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treatments 2 theory > midterm theory exam > Flashcards

midterm theory exam Flashcards

1
Q

_______ are composed of flexible, non-contractile connective tissue

A

ligaments

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2
Q

________ limit and control the ROM at the joint while still allowing movements to occur

A

ligaments

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3
Q

name the cause of a sprain

A

sudden twist/wrench of a joint beyond its normal range

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4
Q

contributing factors to sprains

A

congenital ligamentous laxity
previous sprains
altered biomechanics causing stress on ligament/joint
connective tissue pathologies

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5
Q

grade 1 (mild or first degree sprain)

A

MINOR stretch/tear to ligament
NO instability on PR testing
CAN CONTINUE w/ activity with some discomfort

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6
Q

grade 2 (moderate or second degree sprain)

A

TEARING of ligament
SNAPPING sound @ time of injury & joint gives way
joint HYPERMOBILE yet stable on PR testing
difficulty continuing activity due to px

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7
Q

grade 3 (severe or third degree sprain)

A
  • COMPLETE RUPTURE/AVULSION of ligament
  • SNAPPING sound @ time of injury & joint gives way
  • instability w/ no end point on PR testing
  • person cannot continue activity due to instability & px
  • px is present in acute stage and hypermobile in direction the ligament is meaning to test in chronic phase
  • palpable gap
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8
Q

joint effusion

A

injury is severe enough to inflame the synovium

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9
Q

hemarthrosis

A

bleeding into the synovial space

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10
Q

most common ankle sprain

A

inversion sprain
anterior talofibular ligament

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11
Q

what ligament is most frequently sprained in conjunction with the anterior talofibular ligament?

A

calcaneofibular ligament

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12
Q

eversion sprain of the ankle? what is injured?

A

ankle is forced into eversion
deltoid ligament is affected

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13
Q

what type of fracture is common with an eversion sprain of the ankle? (deltoid ligament sprain)

A

avulsion fracture @ tibia

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14
Q

out of the two collateral ligaments of the knee, which one most commonly injured?

A

medial collateral ligament

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15
Q

what are the 4 ligaments that can be sprained in the knee?

A

medial collateral
lateral collateral
anterior cruciate
posterior cruciate

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16
Q

mechanism of injury for medial collateral ligament of the knee

A

foot fixed the the ground, knee is struck by a medially directed/valgus force

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17
Q

mechanism of injury for the lateral collateral ligament of the knee?

A

lateral directed/varus force to the knee

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18
Q

mechanism of injury to the anterior cruciate ligament of the knee

A

tibia is forced anteriorly

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19
Q

mechanism of injury for the posterior cruciate ligament of the knee

A

tibia is forced posteriorly

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20
Q

what is the most common mechanism of injury for a wrist sprain?

A

forced hyperextension

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21
Q

what are the 6 ligaments that can be affected with a wrist sprain?

A

palmar radiocarpal
dorsal radiocarpal
ulnar collateral
radial collateral
inter carpal
triangular fibrocartiaginous

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22
Q

what is damaged during a hyperflexion injury of the wrist?

A

dorsal radiocarpal ligaments
also the extensor tendons and wrist bones

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23
Q

what is injured during a forced hyperextension sprain of the wrist?

A

all 6 ligaments are possible
flexor muscle tendons and bones of the wrist

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24
Q

grade 1 shoulder sprain (what is affected)

A

AC sprain, tearing of the joint capsule

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25
Q

grade 2 shoulder sprain (what is affected)

A

tear of the joint capsule and the AC ligament

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26
Q

grade 3 shoulder sprain (what is affected)

A

tear of the joint capsule
AC ligament tear
conoid and trapezoid ligament tears
fracture is possible

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27
Q

most common mechanism of injury for shoulder sprain

A

falling on to the shoulder itself

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28
Q

what is tendinitis?

A

inflammation of a tendon

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29
Q

what are tendons made of?

A

regularly arranged dense collagen fibers

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30
Q

a tendon that moves in a straight line

A

paratendon

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31
Q

a tendon that runs across a bony prominence is surrounded by

A

tendon sheath

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32
Q

what is paratendinitis

A

inflammation of the paratendon or tendon sheath

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33
Q

tendinosis

A

degeneration changes occurring with chronic tendon injuries. such as tennis elbow

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34
Q

tendons appear in two shapes:

A

cord like structures
broad sheet like structures-called aponeurosis

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35
Q

what do tendons attach

A

muscle to bone, they are part of the musclotendinous unit

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36
Q

cause of tendinitis

A

chronic overload of tendon which leads to micro tearing and inflammation of the tendon

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37
Q

contributing factors to tendinitis

A

mm imbalances
poor biomechanics
lack of flexibility
chronic degenerative changes in tendon
poor blood supply to tendon
improper equipment
training errors

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38
Q

what are the 4 grades of tendinitis

A

grade 1: px ONLY after activity
grade 2: px @ beginning of activity, disappears during activity, returns after
grade 3: px @ beginning of activity, during & after. px may restrict activity
grade 4: px with ADL, continues to get worse

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39
Q

activities that may cause biceps long head tendinitis

A

swimming, throwing sports where arm is abducted causing compression to tendon
- usually secondary to other pathologies

40
Q

common activities that may cause common extensor (lateral epicondylitis) tendinitis

A

tennis/racket sports, poor technique, wheelchair athletes, plumbing, electrical
“tennis elbow”

41
Q

what tendon is the most commonly injured with a common extensor/later epicondylitis tendinitis

A

extensor carpi radialis brevis

42
Q

activities that may cause common flexor/medial epicondylitis tendinitis

A

repetitive activity such as hammering, screwdriver, golf, overhead serve in tennis
“golfers elbow”

43
Q

what specific weakness is specific to medial epicondylitis/common flexor tendinitis

A

weak grip

44
Q

what nerve compression is common with medial epicondylitis/common flexor tendinitis

A

ulnar nerve compression

45
Q

what two muscles are involved in DeQuervains tenosynovitis

A

abductor pollicis longus and extensor pollicis brevis

46
Q

activities that cause DeQuarvains Tenosynovitis

A

activities that require thumb use, factory work, massage therapy, racquet sports

47
Q

what activities cause patellar tendinitis

A

running, jumping, track and field

48
Q

where is the pain located with patellar tendinitis

A

at the tendon itself.
apex of knee cap to tib tub

49
Q

activities that can cause popliteus tendinitis

A

downhill running/walking combined with pronation of the foot

50
Q

what can be confused with popliteus tendinitis

A

IT band friction syndrome

51
Q

activities that can cause tibilais posterior tendinitis

A

running, step aerobics, stepping machines, combined with excessive pronation

52
Q

impingement syndrome

A

inflammation, pain and deems of tissues between the AC and GH joints

53
Q

what is affected with impingement syndrome

A

supraspinatus
biceps
subacromial bursa

54
Q

what are the 3 progressive stages of impingement syndrome

A

stage 1: edema & hemorrhage of subacromial bursa.
stage 2: tendinitis & fibrosis. both stages are reversible with rest (stop doing activity that causes it) stretching and strengthening
stage 3. incomplete tears or complete tendinous rupture. may be bony changes of acromion & AC joint. surgery usually indicated

55
Q

what is calcification tendinitis

A

late occurring stage of RC tendinitis, usually occurring in the supraspinatus tendon

56
Q

trigger finger

A

overuse of flexor tendons of any finger that may develop thickened nodular swelling. swelling unable to move through tendon sheath & gets stuck. finger gets stuck in flexion until it is passively extended by an external force

57
Q

what position do fingers get stuck in trigger finger

A

in flexion

58
Q

a bursa is not palpable unless…

A

it is inflammed

59
Q

what is bursitis

A

inflammation of a bursa

60
Q

what is the function of a bursa

A

reduce friction, usually between tendons and bones

61
Q

what is a bursa

A

small flat sac lined with synovium. separated by lubricating fluid

62
Q

cause of bursitis

A

overuse of the surrounding structures which leads to excessive friction and inflammation of the bursal walls

63
Q

what is a secondary cause of bursitis

A

tendinitis

64
Q

contributing factors to bursitis

A

poor biomechanics, mm imbalance, postural dysfunction & lack of flexibility
less common: acute trauma, infection, pathologies (RA, OA, gout)

65
Q

what is the most common cause of subacromial bursitis

A

working with arms overhead (carpenters, electricians, etc)

66
Q

subacromial bursae location

A

lies between the acromion and supraspinatus tendon, portion of the bursa is between the deltoid mm and humerus

67
Q

how is the subacromial bursa irritated

A

as it’s compressed between the RC tendons, coracoacromial ligament and the acromion or by the biceps tendon

68
Q

where is the subcoracoid portion of the shoulder bursae palpated

A

through the anterior deltoid mm near the acromion

69
Q

where is the subscapular bursa located

A

between the scapula and subscap mm. not easily palpable

70
Q

where is the olecranon bursa located

A

between the olecranon and the subcutaneous fascia

71
Q

what activities irritate the olecranon bursa

A

repetitive weight bearing or trauma such as dragging the elbow on the ground when wrestling (hitting elbow/blunt force)

72
Q

where is the trochanteric bursa located (2 of them)

A

1) between the glute max tendon and trochanter
2) between the glute med tendon and trochanter

73
Q

where will the pain be located in someone with trochanteric bursitis

A

local to lateral hip and client will not be able to sleep on involved sign

74
Q

what action will make pain worse in someone with trochanteric bursitis

A

climbing stairs and getting out of the car (causes contraction of glute max, pulling on bursa)

75
Q

where is the iliopectineal bursa located

A

between the iliopsoas mm and iliofemoral ligament

76
Q

how would you palpate the iliopectineal bursa

A

client lies supine with hip flexed to 90. bursa is located 1-2cm inferior to middle third inguinal ligament

77
Q

what causes iliopectineal bursitis

A

hip flexor tightness and repetitive activity

78
Q

where is the pain located with iliopectineal bursitis

A

anterior hip and may radiate down anterior leg due to pressure on femoral nerve

79
Q

what nerve may be affected in someone with iliopectineal bursitis

A

femoral nerve

80
Q

where is the ischial bursa located

A

between the glute max and ischial tub

81
Q

how is the ischial bursa palpated

A

through the glute max

82
Q

What referral pain is present with ischial bursitis

A

referral down posterior leg that mimics sciatic pain

83
Q

what action may be painful in someone with ischial bursitis

A

standing in toes

84
Q

what is the cause for ischial bursitis

A
  • sitting for long periods in a hard surface
  • excessive sprinting due to hamstring contracture
85
Q

where is the pes anserine bursa located

A

between the tendons of sartorius, gracilis and semitendenosis mm and medial tibia

86
Q

where is the infrapatellar bursa located

A

between the patella ligament and the tibia

87
Q

how are the knee bursae palpated

A

through overlying tendons

88
Q

where is the prepatellar bursa located

A

between the lower half of the patella, patellar ligament and the skin

89
Q

what can cause knee bursitis

A

frequent kneeling

90
Q

____ bursae are communicating and ____ are non communicating

A

4, 4

91
Q

where is the retrocalcaneal bursa located

A

between the achilles’ tendon and calcaneous

92
Q

how is the retrocalcaneal bursa palpated

A

on either side of the achilles tendon

93
Q

what can cause retrocalcaneal bursitis

A

overuse and tight gastroc & soleus complex are causes of inflammation

94
Q

bakers cyst

A

synovial cyst that appears on the lateral side of popliteal space

95
Q

where does a bunion occur

A

at the first metatarsophalangeal joint capsule

96
Q

what is a bunion

A

a former excessive bone growth, a callus and an inflamed, thickened bursa developing over the joint

97
Q

what causes a bunion

A

hypermobile joint and poor biomechanics allowing the first metatarsal bone to deviate medially. the phalanges deviated laterally forming hallux valgus

treatments 2 theory (3 decks)

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