Lower Extremity I

Question 1

Grading of sprain/strain

Answer 1

. Mild/Grade 1: microscopic tearing or stretching
. Moderate/2: definite tearing
. Severe/3: complete tear

Question 2

Acetabular labrum

Answer 2

. Fibrocartilaginous ring
. Functions as extension of bony acetabulum
. Forms seal, shock absorber of hip joint

Question 3

femoroacetabular joint movement

Answer 3

. Capsule maximally tightened in internal rotation

. Hard end feel

Question 4

Acetabular labral tears

Answer 4

. Active youth OR degenerative in older adults
. Loss of suction seal, synovial fluid leak
. Inc. cartilage compression
. Happens randomly (insidous) more often than acute injury
. Groin pain
. Mechanical symptoms
. Internal rotation and adduction motion deficits

Question 5

Tensor fascia lata

Answer 5

. Muscle
. Flexes hip, abducts and internally rotates thigh
. If it becomes tight it will pull on iliotibial band and tighten it

Question 6

Iliotibial band syndrome

Answer 6

. Friction btw ITB and lat. femoral condyle
. Lat. knee pain
. Common in runners
. Hard to stretch

Question 7

Hamstring actions

Answer 7

. Hip extension

. Knee flexion (2 joint muscle)

Question 8

Hamstring problems

Answer 8

. Strains (grade 1 more common than 3)
. Occur in thick, central part of muscle where tendon and muscle fibers join
. Most heal w/ RICE but are notoriously slow
. Surgery needed for complete tear or avulsion injury

Question 9

Knee OA

Answer 9

. Most common in knee 
. Common over 50 
. Worse in morning, after sitting, or vigorous activity 
. Vagus deformity 
. Joint space narrowing 
. Osteophytes

Question 10

Order of knee exam

Answer 10

. Inspection
. Functional activities 
. ROM
. Bony palpation
. Soft tissue palpation
. Special tests
. Compare both sides

Question 11

Suprapatellar pouch

Answer 11

. Prox. To knee joint btw prefemoral and suprapatellar fat pads
. Bursa
. Communicates w/ knee joint in 85% people
. Fluid in space means effusion

Question 12

ACL injury

Answer 12

. From sudden change in direction, quick deceleration, hyperextension, valgus force or rotational injury
. Popping sensation, severe pain, instability, swelling in a few hours
. Assoc. w/ med. meniscus injury and collateral ligament injury

Question 13

PCL tear

Answer 13

. Post. Directed force w/ foot in plantar flexion

. Cause: fall on bent knee, dashboard injury in car accident (50%)

Question 14

PCL sag sign

Answer 14

. Pt supine w/ knee bent

. Tibia sags

Question 15

T/F menisci have no blood supply

Answer 15

T, tear will not heal

Question 16

Patellofemoral pain syndrome

Answer 16

. Pain in front knee (runner’s knee)
. Chondromalacia if actual articular cartilage irritation
. Happens more in girls, people doing too much too fast
. Mechanical flaws causing this: excessive lat. tracking of patella in femoral groove, weak vastus medialis obliquus (VMO)

Question 17

Ankle sprain grading

Answer 17

1: mild, minimal pain w/ walking
2: moderate, walking painful
3: complete, can’t walk, ankle unstable

Question 18

High ankle sprain

Answer 18

. High ankle ligaments (syndemosis) connect tibia and fibula
. Ankle fracture can passed from deltoid ligament through syndemosis to prox. Fibula (maisonneuve fracture)

Question 19

Achilles tendonitis

Answer 19

. Inflammation from inc. training, flat arches, thigh calves
. Can lead to Achilles tear

Question 20

Tarsal tunnel syndrome

Answer 20

. Pressure on post. Tibial n. As it passes through tunnel of med. ankle
. Burning pain in foot, pins and needs, pain radiating to arch, heel, or toes