injury scenario Flashcards

Question

Posterior lower leg AROM/PROM

Answer 1

plantar flexion dorsiflexion inversion eversion

Answer 2

plantar flexion - gastrocs - soleus dorsiflexion inversion eversion

Answer 3

thompson's test

Answer 4

1. achilles tendon 2. muscle belly - gastrocs -soleus

Answer 5

achilles tendon rupture (acute) achilles tendinopathy (chronics) calf strain (acute)

Answer 6

Hx: push off acute injury with feeling of being kicked in the heel or hit in the calf Ax: NO active PF, NO movement w thompson's test, excessive DF, can't do single leg PF, swelling/bruising Tx: POLICE, hospital, surgial/non-surgical repair

Answer 7

Hx: chronic gradual onset, over training, biomechanical issues, achilles pain worse in morning Ax: Pain w active PF, no weakness, mild pain w passive DF, tenderness on palpation 2-6cm above calcaneous Tx: biomechanical correction of feet, assess footwear, eccentric loading program!!!!!, tape

Answer 8

Hx: acute injury, can occur either in gastroc or soleus musculotendinous junction, mid belly or high on medial/lateral heads of gastroc, result of forceful push, feels like being hit in the calf Ax: TOP over injury site, pain and weakness w active PF, possible pain w passive DF, possible swelling Tx: POLICE, heel lifts to unload calf, NO stretching for first 1-2 weeks depending on severity isometric --> concentric --> eccentric exercise, taping

Answer 9

gait lower extremity biomech: tibial torsion

Answer 10

PF/DF INV/EVER Toe flex/Ext

Answer 11

1. gastroc soleus length test 2. tuning fork

Answer 12

1. dorsal pedal pulse 2. anterior compartment 3. tibia

Answer 13

acute anterior compartment syndrome (acute) chronic anterior compartment syndrome (chronic) medial tibial stress syndrome (chronic)

Answer 14

Hx: impact from external force, object or other player, numbness in foot, pain and tightness in front of leg, loss of sensation 1st inter-webbed space, progressively worsening symptoms, not relieved with rest AX: decreased dorsal pedal pulse, TOP and tightness with palpation anterior compartment, weakness DF, no improvement in symptoms with rest TX: Medical EMERGENCY, send to ER

Answer 15

HX: Chronic, comes on every time athlete exercises lower extremity, numbness, possible weakness (drop foot), feeling of tightness in anterior leg AX: Weakness with resisted DF, decreased dorsal pedal pulse, tightness and pain with palpation anterior compartment, improves almost immediately with rest TX: POLIE (no C!), Biomechanical corrections, assess footwear, stretch tight structures, compartmental pressure testing requested by DR; also might request XRAY to rule out stress fracture

Answer 16

HX: Chronic, overuse, court sports, TOP over distal 1/3 tibia, pain increases with exercise and lingers post activity AX: Poor biomechanics, footwear?, possible weakness with resisted inversion, pain along medial aspect of tibia usually 2-3cm sore spot TX: correct biomechanics, assess footwear, ice cups, alternative workouts (decreased pounding), strengthening exercises (Tib post, balance exercises, towel scrunches), low dye tape job to correct foot biomechanics

Answer 17

depth quality

Answer 18

KF (hamstrings) KE (quads)

Answer 19

1. posterior sag 2. posterior drawer 3. lachman's test 4. anterior drawer 5. valgus stress test - in full ext (deep fibers) - at 30 deg flexion (superficial fibers) 6. varus stress test - in full ext - at 30 deg flexion

Answer 20

1. Intracapsular swelling tests - patellar compression - swipe test 2. McMurray's test for meniscus 3. Apley's compression test for meniscus 4. Lateral patellar glide for apprehension 5. Patellar grind test 6. VMO contraction

Answer 21

1. medial joint line (medial meniscus) 2. Lateral joint line (Lateral Meniscus) 3. MCL 4. LCL 5. Medial Retinaculum 6. Underside of Patella

Answer 22

ACL sprain PCL sprain MCL prain LCL sprain Meniscus tear Patellar dislocation/subluxation Patellofemoral pain syndrome (chonic)

Answer 23

HX: Impact by another player from the lateral side, folded back over other player with a twisting motion, athlete will report a “pop”. Might also be a non-contact ACL where athlete goes to cut and knee buckles into valgus and hears a “pop”, sometimes reports pain, sometimes reports no pain, always reports instability. AX: Laxity, or laxity and pain with anterior drawer and Lachman, positive swipe test, positive patellar compression test for swelling, restricted KF/KE TX: POLICE, thorough medical exam, strengthening specific to hamstrings, bracing, possible surgery if ACL ruptured

Answer 24

HX: Impact with dashboard in car accident, falling on another athlete, tibia translating posteriorly on femur, fixed rotation, direct impact, may report “pop” AX: Positive posterior sag, laxity with posterior drawer test, positive intracapsular swelling tests, possible limitation into KF/KE TX: Same as ACL, NO surgery, strengthen quadriceps

Answer 25

HX: Lateral impact from side, athlete might report a “pop”, valgus force applied to knee AX: Generalized swelling in observation, laxity with either one of or both Valgus stress tests, limited ROM KF/KE, TOP over MCL TX: Avoid valgus forces during daily activities, restore ROM, DTFM, brace, surgery very rare

Answer 26

HX: Impact from medial side, athlete might report a “pop”, varus force applied, often from a fall, not a very common injury AX: Generalized swelling, laxity with either one of or both Varus stress tests, limited ROM KF/KE, TOP over LCL TX: Same as MCL, avoid varus stress

Answer 27

HX: Usually planted foot with a rotary force, athlete twists with foot planted, clicking, popping, locking, knee can feel unstable AX: positive Apley’s and McMurray’s tests, IR stresses lateral meniscus, ER stresses medial meniscus, positive intra-capsular swelling tests, TOP along either medial or lateral joint line depending on which meniscus is damaged TX: POLICE, AROM, open-chain strengthening exercises, possible surgery

Answer 28

HX: Dislocation – kneecap completely comes out of groove Subluxation – patellae slipped out of groove, came out partly. Patellae dislocates almost exclusively laterally, can be from impact, or non-contact, generally valgus orientation, extremely painful AX: Limited ROM KF/KE, weakness KE, swelling, positive lateral apprehension test, TOP over medial retinaculum TX: If dislocated immobilize and treat like a fracture, don’t move athlete, call 911. If occurred in past, start to strengthen quadriceps, use a brace, restore squat pattern

Answer 29

HX: Chronic injury, repetitive KF/KE, common in running and running sports, pain behind knee cap, pain worse when sitting with knee bent or when exercising, has been getting progressively worse AX: poor squat pattern, generally VMO contraction test positive (inhibited), positive patellofemoral grind test, TOP to dorsal patellae TX: Rest, ice, biomechanical correction, squat pattern education, patellar taping or strap, stretch and strengthen quads, hip flexors, hip abductors

Answer 30

squat assessment

Answer 31

Knee AROM/PROM a. KF/KE Hip AROM/PROM a. Hip Flexion (HF) b. Hip Extension (HEXT) c. Hip ABDuction (HABD) d. Hip ADDuction (HADD) e. Hip Internal Rotation (HIR) f. Hip External Rotation (HER)

Answer 32

Knee Strength a. KE/KF Hip Strength a. HF b. HEXT c. HABD d. HADD e. HIR f. HER

Answer 33

Ober’s Test: ITB tension Noble’s compression test: ITB friction Straight leg raise: hamstring length Quadriceps length test Measure circumference of quadriceps

Answer 34

-Over quadriceps muscles -Over hamstring muscles -Over iliotibial band/lateral femoral epicondyle

Answer 35

Iliotibial band friction syndrome (chronic gradual) Hamstring strain (acute) Quadriceps strain (acute) Quadriceps contusion (acute)

Answer 36

HX: Gradual onset, increasing symptoms with activity, pain is on lateral side of knee, pain worse with going down stairs, change in training habits AX: Positive Ober’s length test, positive Noble’s compression test, potentially weak hip abductors, poor squat mechanics, TOP over ITB (sometimes) TX:POLIE (No C!), Correct biomechanics, hip strengthening if weak, can provide stretches for tight structures, rolling on ITB

Answer 37

HX: Acute injury, specific incident, generally quick acceleration, might report poor warm-up, most often injured in deceleration phase of sprint, athlete reports a sharp pain in back of leg AX: Weak and painful KF, decreased length on straight leg raise on injured side, TOP to hamstring muscles TX: POLICE, stretch after 2 weeks, restore movement, start with very easy hamstring strengthening, progress to dynamic hamstring length, incorporate eccentric strengthening

Answer 38

HX: Acute injury, specific incident, landing from a jump, or acceleration, athlete reports a sharp pain in front of leg AX: Weak and painful KE, limited and painful quadriceps length test, depending on which quadriceps is injured might also have pain with hip flexion (if rectus femoris is involved), TOP over quadriceps TX: POLICE, quadriceps strengthening, quadriceps stretching after 2 weeks

Answer 39

HX: Acute injury, another player or object impacted into leg, loss in ROM, quadriceps feeling very swollen AX: Strong but painful KE, limited quadriceps stretch test, visible bruising or swelling, increased quadriceps circumference compared to uninjured side, tender over area where was impacted TX: Remove from activity, immediately ice while quadriceps stretched to comfort, apply gentle compression, NO HEAT, NO DEEP TISSUE MASSAGE

Answer 40

1. shoulder posture - supporting shoulder -step deformity -elevated shoulder -protracted shoulder 2. scapulohumeral rhythm

Answer 41

flexion extension abduction adduction ext rotation int rotation

Answer 42

1. Apley's scratch test 2. Wall pushup 3. Hawkin's Kennedy Impingement test 4. Neer's impingement 5. Empty can test 6. Speeds test 7. Yergason's test 8. Cross arm test 9. Depression of acromion 10. Apprehension test 11. Sulcus sign 12. Anterior --> posterior glide

Answer 43

- Palpation of Supraspinatus Tendon - Palpation of Biceps Tendon

Answer 44

HX: Chronic activity, overuse of shoulder, generally overhead activities (throwing, swimming), can involve a number of structures (most common Supraspinatus tendon, or bursa), pain with certain movements of arm, worse with activity AX: Painful arc (motion in ABD from 90-120°), Pain with apley’s scratch test, possible winging with Wall push-up, positive Hawkin’s Kennedy test for pain, pain with Neer’s impingement test, Positive Empty Can test for pain, TOP to Supraspinatus TX: Correct shoulder biomechanics, closed chain scapular control, improve scapulohumeral rhythm, avoid overhead activities, rotator cuff strengthening (no overhead rotation), sport specific mechanics

Answer 45

HX: Overuse, chronic, overhead activities, common in throwing sports, pain when raises arm forwards AX: Pain with active flexion above 90°, pain with Speed’s test and Yergason’s test, pain on palpation to Biceps tendon, might see scapulohumeral dysfunction, might see weakness with wall push-up TX: Treat biomechanics, modify aggravating activities

Answer 46

HX: Traumatic, acute injury, fall on point of shoulder, hit by another player, fall on arm/hand at side of body, common in contact sports AX: Limited ROM in all directions with pain, limited strength in all directions with pain, pain with cross arm test, pain and laxity with acromial depression TX: Ice, sling can help with pain, restore ROM, pendulum exercises, pad around ACJ for return to sport, ACJ tape job, can refer to DR. for X-rays if suspect clavicular fracture

Answer 47

HX: Acute injury, generally trauma, athlete will report feeling of “shoulder popping out”, shoulder might feel unstable, athlete might tell you shoulder is out, fall on outstretched hand (FOOSH) injury AX: posture of athlete presentation (slumped forward), if athlete tells you shoulder is out don’t continue to assess --> hospital, limited mobility into end range all movements, positive apprehension test, perhaps positive one of Sulcus sign, and/or Anterior --> Posterior glide TX: Subluxation= POLICE, strengthening program for rotator cuff, scapular stabilization Dislocation= Treat as a fracture, immobilize in position of presentation, seek immediate medical attention, ICE, keep athlete comfortable, if out of sling, can start with pendulum exercises and progress as per subluxation

Answer 48

-Scapulohumeral rhythm -Hand posture -Carrying angle

Answer 49

- Elbow Flexion - Elbow Extension - Wrist Flexion - Wrist Extension - Pronation - Supination

Answer 50

- Elbow Flexion - Elbow Extension - Wrist Flexion - Wrist Extension - Pronation - Supination - Grip Strength

Answer 51

Varus stress test Valgus stress test

Answer 52

Wrist extensor stretch test Wrist flexor stretch test

Answer 53

- common extensor origin - common flexor origin - olecranon

Answer 54

Olecranon bursitis Lateral Epicondylagia (Tennis Elbow) Medial Epicondylalgia (Golfer's Elbow) Collateral Ligament Sprain

Answer 55

HX: Acute or repeated trauma, fall on point of elbow pain on point of elbow, pain with pressure over elbow, swelling on elbow AX: Visible swelling, TOP over olecranon, boggy feeling on palpation of olecranon TX: POLIE (No C!), protective padding for sport, alleviate aggravating factors

Answer 56

HX: Chronic, pain with gripping, pain worse when using arm, pain over lateral epicondyle, can also come from minor trauma, pain with certain wrist movements AX: Pain with active wrist extension, decreased wrist flexion PROM with pain, pain with resisted supination, decreased grip strength that elicits pain, pain with stretch test of wrist extensors, TOP over CEO, assess scapulohumeral rhythm TX: correct shoulder biomechanics, stretch wrist extensors, gentle strengthening isometric to concentrically, eccentric wrist extensor program, supination strength, compression band

Answer 57

HX: Chronic, pain with gripping, worse when using arm, pain over medial epicondyle, pain with wrist flexion AX: Pain and weakness with active wrist flexion, pain with gripping, worse when using arm, pain with resisted pronation, pain with stretch of wrist flexors, TOP over CFO, assess scapulohumeral rhythm TX: Correct shoulder biomechanics, stretch wrist flexors, gentle strengthening isometric to concentrically, eccentric wrist flexor program, compression band

Answer 58

HX: Trauma to elbow, another athlete landing on elbow, acute pain in medial or lateral side of elbow AX: Limited elbow flexion or extension, visible swelling, laxity and pain with either radial or ulnar collateral ligament stress test TX: POLICE, support elbow, restore ROM, begin strengthening, gradually increase loading through ligament.

Answer 59

- thenar eminence - hand posture

Answer 60

a. Wrist Flexion b. Wrist Extension c. Radial deviation d. Ulnar deviation e. Finger flexion f. Finger extension g. Thumb movements - Extension - Flexion - ABDuction - ADDuction - Opposition

Answer 61

AROM/PROM plussss grip strength!!!!!

Answer 62

a. Ulnar collateral ligament of thumb –> Valgus stress at 0° and 30° of MCP jt flexion b. Radial collateral ligament of thumb c. Ulnar and radial collateral ligaments of interphalangeal (IP) joints

Answer 63

a. Phalen’s Test – Carpal tunnel b. Tinel’s Tap Test – Carpal tunnel c. Derkan’s Test – Carpal tunnel c. Scaphoid compression test d. Pinch Test – Ulnar collateral ligament

Answer 64

a. Anatomical snuff box b. Ulnar collateral ligament of thumb c. Radial collateral ligament of thumb d. Ulnar and radial collateral ligaments of interphalangeal (IP) joints

Answer 65

HX: Can be acute or chronic/repetitive trauma, pain or numbness/tingling in median nerve distribution, might report hand feeling clumsy, worse with direct pressure or when using hand AX: Possible atrophy of thenar eminence, decreased grip strength, positive Phalen’s test, positive Tinel’s tap test, positive Derkan’s test TX: Rest, ice, brace to maintain neutral wrist (no compression!), very gentle ROM and strength exercises, correct any loading issues, correct upper body extremity mechanics

Answer 66

HX: Fall on an outstretched hand (FOOSH), need to be cautious as is frequently confused for a wrist sprain, lots of pain in wrist on radial side, pain with movement AX: Decreased ROM in all directions, especially painful into radial deviation, weakness with thumb movements, positive scaphoid compression test, positive pain with palpation of anatomical snuff box TX: Send for medical attention with DR and Xray, immobilize, ice, once out of cast or possible surgery start to restore ROM

Answer 67

HX: Fall on hand with thumb being forced backwards, trying to tackle another player and thumb getting jammed back or stuck in jersey, common with sports involving a ball and catching AX: Swelling visible around MCP joint of thumb, limited AROM/PROM into extension and ABD, positive pinch test, laxity and pain with ulnar collateral ligament stress test of 1st MCP, possible damage to radial collateral ligament depending on direction of fall TX: POLICE, ROM and strengthening, (Thumb extension, abduction, with and without resistance), tape job, splint

Answer 68

HX: Common in ball sports, player will report jamming end of finger, might also be a valgus or varus force, finger is generally quite swollen, there is limited mobility AX: Visible swelling around injured finger, limited AROM/PROM into Flex/Ext, pain and laxity with either UCL or RCL of injured finger and joint TX: Ice bucket, splint finger, self massage, gentle ROM, gentle strengthening, DTFM to injured ligament, buddy tape for return to sport

Answer 69

eccentric loading program

injury scenario Flashcards

(95 cards)