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Flashcards in Lower Extremity Deck (37):
1

Most commonly involved muscle in hamstring strains with running? with kicking?

running = Biceps femoris (b/c this mm incurs the most stretch, occurs at aponeurosis = shorter rehab). kicking = SemiMem (at proximal free tendon = longer rehab, maybe surgery). Generally, the more proximal location of pain, the time needed for rehab.

2

Diff b/w sports hernia and inguinal hernia

Sports hernia is a weakening of the posterior inguinal wall, causing dull diffuse pain around the groin that radiates to the inner thigh or perineum. Can progress to inguinal (overt) hernia. Sports hernia is progressive and can be bilateral or unilateral.

3

What is a hip pointer?

direct blow to iliac crest

4

4 types of labral tears

radial flap, radial fibrillated, longitudinal peripheral, abnormally mobile (partially detached),

5

What motions to avoid with labral repair?

early flexion and ABD

6

what is coxa saltans?

snapping hip

7

what is meralgia paresthetica?

compression of lateral femoral cutaneous nerve that causes extreme burning down the thigh

8

SCFE vs LCP

SCFE = 10-17 y/o obese male with groin or knee pain, insidious onset. Medical emergency! Place on crutches+ NWB. LCP = 4-8 year old male, limping, decreased ROM.

9

Most causative factor of adductor strain?

adductor weakness

10

Most common location of hip labral tears? Mechanism?

anterior - loaded rotation

11

What arc of motion does the patellofemoral joint experience the most compression with OKC exercise? What ROM should be worked in for TherEx?

full extension, work in 50-90 degrees of flexion

12

What arc of motion does the patellofemoral joint experience the most compression with CKC exercise? What ROM should be worked in for TherEx?

increased flexion, work in 0-50 degrees

13

If posterior lachman is positive at 30, what should you suspect? Positive at 90? Positive at both 30 and 90?

(+) at 30= suspect post lateral corner,; (+) at 90= suspect PCL; (+) at both 30 and 90= suspect PCL

14

What is Ege's test?

used to detect meniscal tear. Pt can IR (to diagnose lateral mm) or ER (to diagnose medial mm)

15

Microfracture of the knee is used for chrondral lesions less than ____ mm? What type of cartilage is formed after wards and why is this important?

4mm. A fibrocartilaginous cap is formed, which is less resilient and has less stiffness than type II hyaline cartilage

16

Loss of ROM after ACL may be due to surgical error? If the femoral tunnel is placed too anterior? If the tibial tunnel is placed too anterior?

Femoral too anterior = pt may lose flexion. Tibial tunnel too anterior = pt may lose extension.

17

What does tape do for patellar tracking?

Nothing! But it may decrease pain by applying a low load to the lateral structures of the knee. So you do not need to evaluate tracking pre/post tape.

18

Step and Twist mechanism with immediate swelling? Step and twist with delayed swelling?

ACL, Meniscus

19

Unahppy triad?

ACL, MCL, lateral meniscus

20

When does the inferior patellar pole make contract with the superior trochlea?

20 degrees of flexion

21

Mechanism for PLRI? Structures involved (6)? Special Tests (7)?

mech: hyperextension. Structures: LCL, arcuate ligament, fabofabellar ligament, PL capsule, IT band, biceps femoris, popliteus. Tests: post drawer, posterior lachman, dial at 30 & 90, reverse pivot shift, posterolateral drawer, posterolateral ER test, ER recurvatum

22

Most common rotatory instability?

AMRI. This is the most frequent cause of ACL disruption

23

Mechanism of ALRI?

IR + varus

24

Mechanism of PMRI?

valgus + hyperextension

25

Phase of healing that lasts 4-6 weeks and focuses on decreasing swelling, gradually restoring PROM & WB, and enhancing volitional control of the quad

Proliferation phase

26

5 weeks post op BTPB, what OKC range is inappropriate?

60-30 degrees of flexion

27

OKC range that is safe to work into after ACLR?

70-90

28

ACL experiences the most stress in what range?

0-50 degrees

29

When the knee is flexed, what fibers of the ACL are stressed the most? What special test will stress these fibers?

anterior bundle, anterior drawer

30

What causes turf toe?

repetitive 1st MTP extension

31

What is a jone's fx?

fx at base of 5th metatarsal

32

syndesmotic injury mechanism?

ER + DF

33

Why does compliance decrease with foot orthoses?

irritation of skin, decreased performance, discomfort of brace

34

critical stress fx sites of Lower leg

anterior tibia, mediall mall, navicular

35

sinus tarsi syndrome

compression of tibial nerve or it's branches

36

Common locations of compartment syndrome in young athletes?

thigh, lower leg, medial compartment of foot

37

With syndesmotic injury you want to avoid what?

DF! As this will increase the tib-fib joint space and exacerbate the injury