Flashcards in Lower Extremity Deck (37):
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.
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.
What is a hip pointer?
direct blow to iliac crest
4 types of labral tears
radial flap, radial fibrillated, longitudinal peripheral, abnormally mobile (partially detached),
What motions to avoid with labral repair?
early flexion and ABD
what is coxa saltans?
what is meralgia paresthetica?
compression of lateral femoral cutaneous nerve that causes extreme burning down the thigh
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.
Most causative factor of adductor strain?
Most common location of hip labral tears? Mechanism?
anterior - loaded rotation
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
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
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
What is Ege's test?
used to detect meniscal tear. Pt can IR (to diagnose lateral mm) or ER (to diagnose medial mm)
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
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.
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.
Step and Twist mechanism with immediate swelling? Step and twist with delayed swelling?
ACL, MCL, lateral meniscus
When does the inferior patellar pole make contract with the superior trochlea?
20 degrees of flexion
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
Most common rotatory instability?
AMRI. This is the most frequent cause of ACL disruption
Mechanism of ALRI?
IR + varus
Mechanism of PMRI?
valgus + hyperextension
Phase of healing that lasts 4-6 weeks and focuses on decreasing swelling, gradually restoring PROM & WB, and enhancing volitional control of the quad
5 weeks post op BTPB, what OKC range is inappropriate?
60-30 degrees of flexion
OKC range that is safe to work into after ACLR?
ACL experiences the most stress in what range?
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
What causes turf toe?
repetitive 1st MTP extension
What is a jone's fx?
fx at base of 5th metatarsal
syndesmotic injury mechanism?
ER + DF
Why does compliance decrease with foot orthoses?
irritation of skin, decreased performance, discomfort of brace
critical stress fx sites of Lower leg
anterior tibia, mediall mall, navicular
sinus tarsi syndrome
compression of tibial nerve or it's branches
Common locations of compartment syndrome in young athletes?
thigh, lower leg, medial compartment of foot