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Sports > General & LE > Flashcards

General & LE Flashcards

1
Q

What is the rule for return to play after a concussion?

What is the big risk if this is rushed?

A

NO SAME DAY RETURN TO PLAY
Must be asymptomatic for 24 hrs prior to starting return to play protocol -> each stage is 24 hrs and progressive -> takes about 6-7 days
BIG RISK = second impact syndrome!

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2
Q

What do you do with football player in regards to their gear when concern for C-spine injury?
To move the player what is the best way to do it that keeps C-spine best immobilized?

A

LEAVE ALL GEAR ON - only remove facemask!

8 person lift is BETTER than a log roll!

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3
Q

What is spear tacklers spine and what are the return to play recommendations

A

Acquired cervical stenosis w/ loss of lordosis

ABSOLUTE CONTRAINDICATION TO RETURN TO PLAY!!!

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4
Q

What are the top 3 causes of cardiac death listed in descending order (from MOST common to less common)

A
  1. ) Hypertrophic obstructive cardiomyopathy
  2. ) Commotio cordis (get Vfib from blow to chest)
  3. ) CAD
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5
Q

What is the MC solid organ injury in sports?

A

Kidney! (to help remember just think that there are 2 of them - so more likely to get hit!)

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6
Q

After Mono what organ must be protected and when are they allowed return to play?

A

Spleen -> risk of spleen rupture!

No return to play until 3-4 weeks after resolution of Sx and no more splenomegaly seen on US

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7
Q

What is the general return to play recs for Herpes, Impetigo, and CA-MRSA?

A

No new lesions x 48 hrs

Has been on abx for 72 hrs

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8
Q

What is the female athlete triad?

A
  1. ) Menstrual dysfxn (> 3 months)
  2. ) Energy Deficiency (+/- eating disorder)
  3. ) Osteopenia (> 2 stress fxs)
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9
Q

What are the 3 main skeletal muscle types?

A

I Slow Red Oxidative (fatigue resistant) -> first recruited
IIA Fast oxidative (fatigue resistant)
IIB Fastest (easily fatigable) -> Glycolytic

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10
Q

What cells are responsible for muscle healing after injury?

What medication can help reduce fibrous tissue formation?

A

Satellite cells

Losartin

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11
Q

What nerves are at risk for injury during hip arthroscopy related to:

  1. ) Positioning post
  2. ) Anterolateral portal
  3. ) Anterior portal
  4. ) Posterolateral portal
A
  1. ) Pudendal nerve palsy (Remember all the P’s: Positioning Post Pudendal n!!)
  2. ) Superior gluteal nerve
  3. ) LFCN
  4. ) Sciatic nerve - ESP if hip in ER
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12
Q

What are the abnormal values for the:

  1. ) Center edge angle
  2. ) Alpha angle
A
  1. ) CEA: 20-40 degrees is normal ( < 20 = dysplasic; > 40 = Pincer/over-covered)
  2. ) Alpha angle: < 50 is normal; > 55 is CAM (on frogleg lateral - one line down neck and the other that crosses where the femoral head loses its sphericity)
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13
Q

Where does the primary lesion in CAM-FAI occur? Where is secondary?

A

Anterior superior cartilage delamination PROCEEDS labral tear at chondrolabral jxn (coup) -> (counter coup) posterior inferior cartilage wear

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14
Q

What is the most common reason for FAI surgery failure?

A

Persistent FAI -> failure to fully treat in 1st surgery

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15
Q

What hips should NOT be scoped? (3)

A
  1. ) Severe Pincer
  2. ) DDH
  3. ) Arthritis
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16
Q

What are the two forms of snapping hip?

What is there PE finding?

A

1.) External -> due to IT over GT
PE finding -> use Ober test, hip adduction/extension (can SEE it)
2>) Internal -> due to iliopsoas
PE finding -> extend hip from FABER (can HEAR it)

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17
Q

What is the treatment for femoral neck stress fracture - tension sided vs compression sided

A

Tension side -> FIX it (screws or DHS)

Compression side -> NWB/protected WB

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18
Q

What structures does the middle geniculate artery supply?

A

Cruciate ligaments and posterior horns of bilateral meniscus

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19
Q

What are the location of the ACL bundle insertions on the femur and tibia?

A

The names are for their insertion on the tibia.

Then just remember that the AM is Above the PL on the femur.

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20
Q

What is the distance b/t the LCL and Popliteus insertion on the femur?

A

18.5 mm (POP is DAD…since 1850!)

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21
Q

Of the cruciates and collaterals which ligament is the strongest? Weakest?

A

Strongest -> MCL

Weakest -> LCL

22
Q

What are the 3 layers of the medial side of the knee?

A
  1. ) Sartorious (w/ saphenous nerve running on backside)
  2. ) sMCL, POL, SM
  3. ) deep MCL
23
Q

What rotational motion does the popliteus give the knee?

A

Internally rotates the tibia (remember it unlocks the knee from EXTension where the tibia is EXTernally rotated)

24
Q

How do you test for a posteriomedial corner injury?

A

Slocum test -> tests mostly the POL -> do this by externally rotating the tibia and giving anterior drawer stress

25
Q

What measurement should make you consider a tibial tubercle anteromedialization procedure?

A

TT-TG > 20

26
Q

What is the arcuate sign and what does it signify?

A

Avulsion of top of rim of fibula -> PLC injury!

27
Q

What does the double PCL sign mean?

What does the double anterior horn sign mean?

A
  1. ) Double PCL -> flipped medial meniscus bucket-handle tear
  2. ) Double anterior horn -> flipped lateral meniscus tear (posterior horn flipped anteriorly)
28
Q

What leads to meniscus extrusion?

A

Meniscal root tear

29
Q

What is a ramp lesion?

A

Meniscocapsular lesion

30
Q

What pathology is seen when meniscal cyst is present?

A

Horizontal meniscus tear

31
Q

When should a discoid meniscal tear be fixed?

A
  1. ) If symptomatic and/or has tear

2. ) Wrisberg variant w/ non capsular attachment

32
Q

What type of cartilage and collagen does microfracture create?
How deep must you go? How much is too deep and what is down side?

A

Fibrocartilage -> Type I collagen
Must go past/removethe calcified cartilage layer, but DO NOT pass the subchondral plate or else this leads to osseous overgrowth

33
Q

What injury creates Quadriceps avoidance gait?

What is Quadriceps avoidance gait? (3 facts/descriptors)

A

ACL injury

  1. ) Decreased stride length & avoidance of knee flexion in mid-stance phase
  2. ) Loss of normal femoral IR in terminal swing phase
  3. ) Decreased tibial anterior translation in late swing
34
Q

What ACL autograft has the highest strength and stiffness?

A

HS autograft

35
Q

ACL Tunnel placement:
What happens if your FEMORAL tunnel is too:
1.) Anterior (MC ERROR!)
2.) Posterior
What happens if your TIBIAL tunnel is too:
3.) Anterior
4.) Posterior

A

(*see drawing on slide 212/3 if needed)

  1. ) Tight in flexion
  2. ) Tight in extension
  3. ) Tight in flexion/extension will be limited (impingement on roof)
  4. ) LAX in both flexion and extension/impingement on PCL
36
Q

What does ACL injury put you at risk for?

A

At risk for re-injury to ipsilateral ACL AND to contralateral ACL

37
Q

How can ACL graft risk of infection be reduced?

A

Soak in Vancomycin

38
Q

At what amount/angle of posterior tibial slope does ACL graft failure risk increase?

A

> 12 degrees!

39
Q

What is the largest/most prominent risk factor for ACL injury?

A

Neuromuscular coordination and training

40
Q

What gene is protective/reduces risk of ACL tear?

A

COL5A1 gene

41
Q

When do you fix the PCL?

When do you non-op and what treatment do you Rx?

A

FIX: 1.) Bony avulsion or 2.) In combo with other ligament injury
Otherwise NONOP -> quad rehab

42
Q
  1. ) How do you treat an isolated MCL tear?

2. ) Isolated LCL tear?

A
  1. ) Nonop unless -> Distal avulsion/Stener lesion

2. ) If isolated (which is rare) then non-op; otherwise reconstruct as part of multilig surgery

43
Q

How do you treat PLC injuries?

A

Repair AND Reconstruct - has best outcomes!

44
Q

How do you treat an acute tib/fib dislocation?

Recurrent/chronic?

A

Nonop!

Operative!

45
Q

What causes intermittent claudication (calf pain and paresthesias) and decreased pulses esp w/ knee extension and ankle dorsiflexed. Also, symptoms INCREASE with walking and RELIEVED with running.
What structure causes this?
What is treatment?

A

Popliteal artery entrapment syndrome
Aberrant medial head of gastroc
Surgical release!

46
Q

What is the treatment for 1st time patella dislocation?

A

Non-op, unless there are loose bodies present!

47
Q

What gives the highest risk of recurrent patellar instability?

A

Trochlear dysplasia

48
Q
  1. ) What value helps to diagnose exercise-induced asthma?
  2. ) What is tx?
  3. ) What other problem should be ruled out?
A
  1. ) FEV1
  2. ) Beta-2 agonist
  3. ) Rule out vocal cord dysfxn
49
Q

What gene does CA-MRSA have that hospital acquired MRSA does not?

A

PVL gene

50
Q

What is the long term consequence of PCL injury?

A

Arthritis of the patellofemoral joint and medial femoral joint

51
Q

Exertional Compartment Syndrome - what numbers are diagnostic?

A

> 30 mmHg after 1 min
20 mmgHg after 5 min
15 mmHg at rest

52
Q

In a displaced, irreducible tibial eminence fracture - what is most common structure interposed?

A

Anterior horn of medical meniscus

Sports (2 decks)

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