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Flashcards in Part 2 and 3 Deck (221)
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1
Q

________ is most common in runners and cyclists with gene varum

A

Iliotibial band syndrome

2
Q

what is the characteristics for Iliotibial band syndrome

A

dull pain and clicking at the lateral femoral condyle

3
Q

what are the orthopedic tests for Iliotibial Band syndrome

A

Ober’s

Noble

4
Q

whats the most efficient treatment for iliotibial band syndrome

A

stretch the tensor fascia lata

strengthen the vastus medals obliquis

5
Q

Facet Syndrome is known to have a ____ pain pattern

A

Sclerotomal (referred)

6
Q

what is the sensory distribution of facet syndrome

A

diffuse deep poorly localized

  • local over the gluteals and anteriorly into the groin
  • rarely below the knee
7
Q

T/F

facet syndrome will have motor changes in the patient

A

False

8
Q

T/F

facet syndrome will have decrease reflex response in the patient

A

false

no changes

9
Q

what is the x- ray view of choice to rule in or out facet syndrome

A

lateral lumbar

10
Q

which 2 x ray measurements are used for facet syndrome

A

mcnabbs

Hadley’s

11
Q

what is the best management for facet syndrome

A
  • reduce lumbar lordosis
  • Pelvic tilt
  • wiliam exercises
12
Q

IVF Encroachment AKA

A

lateral recess stenosis

13
Q

T/F

Lateral recess stenosis is know for a sclertomal pain pattern

A
false 
dermatomal (radicular)
14
Q

what is the sensory distribution of pain for lateral recess stenosis

A
  • sharp radicular, well define

- distinct dermatomal pattern (peripheralization)

15
Q

what type of motor changes are seen with IVF encroachment

A

atrophy

weakness

16
Q

What are types of reflex changes with lateral reflex stenosis

A

Hypo-reflexia to absent

17
Q

What is the view to take for lateral recess stenosis

A
  • lateral=lumbar

- Oblique=Cervicals

18
Q

What is IVF encroachment usually due from

A

DJD (chronic and progressive)

19
Q

what are the orthopedic tests called when testing for lateral epicondylitis

A
  • Cozens

- Mills

20
Q

which muscle is commonly involved with lateral epicondylitis

A

Extensor carpi radialis

21
Q

what are the treatments for lateral epicondylitis

A
  • transverse friction massage
  • Ultrasound
  • Brace the wrist NOT the elbow
22
Q

An Avulsion fracture at the ASIS is due to which muscle

A

sartorius

23
Q

Avulsion fracture to the AIIS is due to which muscle

A

rectus femoris

24
Q

Biceps femurs can cause an avulsion fracture to what area

A

Ischial Tuberosity

25
Q

the hip adductors can cause an avulsion fracture to what area

A

Pubis

26
Q

which muscle is most common to atrophy first with a knee injury

A

vastus medialis

27
Q

Vastus medials is _______

A
  • most important muscle in the knee
28
Q

Heel strike uses what muscle

A

rectus femoris

29
Q

foot flat uses what muscle

A

foot dorsiflexors
quads
gluteus medius and maximus

30
Q

Kush off/toe off uses what muscle

A

gastrocnemius

soleus

31
Q

Autoimmune diseases is most common in _____

A

females 20-40 yrs

32
Q

a fibrotic, degenerative inflammation affecting the skin, muscles, cardio-vascular system and viscera is called what

A

Scleroderma

33
Q

what are the signs and symptoms of scleroderma

A
poly-arthralgia
G-I, renal and cardiopulmonary disturbances
calcinosis
Raynaud's (acro-osteolysis)
esophageal dysfunction
sclerodactyl 
Telaniectsia -spider veins
(CREST syndrome)
34
Q

A syndrome characterized by joint and myofascial pain , morning fatigue, headaches, anxiety and disturbed sleep.

A

Fibromyalgia

35
Q

what is the treatment for fibromyalgia

A
rest
heat (no cryotherapy) 
massage 
ROM exercises 
psychotherapy
36
Q

a diffuse inflammatory disorder of striated muscle resulting in symmetrical muscle weakness of PROXIMAL limbs and trunk … affects females 40-60 yrs

A

Polymyotisis

37
Q

Polymyositis affects females ____> males

A

2x

38
Q

what are the sings and symptoms for polymyositis

A
  • motor disability
  • muscle tenderness
  • pain
  • dysphagia
  • heliotropic rash of eyelids
    G-I and skin manifestations
39
Q

what are the lab findings for Polymyositis

A
  • increase aldoase
  • CPK
  • SGOT
  • creatinuria
40
Q

an auto-immune disorder characterized by xerophthalmia( keratoconjunctivitis sicca) xerostomia and rheumatoid arthritis. Primarily affects females 9:1 ages 40-60

A

Sjorens

41
Q

what are the lab findings with sjorens

A

rheumatoid factor (zero-positive)
leukopenia
eosinophilia
anti-RNA

42
Q

Sjoren disease may be associated with what other disorders

A
  • RA
  • SLE
  • -Polymyositis
  • Felty’s syndrome
  • Hashimoto’s syndrome
43
Q

a seronegative arthritis with inset before age 17.

A

Still’s disease ( juvenile arthritis)

44
Q

signs and symptoms for Still’s disease

A
  • intermittent fever
  • salmon colored macular rash
  • polyarthritis
  • arthralgia - affecting the apophyseal joints of the upper cervicals
    tenosynovitis
    pericarditis
45
Q

a chronic inflammatory disorder of connective tissue.

A

Systemic Lupus Erythematosus

46
Q

Signs and symptoms for SLE

A
  • exacerbations and remissions
  • migratory joint pain of the hands and feet
  • non- pruritic scaling erythema of the face
  • photosensitivity
  • vasculitis
    visceral (cardiopulmonary and renal manifestations
47
Q

what are the lab findings of SLE

A

ANA
anti- DNA
LE cell

48
Q

Cubitus Varus (elbow)

A

gunstock deformity

49
Q

Cubitus Valgus (elbow)

A

increased carrying angle

50
Q

ulnar deviation

A

Carpus varus/ RA

51
Q

Radial deviation

A

carpus valgus/ Madelung’s deformity

52
Q

coxa varus

A
knock knee ( femoral angle < 120 
affects gluteus medium and minimus
53
Q

coxa valgus

A

femoral angle >130

bow legs

54
Q

Gene varus

A

bow legs

55
Q

gene valgus

A

knock knee

weak gluteus medius, minimus

56
Q

talipes varus

A

inverted ankle

57
Q

talipes equinus

A

plantar- flexion deformity

58
Q

talipes valgus

A

everted ankle

59
Q

talipes calcaneus

A

dorsiflexion deformity

60
Q

pes planus

A

flat foot

61
Q

pes Cavus

A

high arch

62
Q

___% of structural scoliosis is idiopathic

A

70

63
Q

infantile scoliosis is between what age

A

0-3 yrs

64
Q

Juvenile Scoliosis

A

3-10 yr

65
Q

adolescent scoliosis

A

10-16 yrs

66
Q

which age group of scoliosis is considered the most important, most progressive, associated with menses, has Risser;s sign

A

adolescent

67
Q

what is the management for < 20 scoliosis

A
conservative tx 
- manipulation
- heat 
- massage 
- exercise 
Bracing is not indicated 
- re-examine 4x a year 
- re-xray  2x year  for 2-3 years after skeletal maturity
68
Q

what is the management for scoliosis that is > 20 + 1 a month

A
  • refer for bracing
  • milwakkee , visser bracing ( 23hr/day)
  • Blount’s exercises for flexibility
69
Q

what is the management for a scoliosis that is > 50

A

surgery

70
Q

a scoliosis that is > ___ may cause cardio-pulmonary problems

A

60

71
Q

what is the measurement for lumbar canal stenosis

A

,15mm (eisenstiens method)

72
Q

what is the measurement for interpedicular distance that will be considered stenosis

A

<26mm

73
Q

what is the best view for the GH joint and labrum

A

baby arm view

74
Q

what is the default view for the greater tuberosity , rotator cuff calcification

A

external rotation

75
Q

a condition of the thoracic spine typically seen in adolescents (13-17) and characterized by schmorls nodes, anteriorly wedged vertebrae, decreased disc spaces, increased dorsal kyphosis

A

scheurermenn’s disease

76
Q

what is the common age for scheuermenns

A

13-17

77
Q

what is th sign and symptoms of scheuermenn’s

A
  • back pain
  • fatigue
  • painless DJD
  • Hyper-kyphosis
  • postural stress
78
Q

the aka of scheuermenns

A

Juveniles Kyphosis Dorsalis

79
Q

what is the best exercises for all shoulder problems

A
  • Codman’s exercise
80
Q

what are the 3 different codman exercise

A
  • pendulum
  • broomstick
  • wall climbing
81
Q

Passive ROM exercises for most shoulder problems : sub-acromial bursitis, rotator cuff tendinitis, frozen shoulder and impingement syndrome

A

Codmans

82
Q

External Rotation is good what views of the shoulder

A

greater Tuberostiy
rotator cuff calcification
subacromial bursitis

83
Q

The baby arm view of the shoulder is good for which landmarks

A

GH

Labrum

84
Q

CBC count is good to order for ____

A

anemia

85
Q

Erythrocyte count

A

4.0-6.0 mm

86
Q

Hemoglobin count

A

15 grams

87
Q

Hematocrit count

A

35%-55%

88
Q

Sedimentation Rate:

A

<15-20 mm/hr

89
Q

Platelet count

A

150,000-350,000 mm (aka thrombocytes)

90
Q

Normocytic/ Normochromic

A

acute hemolysis/ hemorrhage, aplastic/ hypoplastic

91
Q

Microcytic/ Normochromic

A

lead poisoning, infection, liver disease, malignancy

92
Q

microcytic/ Hypochromic

A

iron deficiency

93
Q

Macrocytic/ Normochromic

A

vitamin B12/ folic acid deficiencey, pernicious anemia

megaloblastic anemia.

94
Q

Normal White blood cell count

A

5,000 to 10,000mm

95
Q

Neutrophils is _ % of the white blood cells and their main function is to _____

A
  • 60

- acute bacterial infections , inflammatory disorders

96
Q

Lymphocytes is ___ % of the white blood cells and the main function is ____

A
  • 30 %
  • viral infections
  • chronic inflammation
97
Q

Monocytes is ___ % of white blood cells and the main function is ____

A

8%

- phagocyte for large particles (dust,fungi)

98
Q

Basophils is _% of white blood cells and the function is ____

A
  • 0%

- produce histamine and herapin

99
Q

Eosinophils is __% of white blood cells and the function is ___

A
  • 2%
  • allergies
  • asthma
  • parasitic infections
100
Q

C- Reactive Protein (CRP) is what

A

an abnormal protein seen in tissue inflammation or destruction

101
Q

Erin tests are most appropriate for what

A
  • diabetes or kidney disease
102
Q

Normal values for urine test ( volume, specific gravity and pH)

A
  • volume - 800-2000ml/24hours
  • Specific gravity - 1.010-1.030
  • pH- 4.6-8 (avg 6)
103
Q

Squamous epithelial cells in a urine test is considered a disease of some kind

A

false

normal

104
Q

hyaline cast are shown in urine when there is renal disease

A

false
- non-specific
seen in concentrated urine and in one that exercised a lot

105
Q

WBC casts in urine determines what

A
  • glomerulonephritis

- pyelonephritis ( form of infection)

106
Q

RBC casts in urine determines what

A
  • glomerulonephritis
107
Q

epithelial casts in urine determines what

A
  • glomerulonephritis
108
Q

with glomerulonephritis what type of casts are usually seen in the urine

A
  • WBC casts - RBC casts - epithelial casts
109
Q

waxy casts in urine determines what

A
  • chronic renal disease
110
Q

Organ panels are good to determine ___

A

which organ is bad

111
Q

with a patient that has had an heart attack , what will show up in the organ panel

A
  • AST (SGOT)
  • LDH
  • CPK
  • HBDH
  • potassium
112
Q

patient with prostate cancer , what panels will show up

A
  • acid phosphaatase
  • alkaline phosphatase
  • PSA
113
Q

What is shown with someone that has had muscle damage

A
  • AST
  • CPK
  • creatine
  • Creatinine
  • LDH
114
Q

what are the 3 types of CPK and which ones are they related to

A
  • CPK1- Brain
  • CPK2 - heart
  • CPK3- Muscle
115
Q

CPK3 is seen in what conditions

A
  • Polymyositis

- MS

116
Q

muscle tension with no change in muscle length . the strength is specific to the angle at which the exercise is performed

A

Isometric

117
Q

____ exercises is good to perform after passive exercise when someone has had an muscle injury

A
  • isometric
118
Q

resistance to muscle contraction remains constant through range of motion

A

isotonic

119
Q

____ is a full range of movement against a rate limiting device

A

isokinetic

120
Q

what is the 0 rule referring to when it comes to bone cancers

A

any bone cancer starting with an O is males 2:1 and ages 10-25

121
Q

A condition of the thoracic spine seem in adolescents that have multiple schmorls nodes, anteriorly wedged vertebrae, decreased disc space and increased dorsal kyphosis

A

Scheuermann’s disease

122
Q

what are the signs and symptoms of scheurmann’s

A

back pain
fatigue
muscle imbalance due to postural stress

123
Q

scheurmann’s can lead to _____ and ___

A

painless DJD and hyper-kyphosis

124
Q

aka for scheurmann’s

A

juveniles kyphosis dorsalis

125
Q

Anterior displacement of a vertebral body relative to its base vertebra

A

spondylolistheisis

126
Q

spondylolistheis on a AP lumber shows a ____ or ___ of ____ signs

A
  • inverted napoleon hat
  • bow line
  • brailsford
127
Q

spondylolisthesis is determined by ____ and _____

A
  • Ulmann’s line

- Meyerding’s classification

128
Q

what is the most common type of spondylolisthesis that occurs at L5

A

Isthmic

129
Q

what is the most common spondylolisthesis that occurs at L4

A

Degenerative

130
Q

what is the only bone tumor that grows off the bone

A

osteochondroma

131
Q

pedunculate or sessile
cartilage capped
coat hanger or cauliflower exotosis

A

osteochondroma

132
Q

osteochondroma grows away the ___ and favors the ____ and ___

A
  • epiphysis
  • knee
  • humerus
133
Q

name the least common type of bone tumors

A
  • chondrosarcoma
  • fibrosarcoma
  • osteoblastoma
  • ABC
134
Q

age >40 what is the type of bone tumors that will most commonly occur

A
  • metastatic carcinoma
  • multiple myeloma
  • Paget’s
135
Q

20-40 age group with bone tumors will be most likely which type

A
  • giant cell tumor

- fibrous dysplasia

136
Q

<20 bone tumors are most likely what kind

A
  • benign tumors
  • tumor stimulating conditions
  • osteosarcoma
  • Ewing’s
137
Q

Bine infarct most commonly occurs with _________

A
post surgical 
fracture 
alcoholism 
steroid therapy 
caisson disease
138
Q

AVN is commonly found in the ____

A

meta- epiphyseal region of long bone

139
Q

“well defined white chewing gum”

A

AVN

140
Q

Radiating periosteal reactions AKA

A

speculated
sunburst
malignancy (osteosarcoma)

141
Q

Laminated periosteal reaction

A

onion skin

wings sarcoma

142
Q

parallel periosteal reaction

A

bone infection

143
Q

Lumber canal stenosis is when the measurements are below ____

A

15mm

144
Q

interpedicular stenosis is when measurements is below _____ mm

A

26mm

145
Q

Deep boring pain , unrelenting constant . may be worse at night nut related to activity, position or rest

A

bone

146
Q

Dull, achey , difficult to localize and aggravated with movement/position

A

muscle/somatic

147
Q

Sharp , severe, shooting pain, tingling, radiating or dermatomal pain

A

nerve root

148
Q

referred, diffuse, ill-defined ashiness , throbbing, cramming, heaviness, color and temp changes

A

vasulcar

149
Q

vague unpleasant quality , burning, gnawing contralateral to the lesion . symptoms aggravated by stress

A

thalamic

150
Q

visceral

A

diffuse, poorly localized and referred

151
Q

pain increases with motion or position , decrease with rest

A

arthritis

152
Q

dull, achy , poor;y localized pain, arising from deep somatic tissue, facet syndrome or spondylolisthesis

A

Sclerotogenous

153
Q

mc mechanism of ankle injury

A

inversion stress with foot planter flexion

154
Q

mc ankle ligament damaged on inversion

A
  • anterior talo fibular lig.
  • calcanei-fibular
  • posterior tala-fibular
155
Q

mc damaged ligament in the ankle with eversion

A
  • deltoid ligament
156
Q

Patient coes in will pain in the shoulder of unknown cause, there is decrease ROM in all directions especially in external rotation , muscle atrophy is also noted … X-ray findings were a negative study

A

Frozen shoulder ( adhesive capsulitis)

157
Q

what is the best Tx for adhesive capsulitis

A

ROM and Codman’s exercises

avoid bracing

158
Q

patient has knee pain and is worse by sitting in a cramped position or walking downstairs.. Clinical findings were crepitus at the knee joint, normal ROM and joint effusions

A

Chondromalacia Patella

159
Q

AKA of chondromalacia patella

A

PFA- patellar femoral arthralgia

160
Q

Jumper’s knee is worse going up or down stairs

A

upstairs

161
Q

patient has anterior heel pain radiating from the calcaneus to the ball of the foot. The pain is worse in the morning. exacerbation of pain upon dorsiflexion of the big toe was noted.

A

plantar Fascitis

162
Q

what is the Tx of plantar fasciitis

A

heel pad
ice
massage
achilles tendon stretching

163
Q

what is usually the cause of plantar fasciitis

A

standing, walking pronated

164
Q

shoulder impingement syndrome is the entrapment of the _____, ____ and ______ by the acromion, coracoid ligament.

A
  • biceps tendon
  • supraspinatus
  • sub-acromail bursa
165
Q

patient has pain in the shoulder, she describes it as dull achy and points to the anteroom-lateral portion of the shoulder, clinical findings were palpable tenderness at the greater tuberosity and the bicipital grooves.

A

shoulder impingement syndrome

166
Q

what is the tx for shoulder impingement syndrome

A

-codman’s exercise
adjust caviled (I-S)
- humerus axial distraction

167
Q

name the 3 stages of shoulder impingement syndrome

A

stage 1-Acute phase
stage 2- Recurrent Phase
Stage 3- Chronic phase

168
Q

what typeof exercise is recommended for spondylolithesis

A

william exercise

169
Q

Central canal stenosis is sclertomal referred pain

A
false 
radicular ( dermatomal)
170
Q

what is the sensory distribution for central canal stenosis

A

inconsistant , maybe unilateral, bilateral or single dermatomal

171
Q

are there motor changes with central canal stenosis

A

yes

atrophy and weakness

172
Q

what are the reflex changes with central canal stenosis

A

hypo-reflexia to absent

173
Q

what is the best diagnostic imaging required for central canal stenosis

A

CT scan

174
Q

what is the AKA for central canal stenosis

A

Spondylotic Myelopathy

175
Q

Piriformis syndrome is ______ dermatomal

A

multi

176
Q

sensory distribution for piriformis syndrome is _______

A

sciatic -like pain, mainly to buttocks

177
Q

is there motor and reflex changes with piriformis syndrome

A

nope

178
Q

what is the best test for piriformis syndrome

A

NCV

EMG

179
Q

with piriform pain is most upon _____ rotation of the hip

A

external

180
Q

Patient comes in with the complaint of dysphagia, post prandial gastroesoophageal reflux … it is worse when reclining back of belching… x rays show displacement of the stomach above the diapraghm

A

hilt hernia

181
Q

what are the signs and symptoms of leukemia

A
  • elevated lymphoblasts with pancytopenia
  • acute illness with bleeding
  • secondary infections , septicemia, bone and joint pain
182
Q

which leukemia is most common with ages 3-7 years

A

ALL

183
Q

which leukemia is 80% of childhood leukemias

A

acute lymphoblastic leukemia

184
Q

which leukemia is high WBC count and philadelphia chromosome is present

A

Chronic myelogenous leukemia

185
Q

which leukemia is most common in the median age of 65 and among the immunosuppressed

A

Chronic Lymphocytic leukemia

186
Q

what are the signs and symptoms of Rheumatic fever

A
pericarditis
valvular insufficiency - apical systolic rumbling murmur 
migratory polyarthritis 
fever
polyarthralgia 
pharyngitis 
glomerulonephritis 
ASO- titre(strep test)
187
Q

what is the triangle of rheumatic fever

A

-glomerulonephritis
- strep
- pharyngitis
beta hemolytic

188
Q

what plane is flexion/ extension in and with what axis

A
  • sagital

- x- axis

189
Q

what plane is axial rotation, pronation/supination in and with what axis is it in

A
  • horizontal/transverese

- y- axis

190
Q

what plane is inversion/eversion in and what axis is it in

A
  • frontal/coronal
191
Q

retropharyngeal interspace is in what level

A

C2

192
Q

hyoid is in what spinal level

A

C3

193
Q

superior thyroid cartilage is at what spinal level

A

C4

194
Q

inferior thyroid cartilage is at what spinal level

A

C5

195
Q

cricoid cartilage/ retrotracheal interspace is at what spinal level

A

C6

196
Q

spine of the scapula is at what level

A

T3

197
Q

angle of the scapula is at what levels

A

T6

198
Q

angle of scapula seated is at what level

A

T7

199
Q

PSIS and ASIS is at what level

A

S2

200
Q

____ poisoning results with a cherry red skin and mucosa, clonus and headache

A

CO

201
Q

what type of drug is tar dive (orofacial) dyskinesia

A

antipsychotic drugs

202
Q

pt with appendicitis will have pain upon_____

A

flexion

203
Q

what type of lung disease will be hyper-resonant with radiolucent films

A
  • Emphysema

- Pneumothorax

204
Q

pt has muffled lung sounds, chest pain, dyspnea, orthopnea and a dry non productive cough

A

pleural effusion

205
Q

exam findings for pleural effusion

A

decrease fremitus
dullness on percussion of lungs
decrease breath sounds near lung bases

206
Q

pneumonia will have decrease voice sounds and decrease tactile fremitus

A

false

opposite

207
Q

what is the result of hypertension in the upper extremities, head and neck dizziness, epistaxis, headache) decrease blood pressure in the lower extremities

A

coarctation of the aorta

208
Q

which is considered the worst prognosis for diabetes

A

diabetes insipidus

209
Q

____ may be due to diabetes, pt will havee puffy face, peripheral neuropathy, increased urinary proteins with ascites, hypokalemia and hypercholesterolemia

A

nephrotic syndrome

210
Q

which test is used to confirm mononucleosis

A

heterophil (paul- bunnerl)

211
Q

which stage of lyme disease is affected more with the musculoskeletal system

A

stage 3

212
Q

3 phases of Degeneration is described by who

A

Kirkcaldy- Willis

213
Q

what are the 3 phases of degeneration

A
  1. segmental dysfunction
  2. Instability - repetitive trauma/ postural stress - scarring of articular tissue/disc
  3. Stabilization - Chronic overstress of spinal joints along with trauma may produce pro inflammatory changes - osteophytic changes occur
214
Q

Segmental Dysfunction Hypothesis

A
  • aka fixation theory

- inflammatory or non - inflammatory mechanisms may trigger segmental fixation

215
Q

3 components of SDF

A
  1. locked joint or entrapped/ pathologic meniscus
  2. abnormal muscle function - fixation causes facilitation resulting in muscle spasm
  3. abnormal biochemical processes in the joint (inflammation decreases mobility)
216
Q

the findings of SDF include a triad of: ____

A
  1. point of tenderness or altered pain threshold
  2. decreased of altered motion
  3. abnormal tension of para- vertebral muscles
217
Q

who came up with the nerve compression hypothesis

A

DD Palmer

218
Q

_________ Hypothesis - nerve pressure due to subluxation or IVF encroachment may cause : loss of nerve transmission, decrease action potential, altered axoplasmic flow (trophic changes to nerve and wallerian degeneration, micro-circulation ischemia to the nerve root.

A

Nerve compression hypothesis

219
Q

Acute nerve compression causes_____ and chronic causes _____

A
  • increase signal, irritation , spasm , hyperesthesia, increase sympathetic activity
  • chronic - decrease signal hyoesthia, decrease reflexes, paresis, flaccidity, increase parasympathetics
220
Q

Axoopasmic Aberration Hypothesis

A

compression or segmental dysfunction may affect growth and function of nerve roots/ nerves by altering normal flow of neural proteins, glycoproteins, neurotransmitters and Nerve Growth Factors

221
Q

_____ Hypothesis explains that inflammation may predispose to spinal lesions and arthritis by cellular response which releases histamine by mast and plasma cells and tissue response

A

Inflammation