Lecture Exam 3 Flashcards by Alyicia Ewing

Q

which ROM value of the hip is this?

0-120 degrees

A

flexion

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Q

which ROM value of the hip is this?

0-20 degrees

A

hyperextension

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Q

which ROM value of the hip is this?

0-40 degrees

A

abduction

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Q

which ROM valueS of the hip is this?

0 -45 degrees

A

LR & MR

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Q

the end feel for hip flexion is…

A

soft tissue

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Q

the end feel for all motions of the hip (except flexion) is…

A

firm (joint capsule)

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Q

the following is the open pack position of what joint?

30 degrees abduction
30 degrees flexion
slight ER

A

hip joint

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Q

the following is the closed pack position of what joint?

IR
extension
abduction

A

hip joint

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Q

which special test is being described?

Purpose: hip flexor tightness test
Position: pt in supine with legs off of table; flex opposite knee to chest
Force: passively extend hip being tested
- sign: thigh suspended above table = tightness

A

thomas test

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Q

which special test is being described?

Purpose: general hip pathology
Position: pt in supine with leg in Flexion, ABduction, and ER
Force: drape testing foot on knee of opposite leg & push down
- sign: reproduce symptoms/pain

A

FABER test

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Q

which special test is being described?

Purpose: femoral anteversion (MR)
Position: pt in prone; knee flexed to 90 degrees & palpate greater trochanter
Force: MR & LR until greater trochanter is in most lateral position (protruding the most)
- sign: greater than 8-15 degrees of anteversion

A

craig’s test

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Q

which special test is being described?

Purpose: IT band tightness
Position: pt in sidelying; lower leg flexed for stability & upper leg is abducted & hyperextended
Force: stabilize pelvis & passively/slowly allow leg to drop
- sign: doesn’t drop below level of the hip

A

ober’s test

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Q

which special test is being described?

Purpose: vertebral disc pathology
Position: pt in supine with both legs extended
Force: with a hand under the heel of the involved side, passively flex the hip while keeping the knee in full extension
- sign: reproduce pain in low back/leg

A

wells SLR

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Q

which special test is being described?

Purpose: hamstring length
Position: pt in supine
Force: passive straight leg raise
- sign: has more than 29 degrees of KNEE flexion

A

90/90 SLR

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Q

what pathology of the hip is being described?

most common in geriatric population
90% occur due to fall
associated with loss of mobility
classified by location & severity
morality rate in 1st year: 12-36%

A

hip fracture

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Q

what procedure is being described?

replaces femoral head & acetabulum
post-op results 98% with a lifespan of 15-20 years
2 types of fixation: cemented & cementeless
approaches: posterior/posterolateral, direct lateral, anterior/anterolateral

A

total hip replacement (THA/THR)

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Q

which THA fixation type is being described?

allows for early WBAT day 1

A

cemented

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Q

which THA fixation type is being described?

porous covered prostheses that allows osseous growth into surfaces of the implant
ingrowth occurs over 3-6 months
delayed/limited WB orders
chosen for those <60 who are active with good bone quality

A

cementless

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Q

which approach to THR is being described?

incision usually 15-25cm long
glute max is divided, med is retracted, and min is divided from capsule

precautions:
- no adduction/IR past neutral
- no hip flexion beyond 90 degrees
- no combination of these actions

A

posterior/posterolateral approach

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Q

which approach to THR is being described?

preserves insertion of glute med/min
decreases antalgic gait

precautions:
- no hip extension/add/ER past neutral
- no flexion beyond 90 degrees
- no combined ext/abd/ER
- no leg crossing
- do NOT step THROUGH in early ambulation

A

direct lateral approach

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Q

which approach to THR is being described?

no mm are detached
incisions are anterior & distal to ASIS
anterior capsulotomy & repair
fast WB post-op & rapid recovery of mm strength

precautions:
- no hip extension/add/ER past neutral
- no flexion beyond 90 degrees
- no combined ext/abd/ER
- no leg crossing
- do NOT step THROUGH in early ambulation

A

direct anterior/anterolateral approach

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Q

what procedure is being described?

used for younger, thinner, healthier patients
less blood, pain, cost, and time of hospital stay
“appealing” scar; small incisions (10cm or less); 1-2 incisions

A

minimally invasive hip replacement (MIS THA)

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Q

what procedure is being described?

replacement of the damaged femoral head with a bipolar prosthesis
posterolateral approach commonly used

precautions:
- avoid exercises that compress or shear hip joint to prevent erosion of acetabular cartilage
- follow WB orders & progress strength slowly

A

hemiarthroplasty

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Q

what impairment is being described?

40-90% of patients taking prophylactic meds develop this after hip surgery
typically involves deep veins of legs & calf
can become dislodged & travel as an embolus

A

DVT

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what impairment is being described? *trochanteric:* - irritation/inflammation due to trauma/compression/friction of IT band over bursa - pain is in lateral hip (thigh to knee) *ischial:* - pain over ischial tuberosity - caused by direct contusion or extended periods of sitting

bursitis

what impairment of the hamstrings is being described? - injury at origin due to forceful contraction or decelerating the lower leg against a concentric quad mm activity

hamstring strain

what impairment of the hip flexors is being described? - iliopsoas injury - sudden, forceful hip extension/flexion against resistance

hip flexor strain

which impairment of the adductors is being described? - "groin pull"

adductor strain

which ROM of the knee is this? 0-150 degrees

knee flexion

which ROM of the knee is this? 0 degrees

knee extension

the following is the open pack position of what joint? 25 degrees of flexion

knee

the following is the closed pack position of what joint? full extension with ER

knee

the following is the capsular pattern for what joint? flexion > extension

knee

which special test of the knee is being described? isolates posterolateral bundle since knee is flexed (most common)

Lachman's test

which special test of the knee is being described? senses tears of ACL in anteromedial bundle

anterior drawer test

which special test of the knee is being described? multidirectional rotational test

pivot shift test

what ligament injury is being described? contact: - blow to lateral side of knee (valgus force) - may involved MCL & medial meniscus (unholy triad) non-contact: - deceleration activity (78% occur when tibia is externally rotated on a planted foot) - women sustain this injury 3x more than men

ACL injury

what ligament procedure is being described? - intraairticular tissue graft is used to refabricate function of damaged ligament to restrain the knee - autograft, allograft, or synthetic graft can be used

ACL reconstruction

what ligament injury is being described? - not common - usually involves injury of another knee structure - blow to anterior tibia with knee flexed

PCL injury

what ligament injury is being described? - this ligament is blended with the medial meniscus, so injury here often involves other knee structures contact: - valgus force applied to lateral knee non-contact: - lower leg is fixed - tibia is ER & a valgus force is applied to lateral knee

MCL

what ligament injury is being described? - due to varus force across the knee - not common - other structures may be involved

LCL injury

what type of meniscal injury is being described? foot is fixed on ground & femur is internally rotated

medial meniscus injury

what type of meniscal injury is being described? LR of femur on a fixed tibia

lateral meniscus injury

what meniscal procedure is being described? removal of torn cartilage from an isolated meniscus injury (arthroscopic procedure)

subtotal/partial meniscectomy

what meniscal procedure is being described? suturing the torn meniscus back together (arthroscopic procedure)

meniscal repair

a larger Q angle pulls the patella in what direction?

a lateral direction

true or false? the larger the Q angle, the lower the odds of *patellofemoral compression, lateral tracking, lateral dislocation, and degeneration*

false

the following types of compartments are associated with what surgical procedure of the knee? unicompartmental bicompartmental tricompartmental

TKA

which type of compartment (for TKA) is being described? medial or lateral surface is replaced

unicompartmental

which type of compartment (for TKA) is being described? entire femoral & tibial surfaces are replaced

bicompartmental

which type of compartment (for TKA) is being described? femoral, tibial, and patellar surfaces are replaced

tricompartmental

which type of TKA fixation is being described? - use of acrylic cement - most common - may see loosening overtime

cemented

which type of TKA fixation is being described? - rapid growth of bone into the surface of a porous/beaded implant - higher rate of loosening

cementless

which type of TKA fixation is being described? cemented fixation of tibia part of knee & uncemented fixation of femoral part of knee

hybrid

what grade sprain of the knee is being described? no joint instability (incomplete stretching of ligament fibers)

grade l sprain

what grade sprain of the knee is being described? some loss of joint stability (moderate sprain, some fibers are torn)

grade ll sprain

what grade sprain of the knee is being described? loss of joint stability (rupture, all (or almost all) fibers are torn)

grade lll sprain

which ROM value of the ankle is this? 0-20 degrees

DF

which ROM value of the ankle is this? 0-50 degrees

plantar flexion

which ROM value of the ankle is this? 0-35

IN

which ROM value of the ankle is this? 0-15

EV

DF/PF occur at what joint?

talocrural joint

IN/EV occur at which joints?

subtalar & transverse tarsal joints

IN, abduction, & PF create what movement of the ankle/foot?

supination

EV, abduction, & DF create what movement of the ankle/foot?

pronation

what is the capsular pattern of the ankle?

PF > DF

what is the open pack position of the ankle?

10 degrees PF mid IN/EV

what is the closed pack position of the ankle?

full DF

which special test of the ankle is being described? tests to see if ankle ligament is intact

anterior drawer test

which special test of the ankle is being described? tests ankle ligament's resistance to maximal IN stress

talar tilt test

what pathology of the ankle is being described? - occurs secondary to IN stress - common pathology

lateral ankle sprain

what pathology of the ankle is being described? - rare for these structures to be injured - occurs due to MASSIVE EV stress - common to occur WITH an ankle fracture

deltoid ligament sprain

what pathology of the achilles is being described? - repetitive overloading/overuse of tendon - pain at mid part - may see with switch from high to low heels or due to athletics

achilles tendonitis

what pathology of the achilles is being described? - forceful PF contraction with acceleration or deceleration - men > women - pain, swelling, palpable defect - positive thompson test

achilles rupture

what pathology of the ankle is being described? - acute or chronic increased tissue pressure in a fascial space - leads to occlusion of vessels & reduced neuromuscular function

compartment syndromes

what type of ankle/foot fracture is being described? vertical or axial loads that compress tibia into talus

pilon fracture

what type of ankle/foot fracture is being described? - intraarticular depression fracture - most common fx

calcaneal fracture

what pathology of the ankle/foot is being described? - activity-induced leg pain along the posterior medial/anterior lateral area of 2/3 of the tibia anterior: overuse of weak tibialis anterior hypomobile gastroc/soleus foot pronation pain with DF & passive stretching into PF posterior: posterior medial pain tight gastric/soleus weak tibialis posterior foot pronation pain with DF/EV

shin splints

what pathology of the ankle/foot is being described? - very common - inflammation of plantar aponeurosis - excessive subtalar pronation - limits gait at heel strike

plantar fasciitis