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MSK > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Preclinical Disability

A

-progressive and detectable but unrecognized decline in physical function in older adults
-decreased task efficiency

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2
Q

Phenotypes

A

-describes how an individual’s characteristics are a result of their genotype interacting with the environment

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3
Q

Musculoskeletal system and aging​

A

-Skeletal muscle of older people is more easily damaged with the loading
-Aging collagen increased cross-links between molecules, increasing the mechanical stability and tissue stiffness
-Tendons exhibit a lower metabolic activity that compromises healing
-joint increased stiffness and decreased flexibility and proprioception

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4
Q

Bone Remodeling influences

A

-mechanical stress
-Calcium and phosphate
-hormonal levels

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5
Q

4 causes of Fractures

A

Traumatic, stress, insufficiency, pathologic

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6
Q

Traumatic Fractures

A

-sudden impact
-Transverse, oblique, spiral
-mostly radius and ulna
-most affected 5-14

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7
Q

Stress Fractures

A

-partial break
-rhythmic repeated microtrauma
-most in tibial shaft and metatarsal

  1. Compressive: forceful heel strike during prolonged marching
  2. Distractive: muscle pull on bone

RF
-increase intensity of training
-females: pelvic and sacral fractures

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8
Q

Insufficiency Fracture

A

-normal stress applied to abnormal bone
-decreased elastic resistance or decreased mineralization
-minor trauma

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9
Q

Pathologic Fracture

A

-abnormally fragile bone by disease

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10
Q

Classification of Fractures

A

Transverse: right angle line, shearing

Oblique/Spiral: twisting force

Comminuted: broken into fragments

Segmented: broken with a segment of free bone is left

Butterfly: separation of a wedge

Greenstick: splintering of bone

Torus: bone bulges out from stress

Hairline/crack: skinny crack

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11
Q

Vertebral Compression Fracture

A

-most common osteoporosis related fracture
-minor
-pain worse with spinal extension
-height loss and respiration dysfunction

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12
Q

Fracture Healing

A
  1. Hematoma (6-12h): Blood clot forms and inflammation
  2. Proliferation (1-2d): granulation tissue and fibrocartilage
  3. Callous Formation (1-3w):
    Soft callous
  4. Ossification (6w): Soft callous replaced by bony callous
  5. Remodeling (4m-1y): restoration of medullary canal
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13
Q

Factors to Hinder Fracture Healing

A

-inadequate blood supply
-poor nutritional status
-poos apposition
-infection
-corticosteroid

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14
Q

Clinical Manifestations of Fractures

A

-point tenderness
-pain with weight bearing
-swelling and bruising
-loss of mobility

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15
Q

Complications of fractures

A

-malunion
-delayed union
-nonunion: fibrous union or false joint

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16
Q

Bone Grafting

A

-enhance bone repair

Autogenous: taken from self, iliac crest of fibula

Allogeneic: donor bank

Tissue Engineering: Porous scaffolds and biodegradable plastics

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17
Q

Bone Healing Prognosis (time)

A

Children: 4-6w
Adolescents: 6-8w
Adults: 10-18w

Negative Predictors:
-Calcium channel blockers and NSAIDs

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18
Q

PT Implications for LE Fractures

A

-can begin rehab within 1 week
-immobilized until callus formation
-treat swelling, pain, and ROM deficits
-Weight bearing limitations

Look for
-compartment syndrome
-fat embolisms
-nerve issues

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19
Q

Radiologist

A

-physicians specializing in radiology

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20
Q

Radiographers

A

-technicians who produce images

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21
Q

Highest Radiodensity

A

-Metal/lead

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22
Q

Lowest Radiodensity

A

-air

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23
Q

Lowest Radiographic density

A

-Metal

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24
Q

Highest Radiographic density

A

-air

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25
Q

High Radiodensity Color

A

-white image

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26
Q

High Radiographic Density Color

A

-black image

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27
Q

Contrast-Enhanced Radiographs

A

-contrast medium injected into body and radiograph taken

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28
Q

Arthrography

A

-joint and soft tissues

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29
Q

Myelography

A

-spinal cord
-nerve root
-dura

L2-L3, L3-L4, C1-C2

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30
Q

CT Scan

A

-Conventional Tomography
-different depths of bone
-computer msthmatically reconstructs image

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31
Q

Nuclear Imaging

A

-radiopharmaceuticals to see changes in anatomy structure by emmiting gamma rays

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32
Q

PET Scan

A

-Positron Emission Tomography
-inject glucose to see abnormal cells

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33
Q

Radionuclide Bone Scan

A

-distribution of disease in bone

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34
Q

Ultrasonograph

A

-refkected sound waves and tissue absorption
-leision to muscles and tendons

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35
Q

Chrondrolysis

A

-degeneration and narrowing of the joint space
-trauma, surgery, immobilization

Sx: Joint stiffness and loss of motion

Tx: pain reflief, surrgery, weight bearing precautions

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36
Q

Osteoarthritis

A

-Degeneration fo joint cartilage that affects underlying bone (subchondral)
-inflammation causes more changes and swelling
-most common msk disorder

Sx: pain, bony enlargements, edema, stiffness, loss of ROM

Tx: behavior, education, meds, surgery

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37
Q

Rheumatoid Arthritis

A

-systemic inflammatory disease
Articular: destruction of joints
Extraarticular: pulmonary, CVD, GI
-associated with graves and hashimotos
-rheumatoid factors found in synovial membranes
-Thickened synovium form destructive granulation tissue Pannus that disolves the joint

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38
Q

Clincial Manifestations of RA: Cervical Instability

A

-C1-C2 subluxation and brainstem compression

Sx: head falling forward, syncope, vestib issues
-posittive Lhermitte sign, shocklike sensations

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39
Q

Clincial Manifestations of RA: Cutaneous

A

-rhumatoid nodules: asymptomatic
-can appear in heart, lungs, GI
-joint contractures
-small vessel vasculitis

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40
Q

Clincial Manifestations of RA: Neurologic

A

-myelopathy
-neck pain
-incontinence
-peripheral neuropathies

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41
Q

Clincial Manifestations of RA: Extra Articular

A

-cardiopulmonary function

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42
Q

Degenerative Intervertebral Disc Disease

A

-age related changes
-decline of blood supply to peripheral disc
-issues with nerves
-spondylolisthesis

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43
Q

Juvenile Idiopathic Arthritis

A

-paurarticular most common
-pain of joints

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44
Q

Spondyloarthropathies

A

-group of disorders formerly considered RA
-inflammation of joints of the spine

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45
Q

Ankylosing Spondylitis

A

-inflammation to the axial skeleton
-leads to fusion and calcification
-pain in back, inflammation fo tendons
-bamboo spine

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46
Q

Diffuse Idiopathic Skeletal Hyperotosis (DISH)

A

-idiopathic variant of OA
-ossification of ligaments
-commonly effects thoracic spine
-no degeneration of vertebreal joints

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47
Q

Sjogren Syndrome

A

-chronic immune disease causes arthritis effects in organ
-moisture producing glands
-second most common autoimmune rheumatic

Sx: dry eyes and mouth

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48
Q

Psoriatic Arthritis

A

-seronegative inflammatoy joint disease
-20% of psoriasis havers

Sx:
-joint destruction
-hand deformities

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49
Q

Reactive Arthritis

A

-arthritis after an infectious process
-nailsR

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50
Q

Reiter Syndrome

A

-reactive arthritis
-triad: urethritis, conjunctivitis, arthritis

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51
Q

Gout

A

-joint pain at night
-poroduces uric acid
-deposition of crystals
-diet of purines

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52
Q

Neuroarthropathy

A

-articular abnormality related the neurologic deficits

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53
Q

Osteochondroses

A

-aka epiphysitis, osteochondritis, necrosis
-affects epiphyses

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54
Q

Osteochondritis Dissecans

A

-subchondral softening and necrosis followed by recalcification
-cartilage and subchondral can become loose
-microtrauma

Sx: activity related pain

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55
Q

Osteonecrosis

A

-death of bone and bone marrow
-avascular necrosis

Sx: prevent weight bearing

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56
Q

Legg-Calve-Perthes

A

-necrosis of proximal femur
-high chance of labral tears
-common in children

Sx: abnormal posture and pain

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57
Q

Osgood-Schlatter

A

-fibers of patellar tendon on tibia
-tendonitis
-boys >girls

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58
Q

Heterotopic Ossification

A

-aka myositis ossificans
-bone formation in non osseous tissue
-after trauma

Sx: loss of ROM, muscle pain
PT: motion, function, no stretching

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59
Q

Polymyalgia Rheumatica

A

-diffuse pain and stiffness of muscle groups
-mostly shoulder and pelvic girdle
-most decelop arteritis

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60
Q

Myopathy

A

-nonspecific proximal progressive muscle weakness after illness
-associated with critical illness myopathy

Hereditary: Musclar dystrophy, myotonia, charcot-marie-tooth

Acquired: inflammatory myopathy, endocrine, illness related, drug induced

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61
Q

Myofascial Pain Syndrome

A

-trigger points: irritable spots of skeletal muscle

-related to pain diagnoses
-can restrict ROM and movement activation patterns

PT: dry needling, ultrasound, flexibility, address posture

62
Q

Coccygodynia

A

-pain of coccyx and muscles attached
-trauma

S/S: pain with sitting

63
Q

Connective Tissue Disease

A

Mixed
or
Overlap (overlaing feature):
-similar to SLE, RA, polymyositis

64
Q

Rhabdomyolysis

A

-break down of muscle due to injury
-proteins in blood cause acute renal failture
-coke colored urine

65
Q

Pelvic Floor Dysfuction

A

Supericial: STP, BS,
Middle: urogenital diaphragm
Deepest: :Levator ani and coccygeus

Under Active: incontinence and prolapse
-surgery
-pregnancy
-SC

Over Active: cannot relax obstructive voiding
-injury or trauma
-nerve entrapment
-psychology

66
Q

Cervical Disc Pathology

A

-Degenerative processes to disc

S/S: pain over cervical spine, limited ROM and motor control, imbalances

Cause: progressive degeneration, repetitive mmts

Better: Laying down

Worse: Sitting, neck motions, coughing

Treatment:
-Surgical: discectomy, fusion
-PT: mobilization, strengthening, manipulation

67
Q

Disc Bulge

A

-nuc pulposus bulges into fiibrosis

68
Q

Disc Protrusion

A

-pulosus breaks past fibrosis

69
Q

Disc Extrusion

A

-pulposes breaks past outer lamina of annulus

70
Q

Disc Sequestration

A

-pulposus detaches from annulus near SC canal

71
Q

Thoracic Disc Pathology

A

-Degenerative processes to disc

S/S: asymptomatic, non specific pain, limited motor control, neurological changes, positive neural tension

Cause: progressive degeneration, repetitive flexion mmts, trauma

Better: Laying down, standing

Worse: Sitting, bearing down, coughing

Treatment:
-Surgical: laminectomy
-PT: decrease symptoms, walking, stabilization

72
Q

Cervical Facet Dysfunction

A

-facets on nerve roots or degeneration

S/S: Non specific neck pain, limited ROM and mobility

Cause: Degeneration or trauma, poor posture
-Primary: older pop, degeneration, hx of trauma
-Secondary: younger pop, trauma, acute injuries

Better: lying down, opening pattern

Worse: closing pattern, repetitive motions, sleeping position

Treatment: changing motions, posture, decrease imbalances, increase ROM

73
Q

Cervical Muscle Strain

A

-soft tissue injury

S/S: pain over cervical spine, limited ROM and muscle spasms

Cause: trauma, repetitive mmts, stretch or compression

Better: Laying down, modalities

Worse: Sitting, stretching, neck motions, sleeping

Treatment:
-PT: modalities, massage

74
Q

Cervical Radiculopathy

A

-spinal root dysfunction

S/S: pain and limited ROM numbness and tingling, weakness of musculature

Cause: progressive degeneration that cause impingement, herniation,a cute injurry

Better: open movements, UE above head to unload

Worse: pattern of limitation, neck motions

75
Q

Degenerative Joint Disease

A

-Degenerative processes to facet surfaces with loss of cartilage

S/S: unilateral pain, stiffness, cracking, loss of normal spine curvature

Cause: progressive degeneration, repetitive mmts, breakdown of hyaline cartilage

Better: stretching, modalities

Worse: inactivity, activities, close down facet joints, more wear and tear

76
Q

Whiplash

A

-quick trauma where head is forcefully displaced

S/S: neck pain, headache, shoulder pain, anxiety days after trauma, limited ROM, guarding

Cause: head displacement (extension) causing tissue damage

Better: rest

Worse: neck motions

77
Q

Scoliosis

A

lateral curve of spine >10deg

-Idiopathic: structural with no cause
-Infantile Idiopathic: <3yrs, can grow out of
-Juvenile: 3-10, second most common, risk for poorest outcomes
-Adolescent: >10, most common

-Functional: abnormalities that affect spine
-Neuromuscular: probelms occuring during spine development, cannot correct
-Degenerative: as the body ages

S/S: pain

Cause: progressive degeneration, repetitive mmts

Treatment:
-Surgical: >45
-Bracing: 25-40
-PT: mild, treating contributing factors, focused on injury in tissues

78
Q

Lumbar Disc Pathology

A

-Degenerative processes to disc (L4/5 and L5/S1)

S/S: dull pain over lumbar spine, nerve pain, guarding

Cause: bending forward, falling, coughing, bearing down, repetitive mmts, poor posture (tight hip flxors and hamstrings)

Better: Laying down with knees and hips flexed, walking, extension

Worse: Sitting, bending forward, lifting

Treatment:
-PT: decrease symptoms, inflammation
-extensor based exercises

79
Q

Lumbar Degenerative Joint Disease

A

-Degenerative processes to facet surfaces with loss of cartilage

S/S: unilateral pain, stiffness, cracking, loss of lumbar lordosis

Cause: progressive degeneration, repetitive mmts, breakdown of hyaline cartilage

Better: sitting, flexion based, restt

Worse: inactivity, activities, close down facet joints, more wear and tear

PT: thoracic extension, conditioning, education

80
Q

Interforaminal Stenosis

A

-loss of interforaminal space and disc height

S/S: shooting pain over lumbar spine, nerve pain, weakness

Cause: bone spurs, wear and tear, inflammation, progressive

Better: openinng space, beinding forward, decompression

Worse: closing mmts, walking, compression

Treatment:
-PT: improve joint and muscle mobility,
-flexion based exercises, education

81
Q

Lumbar Radiculopathy

A

-spinal root dysfunction

S/S: shooting pain and numbness and tingling, weakness of musculature, leg pain

Cause: progressive degeneration that cause impingement, herniation,a cute injurry, DDD, DJD, Spondylolisthesis, leg lengths

Worse: coughing, sitting

PT:
-surgery
-releiving symptoms
-exercise
-education

82
Q

Lumbar Ligament Strain

A

-tearing of fibers of lumbar ligaments (80% of lumbar cases)

S/S: localized LBP without referral

Cause: forces exceed tissue capacity, fails at weakest point, overuse, hyper ROM,

Better: rest, neutral postures

Worse: stretching of ligs, end range positions

PT: pain free motion, strength, stabilization of trunk

83
Q

Lumbar Muscle Strain

A

-soft tissue injury, most common LB injury (errector spinae)

S/S: pain over low back, pain with resisted extension, does not radiate to leg,

Cause: trauma, repetitive mmts, stretch or compression, body mechanics

Better: neutrtal posture, rest

Worse: Sitting, twisting, lifting, flexionn

Treatment:
-PT: rest, modalities, mobility, strenghening

84
Q

Lumbar Spondylolysis/Spondylolisthesis

A

Spondylolysis: fracture at pars interarticularis (MC: L5)
Spondylolisthesis: superior verttebra slips forward (MC: L4/S1)

-Dysplastic: congenital
-Isthmic: stress fracture, hyperextension
-Degenerative: slippage due to facets
-Traumatic: acute fx
-Pathological: damage due to tumor

S/S: back and/or leg pain with extension, asymptomatic

Cause: forced extension of some kind; degeneration

Better: flexion, rest

Worse: extension

Treatment:
-PT: flexion exercises, bracing
-surgery

85
Q

SI Joint Pathology

A

-pain in the region

S/S: pain in low back to butt to thigh (not lumbar)

Cause: pregnancy, arthropathy, falling

Better: hooklying

Worse: Sitting, walking, cycling

Treatment:
-PT: manipulation, hip ROM, strengthening core

86
Q

Primary Scapular Stabilizers

A

-serratus
-rhomboids
-traps
-levator

87
Q

Secondary Scapular Stabilizer

A

-lats
-pec minor

88
Q

Impingement Syndrome

A

-scompression and damage to soft tissue within the structure (MC: subacromial and superior humeral head)

S/S: ant/lat pain and flx/abd for external inpingement, pos pain and ER/IR issues for internal, weakness of RTC muscles, ROM issues

Cause:
Primary: structure abnormalities (internal impingement), dimished space
Secondary: excessive acromion curve

Better: rest

Worse: overhead activities

Treatment:
-PT: inflammation, scapular increase strength, normalize scapulothoracic rhythm

89
Q

Rotator Cuff Tears

A

-SITS
I: Bursitis or tendonitis, pain
II: partial rotator cuff
III: full thickness, loss of ROM and strength

S/S: deltoid pain, greater tub, upper trap

Cause: chronic and degenerative
Intrinsic: blood supply
Extrinsic: acromion morphology, acute injury

Better: out of aggravating position, retraction

Worse: recruitment of supra, protraction, hands behind back

Treatment:
-PT: increase ROM, prevent freezing, strength
-Non surgical: loss of strengthh
-Surgical: immobilized, no AROM for 4-6w, PROM, scap mobilization

90
Q

Biceps Tendon Pathology

A

Tendonitis: acute inflammatory
Tendonosis: degenerative; microtrauma
Rupture
Tendinopathy

S/S: anterior GH pain, weakness in shoulder, can radiate to elbow

Cause: mechanical stress, overhead mmt, functional factora

Better: avoidance of lifting, stretching

Worse: overhead lifting

Treatment:
-PT: 6-8w recovery, rest < massage < mobilization < stabilitty < stength (closed then open)
-surgery: usually not used

91
Q

Shoulder Labral Tears

A

-SLAP (superior labrum ant to post)
-Bankheart (2-6oclock, bicep tendon ass. witth ant dislocation)
-Psterior Labral Lesions (internal impingement)

S/S: aching, instability, catching, popping

Cause: FOOSH, overhead mmt, traction, trauma, dislocation, impingement

Better: out of agg. position, retracion

Worse: overhead activity, liting, hands behind back

Treatment:
-PT: prehab: ROM, prevent freezing, strength
-Surgical: Slap (no PROM ER, no bicep AROM 4w), Bankhart (no ER past 30 4w)
-isometrics, scap mobilization

92
Q

Shoulder Instability

A

-laxity of joint capsule

S/S: pain over deltoid, weakness, neural irritation

Cause: overhead repetitive mmts, dislocations/subluxations, trauma

Better: avoid aggr.

Worse: 90/90, overhead activity

Treatment:
-PT: reduce chance of redislocation, ROM, strength

93
Q

Adhesive Capsulitis

A

-inflamed and stiff shoulder capsule

S/S: loss of ROM, pain in deltoid, nocturnal pain hallmark

Phase 1: insidious, nocturnal pain
Phase 2: diminished pain, ROM loss
Phase 3: pain gone, ROM increases 12-24

Cause:
Primary: insidious
Secondary: response to trauma
-DM, hyperthyrpidism, hypertriglyceridemia

Better: pendulum exercises, steriod injections

Worse: moving arm

Treatment:
-PT: ROM,
-closed manipulation under anesthesia

94
Q

Medial Epicondylitis

A

-tendinosis of flexor tendons

S/S: weak grasp, local tenderness over medial epicondyle

Cause: Insidious, repetitive mmts, young age
Primary: FCRB, pronator teres
Secondary: FDC, palmaris longus

Better: rest

Worse: throwing, gripping

Treatment:
-PT: reduce stress, strength
Phase 1: 1-2w, modification, isometrics, pain free stretching
Phase 2: 2-4w, stretching, concentric
Phase 3: 4-6w, eccentrics, endurance, technique
Phase 4: 6-12w, progressive return to sport, isokinetic

95
Q

Lateral Epicondylitis

A

-tendinosis of extensor tendons

S/S: local tenderness over lateral epicondyle, pain with gripping, stretching pain

Cause: Insidious, repetitive mmts
Primary: ECRB, ECRL
Secondary: EDC, Anconeus

Better: rest

Worse: gripping, turning

Treatment:
-PT: reduce stress, strength
Phase 1: 1-2w, modification, isometrics
Phase 2: 2-4w, stretching, concentric
Phase 3: 4-6w, eccentrics, endurance, technique
Phase 4: 6-12w, progressive return to sport, isokinetic

96
Q

Cubital Tunnel Syndrome

A

-mononeuropathy cause by entrapment of ulnar nerve
-second most common nerve compression injury

S/S: local tenderness over medial elbow, numbness and tingling, claw hand

Cause: direct trauma, stretching, compression
Stage 1: Neuropraxia; myelin sheath
Stage 2: Axonotmetris; interruption of axon
Stage 3: Neurotmesis, neurron disruption

Better: rest

Worse: compression, stretching, sports, position, sleep

Treatment:
-PT: decompression, lifestyle mods, education

97
Q

Elbow Dislocation

A

-discontinuity of ulnohumeral articulation
-most common in children and posteriorly
-leads to lateral instability

S/S: pain, swelling, forearm looks shorter

Cause: fall with hyperextension

Better: rest

Worse: use

Treatment:
-PT: initial immobilization, isometrics

98
Q

Carpal Tunnel Syndrome

A

-compression of median nerve
-ischemia of nerve

S/S: numbeness in index and middle fingers, weakness

Cause: repetittive mmt, decrease in volume of tunnel (spurs, tumor, RA, position), increase in volume of contents (edema, inflammation)

Better: rest

Worse: prolonged wrist flexion, vibration

Treatment:
-PT: nerve glides, mobilization
-surgery

99
Q

De Quervain’s Syndrome

A

-inflammation of EPB and APL tendons
-mom’s hand

S/S: pain on radial side of wrist, weakness

Cause: overuse, repeated radial deviation, thumb abduction

Better: rest

Worse: wide gripping

Treatment:
-PT: reduce stress, strength

100
Q

Trigger Finger

A

-tenosynovitis of flexor digits

S/S: catching of finger, pain and tenderness on volar side

Cause: repetitive forceful gripping, systemic disease, nodules

Better: rest

Worse: gripping

Treatment:
-PT: ROM
-surgical release

101
Q

X-Ray

A

-conventual radiography
-xray penetrates tissues to produce image
-first order imaging
-skeletal images
-high radiation, poor soft tissue visualization

102
Q

CT

A

-computed Tomography
-poor cisuals of soft tissues
-x ray that a computer makes
-primary for traumatic injury
-soft tissueS and bone
-short time
-expensive, high radiation

103
Q

MRI

A

-magnetic Resonsance imaging
-magnetic field affects hydrogens in body
-soft tissues and hematomas no radiation
-long time, expensive, no pacemakers/aneruysms

104
Q

Bone Scintigraphy

A

-injection of radioactive isotrope
-detect fractures, tumors

105
Q

Diagnostic Ultrasound

A

-no contraindictions, low cost
-dependent on skill
-only outline of bone

106
Q

Greater Trochanter Bursitis

A

-pain over greater trochanter
-bursitis, tendinopathy, ITB syn
-Glut min bursa (MC): above and anterior to GT
-Subgluteus med bursa: under glut med, pos and sup GT
-Subgluteus max bursa: lat to GT under max and TFL

S/S: pain in post lat hip, referred pain from L2-L4

Cause: glut tendinopathy, atrophy, ITB on glut med tendon, inflammation, trauma, hyperabduction, fall, tight muscles, gait

Better: rest, pillow between knees

Worse: ipsi sidelying, walking uphill, running, ER, abduction

Treatment:
-PT: ROM, decrease injury, decrease inflammation, mechanics, STM, strengthening

107
Q

Hamstring Strain and Tendinopathy

A

-microtears due to stress
-common due to biarticular
-mostly at musculotendinous junction, eccentric

S/S: pop or tearing sensation, post thigh pain, gluteal pain

Cause: non-contact eccentric rep loading. poor blood supply, degeneration, poor mechanics, imbalances, poor lumbars

Better: rest, slow walking, neutral hip w/ knee flx

Worse: running, eccentrics

Treatment:
-PT: ROM, decrease injury, decrease inflammation, mechanics, STM, strengthening (iso, con, ecc)

108
Q

Hip Labral Tears

A

-tear of labrum
-ass with hip issues
-Radial flap (antersuperior) MC
-Longitudinal LC

S/S: groin pain, locking, stiffness, painful ROM

Cause: disclocation, twisting, hyperflexion, hip abnormalities, rep mmts, degeneration, lax capsule

Better: distraction, open pack

Worse: twisting, squatting, walking

Treatment:
-PT: decrease pain, decrease inflammation, distraction

109
Q

Piriformis Syndrome

A

-sciatic n compression from piriformis

S/S: gluteal pain, sitting pain, PF pain, positive Lasegue’s sign, dyspareunia, pain with BM

Cause: compression, muscle strain, trauma, pregnancy, sitting, weak glutes, weak core

Better: standing ER, traction

Worse: sitting, squatting, lunging

Treatment:
-PT: address impairments, education, ROM, STM

110
Q

ACL Sprain

A

-tear of ACL (85% of resistting ant. translation)
-females more likely
-athletic ppl

S/S: pop or tearing sensation, pain, knee giving out

Cause: violent twist w/o contact, joint laxity, large q angle, weak hamstrings, femoral notch stenosis

Better: elevation

Worse: walking, pivoting, stairs, cutting

Treatment:
Surgery: Hamstring, quad, gastroc, patellar tendon grafts
-1-2 years
-necrosis, revascularization, cellerular proliferation, collagen formation

PT:
Stage 1: Inflammatory 0-14d
-ROM, inflammation

Stage 2: Reparative 15-21d
-ROM, full extension, swelling, flexibility, walking

Stage 3: Remodeling 22-60 60-360d
-pain free ROM, no limitations, return to sport

111
Q

MCL Sprain

A

-tearing of MCL by valgus force at femoral attachment
-combined wiith ACL and med meniscus
-most common lig injury
-well vascularized

S/S: tearing sensation, medial knee brusing, instability

Cause: valgua stress, non contact decceleratioono andc utting

Better: elevation

Worse: running, extension of knee, downhill

Treatment:
-Surgery: rare due to vascularity, bracing instead

-PT:
Phase 1: Acute inflammatory 0-14d
- ROM, protect joint

Phase 2: Reparative 15-21d
-ROM, full extension

Phase 3: Remodeling 22-60 60-360
-pain free ROM, no limitations, return to sport

112
Q

LCL Sprain

A

-tearing of LCL by varus force at fibular attachment
-combined wiith fibular n, PCL
-least common knee lig injury

S/S: pop sensation, lateral knee pain, instability

Cause: varus stress, add flx and ER

Better: elevation

Worse: running, extension of knee, uneven ground

Treatment:
-PT:
Phase 1: Acute inflammatory 0-14d
- ROM, protect joint

Phase 2: Reparative 15-21d
-ROM, full extension

Phase 3: Remodeling 22-60 60-360
-pain free ROM, no limitations, return to sport

113
Q

Meniscal Injury

A

-tearing of meniscus by arthroscopy
-often with ACL
-Medial more common (less mobile)
-Longitudinal tear MC
-Bucket Handle Tear with ACL
-Radial Tear with trauma
-Horizonatal with OA

S/S: popping, clicking, giving away, joint line tenderness

Cause: degeneration, trauma (compressive twisting)

Better: non weight bearing

Worse: weightbearing

Treatment:
-Surgery:
-younger or older and physically active
Meniscectomy: avsacular region
Repair: vascular region

-PT:
-ROM, LE strength, limit compressive forces

114
Q

Patellofemoral Pain Syndrome

A

-pain around or behind patella
-most common knee injury

S/S: pain during flexion and extension behind or around knee, swelling, pain with activity

Cause: overuse with force at patellofemoral, hip/foot/knee issues

Better: avoidance of knee flexion

Worse: prolonged sitting, running, walking

Treatment:
-PT: contributing factors, avoid flexion based things, avoid last 30 of extension

115
Q

Patellar Tendinopathy

A

-Tendinitis: acute inflammation of the patella
-Tendinosis: chronic degeneration
-low metabolic rate

S/S: localized pain around patellar tendon, swelling, pain with activity, no referral

Cause: overuse activity (3-8%) of load applied, repetitive jumping and running, eccentric

Better: rest, bracing

Worse: squatting, running, squatting

Treatment:
-PT: correction of other factors, activity mod, flexibility, abnormalities
-Surgery: if PT fails after 6mon

116
Q

Patellar Dislocation/Subluxation

A

-no contact btwn patella and trochlear groove
-usually young

S/S: pain during flexion and extension behind or around knee, swelling, pain with activity

Cause: trauma, non contact IR and valgus stress

Better: inactivity

Worse: jumping, running, quick stops

Treatment:
-PT: reduce add and hip IR when squatting, bracing, quad strength, footwear
-Surgery: recommended for recurrent dis/sub

117
Q

Achilles Tendinopathy

A

-painful overuse of tendon; male athletes
-Tendinitis: presence of inflammatory cells
-Tendinosis: degeneration, absence of inflammatory cells

S/S: pain at insertion site, swelling of tendon

Cause: overuse, trauma, eccentric loading, pronation, flat floot, weakness

Better: rest

Worse: walking, running, jumping

Treatment:
-PT:
Acute: compression, cryotherapy, rest, heel wedge
Chronic: stretching, night splints, strengthening

118
Q

Ankle Sprains

A

-sprain of ankle ligaments
-lateral ligaments MC
-Syndesmotic sprains: pain can mimic lateral ankle sprains
-Medial ligaments LC

S/S: pain, swelling, redness, loss of ROM, cannot bear weight

Cause: rapid inversion (L), eversion (M), planted DF with ER (H)

Better: NWB, immobilization

Worse: WB

Treatment:
-PT: mobilizations
Phase 1: inflammation, edema
Phase 2: decrease pain, ROM, proprioception
Phase 3: ROM, strength, return to function

119
Q

Shin Splints

A

-pain on anterior/medial shins
-Medial tibial stress syndrome
-common in runners

S/S: pain over shin, increased with WB

Cause: training issues, biomechanical issues, shoes, obesity, increased pronation

Better: NWB, Rest

Worse: walking, jogging, running

Treatment:
-PT: contributing factors, activity modification, NWB, education, stretching, strengthening

-Surgery: fasciotomy

120
Q

Plantar Fascitis

A

-inflammation of plantar fascia
-MC at proximal insertion

S/S: medial heel pain, morning pain

Cause: bone spurs, chronic use, obesity, mechanics, low arches, pronated foot

Better: avoidance of walking

Worse:, running, walking

Treatment:
-PT: contributing factors, strengthen dynamic stabilizers

121
Q

Primary Tumors

A

-develop in the tissue
-75% in prostate, breast, lung
-pelvis, ribs, vertebrae, femur
-most commob bone are metastatic tumors from other places

122
Q

Primary Benign Bone Tumor

A

-bone island, osteoid, osteoblastoma

123
Q

Primary Malignant Bone Tumor

A

-osteo + sarcoma
-chord-
-Ewing
-Giant
-Multiple

124
Q

Primary Benign Soft Tissue

A

-Oma
-cyst
-desmid

125
Q

Primary Malignant Soft Tissue

A

-malignant
-sarcoma
-soft tissue

126
Q

Metabolic Bone Diseases

A

-metabolically active
-peaks at 25-35

127
Q

Osteomalacia

A

-softening of bone

128
Q

Osteopenia

A

-low bone mass

129
Q

Osteopetrosis

A

-increased bone density

130
Q

Osteoporosis

A

-systemic decrease in bone density

131
Q

Paget Disease

A

-2nd most common bone disease
-increased bone resorption and excessive new bone formation

132
Q

Hip Dysplasia

A

-infants and children
-unstable hip that subluxes/dislocation
-positive ortolani or barlow signs

133
Q

Osteogenesis Imperfecta

A

-skeletal fragility and growth deficiency
-brittle bone disease
-bruising and increased laxity

134
Q

Osteomyelitis

A

-inflammation of bone by an infectious organism
-affects spine, pelvis, and legs
-pyrogenic

135
Q

Infections of Prosthesis

A

-primary cause of prosthetic failure is strep
-common sign is persistent joint pain

Hematogenous infection: primary infection elsewhere in body

Contiguous: secondary to nearby infection

136
Q

Spondylodiscitis

A

-infection that affects vertebral spine
-affects discs MC

S/S: pain in spine with radiation to LE
-unusual postures, spine pain and fevers in children

137
Q

ACL Sprain

A

-tear of ACL (85% of resistting ant. translation)
-females more likely
-athletic ppl

S/S: pop or tearing sensation, pain, knee giving out, decreased quad

Cause: violent twist w/o contact, joint laxity, medial blow to knee, weak hamstrings

Better: elevation

Worse: walking, pivoting, stairs, cutting

Treatment:
Surgery: Hamstring, quad, gastroc, patellar tendon grafts
-1-2 years
-necrosis, revascularization, cellerular proliferation, collagen formation

PT:
Stage 1: Inflammatory 0-14d
-ROM, inflammation

Stage 2: Reparative 15-21d
-ROM, full extension, swelling, flexibility, walking

Stage 3: Remodeling 22-60 60-360d
-pain free ROM, no limitations, return to sport

138
Q

MCL Sprain

A

-tearing of MCL by valgus force at femoral attachment with tibal ER
-well vascularized and not under tension, can heal own on in 6w

S/S: tearing sensation, medial knee brusing, instability

139
Q

LCL Sprain

A

-tearing of LCL by varus force at fibular attachment
-least common knee lig injury

S/S: pop sensation, lateral knee pain, instability, swelling, n/t from superficial fib

140
Q

Meniscal Injury

A

-tearing of meniscus
-often with ACL
-Medial more common (less mobile)

S/S: popping, clicking, giving away, joint line tenderness, delayed swelling

Cause: degeneration, trauma (compressive twisting)

141
Q

Patellofemoral Pain Syndrome

A

-pain around or behind patella
-above and below

S/S: pain descending stairs, pain during flexion and extension behind or around knee, swelling, pain with activity, grinding, clicking

Cause: overuse with force at patellofemoral with compression of knee, weak abd extensors and ERs

Better: avoidance of knee flexion

Worse: prolonged sitting, running, walking

Treatment:
-PT: contributing factors, avoid flexion based things, avoid last 30 of extension

142
Q

Patellar Tendinopathy

A

-Tendinitis (jumper’s knee): acute inflammation of the patella
-Tendinosis: chronic degeneration
-low metabolic rate

S/S: pain ascending stairs, localized pain ant patellar tendon, swelling, pain with activity, no referral

Cause: overuse activity (3-8%) of load applied, repetitive jumping and running, eccentric

Better: rest, bracing

Worse: squatting, running, squatting

Treatment:
-PT: correction of other factors, activity mod, flexibility, abnormalities
-Surgery: if PT fails after 6mon

143
Q

ITB Syndrome

A

-lateral knee deviations
-tight TFL, weak glutes, Positive ober

144
Q

PCL Tear

A

-dashboard injuries
-hyperextension injury

S/s: knee swelling, instability

145
Q

Pronation MMts

A

-eversion, abduction, df

146
Q

Supination MMTs

A

-inversion, adduction, PF

147
Q

Hallux Valgus

A

-bunion
-lacking extension
-angle btwn metatarsal and phalanx >15 is abnormal

148
Q

Hallux Rigidus

A

-great toe MTP is rigid
-inflammation

149
Q

Functional Capacity Evaluation

A

-worker’s comp
-residual capacity to perform work
-~4 hrs
-phychometric, physical and functional tests
-compares abilities to work description

150
Q

Industrial PT

A

-promote wellness at worksites with early access
-ergonomics, prevention

151
Q

Y-Balance Stats

A

-difference in legs with anterior position are most prredictive for non contact injuries

152
Q

LESS

A

-12 inch box jump

MSK (19 decks)

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