise

Question 17

Which of the following are measures taken for the patient during the acute and subacute phases of rehabilitation after ligament injury or repair?

A) Pain management
B) Swelling reduction
C) Muscle reeducation
D) Active range of motion (ROM)
E) All of the above

Question 18

What does the acronym RICE stand for?

A) Repetition,incline,compress,energy
B) Rest,ice,compression,elevation
C) Raises,increase,core,elevation
D) None of the above

Question 19

How many weeks of immobilization does it take to produce thickening in the joint capsule,ligaments,and cartilage and decreased compliance resulting in stiffness?

A) 1
B) 2
C) 4
D) 6

Question 20

When beginning progressive resistance exercises after ACL surgery,where would you place resistance (a weight)during straight leg raises?

A) At the ankle
B) Below the knee
C) Above the knee
D) Higher on the thigh