Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine: PBL wrap-ups > Unit 5 Case 1: ACL tear > Flashcards

Unit 5 Case 1: ACL tear Flashcards

1
Q

anatomy in this case

A

anatomy of the knee joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

which movements does the knee joint allow

A

extension
flexion
lateral rotation
medial rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

label the image

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a bursa

A

synovial fluid filled sac found between moving structures in a joint
aim is to reduce wear and tear on those structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

4 bursae located in the knee

A

supra patellar
prepatellar
infra patellar
semimemmbranosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

suprapatellar bursa

A

extension of the synovial cavity of the knee
located between the quadriceps femurs and the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

prepatellar bursa

A

found between apex of the patella and the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

infra patellar bursa

A

split into deep and superficial
deep bursa lies between tibia and patellar ligament
superficial lies between patellar ligament and skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

semimembranosus bursa

A

located posteriorly in the knee joint
between semimembranosus muscle and medial head of the gastrocnemius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does NSAID stand for

A

non steroidal anti-inflammatory drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

examples of NSAID’s

A

aspirin
naproxen
ibruprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

moa of NSAID’s

A

inhibit COX-1 and COX-2 enzymes which convert arachidonic acid into prostanoids
to produce prostaglandins, thromboxane and prostacyclin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

COX-1 of NSAID’s

A

GIT effects
preserves integrity of gastric mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

COX-2 of NSAID’s

A

inducible form
predominates at sites of inflammation
stimulates prostaglandin formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are adverse effects of NSAID’s caused by

A

COX-1 pathways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how are NSAID’s administered

A

orally
topical gel
parenterally
suppositories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when are NSAID’s given

A

for mild-moderate pain as they have analgesic effects
inflammation
and pyretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when should you avoid NSAID’s

A

if severe Renal impairment
heart or liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

NSAID’s side effects

A

GI toxicity
renal impairment
increased risk of cardiovascular events
hypersensitivity reactions
fluid retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how can you gastroprotect when giving NSAID’s

A

low dose NSAID
standard dose of PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

types of prostaglandin

A

E2, PGE2
D2, PGD2
F2 alpha, PGF2 alpha
prostacyclin, PGI2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

prostaglandin function

A

inhibits gastric acid secretion, E2
maintains renal blood flow, E2
inflammation, E2 and D2
pain, E2
inhibits platelet aggregation, E2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

thromboxane function

A

stimulates activation of platelet aggregation

31
Q

thromboxane function

A

stimulates activation of platelet aggregation
blood clotting
vasoconstriction

32
Q

prostacyclin funciton

A

inhibits platelet aggregation
vasodilation

33
Q

label the image

A
34
Q

function of osteoprogenitor cells

A

stem cells to osteoblasts

35
Q

function of osteoclasts

A

erode mineralised bone

36
Q

function of osteoblasts

A

synthesis of osteoid

37
Q

function of osteocytes

A

inactive osteoblasts trapped in mineralised bone

38
Q

function of osteoid

A

organic component of bone matrix

39
Q

label the image

A
40
Q

features of hyaline cartilage

A

perichondrium
type 2 collagen fibres
chondrocytes arranged in groups
articular ends of bones, nose, trachea, ventral end of ribs

41
Q

features of fibrocartilage

A

perichondrium
contains elastin and type 2 collagen
pinna of the ear, epiglottis

42
Q

features of elastic cartilage

A

no perichondrium
chondrocytes are arranged in parallel rows
dense, coarse, type 1 collagen in the matrix
for withstanding tensile strength
intervertebral discs, pubic symphysis

43
Q

inflammatory response to knee injurt

A

immediate response is an increase in synovial fluid
releases IL-1 alpha, IL-1 beta, IL-6, IL-8, TNF- alpha, matrix metalloproteinases, cartilage oligomeric matrix protein

44
Q

function of IL-1 alpha

A

DAMP
released to the extracellular space after apoptosis
stimulated chemokine production
results in infiltration of neutrophils first followed by monocytes

45
Q

function of IL-1 beta

A

pro-inflammatory cytokine
crucial for host defence responses to infection and injury

46
Q

function of IL-6

A

induces synthesis of acute phase proteins (CRP)
serum amyloid A
fibrinogen
hepcidin in hepatocytes
inhibits albumin production

47
Q

function of IL-8

A

chemoattractant produced by tissue and blood cells
targets neutrophils
activates neutrophils in inflammatory regions

48
Q

function of TNF-alpha

A

vasodilation
edema formato
leukocyte adhesion to epithelium through the expression of adhesion molecules
regulates coagulation
contributes to oxidative stress in inflammation sites
induces fever indirectly

49
Q

function of MMP’s

A

activity of inflammatory cytokines and chemokine
collagen breakdown

50
Q

function of cartilage oligomeric matrix protein

A

non-collagenous extracellular matrix protein expressed in cartilage
ligaments and tendons
binds to other ECM proteins
catalyse polymerisation of type 2 collagen fibrils
regulate chondrocyte proliferation

51
Q

where are similar inflammatory responses found to those in the knee

A

elbow
inter pharyngeal joints (hand, foot, tibiotalar of ankle)

52
Q

bundles of the anterior cruciate ligament

A

anteriomedial
posterolateral

53
Q

function of the ACL

A

restraint to limit anterior movement of the tibia
knee rotational stability

54
Q

location of the ACL

A

normally will parallel blumensaats line

55
Q

clinical presentation of an ACL tear

A

popping sensation
significant pain
hemarthrosis (delayed)
loss of full range of motion
tenderness along the joint one
discomfort/ inability to walk
rapid joint swelling

56
Q

hemarthrosis

A

bleeding into the joint

57
Q

differential diagnosis for an ACL tear

A

proximal tibial fracture
distal femur fracture
meniscal tear
collateral ligament tear
quadriceps tendon tear
patellar ligament tear

58
Q

examinations done in order to test ACL tear

A

Lachman test
anterior draw test
x ray
MRI
ultrasound

59
Q

lachman test

A

30 degrees flexion
stabilise femur
pull tibia forward
assess anterior movement of tibia vs the femur
compare knees

60
Q

anterior draw test

A

90 degrees flexion
place thumbs on joint line
index fingers on hamstring tendons
apply forces anteriorly to see tibial excursion
compare knees

61
Q

x ray in this case

A

rule out fractures
doesn’t confirm any soft tissue injury

62
Q

MRI in this case

A

hard and soft tissues
radio waves

63
Q

ultrasound in this case

A

sound waves
check injuries in ligaments, tendons and muscles

64
Q

treatment options for ACL tear

A

elevate and stay off leg (immediate)
apply ice and take NSAID’s (immediate)
leg brace
ACL reconstructive surgery

65
Q

when is ACL reconstructive surgery completed

A

not straight away, when the swelling has reduced
assessed to see if it is severe enough for surgery

66
Q

ACL reconstructive surgery

A
67
Q

phase one of the rehabilitation program

A

weeks 0-2
eliminate the swelling
receive full range of motion
regain strength in hamstrings and quads
exercises: calf raises, lateral band walks, balance, static cycling

68
Q

phase 2 of the rehabilitation program

A

weeks 3-6
regain balance
recover majority of muscle strength
single leg exercises
low impact exercise: walking, swimming and cycling

69
Q

phase 3 of the rehabilitation program

A

weeks 7-12
hopping performance
complete agility exercises
regain strength and balance
light jogging, outdoor cycling and swimming

70
Q

phase 4 of the rehabilitation program

A

3-6 months
knee feels normal but no strenuous sport
polymetrics
sports drills

71
Q

phase 5 of the rehabilitation program

A

months 6+
continue with strength, balance, landing and agility
return to pre-injury exercise

72
Q

MDT involved in an ACL tear

A

physio
trauma team
theatre nurse
social teams
ward nurse
discharge coordinator
clinical support worker
ward clerk
porter
GP
osteopaths
occupational therapist
pharmacist
radiologist
anaesthetist
orthopaedic surgeon

73
Q

psychological implications of an ACL tear

A

very painful
depression
pain after surgery
decreased athletic identity

Medicine: PBL wrap-ups (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions