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Flashcards in Soft Tissue Injuries Deck (126):
1

What is a strain?

Muscle injury resulting in partial or full thickness tear

2

What is a sprain?

Ligamentous injury resulting in a partial or full thickness tear

3

What is the most common part of the body that is sprained?

Ankle

4

True or false: strains can occur anywhere along the muscle, including tendon insertions

True

5

What is tendinitis? How long does it last for? Treatment?

Acute inflammation of tendon, usually from overuse
-usually resolves in 2-3 days
-RICE and PT

6

What is tendinopathy?

Chronic inflammation of a tendon that can last for several months

7

What is the treatment for tendinopathy?

NSAIDs do not work--PT, PRP

8

True or false: shoulder injuries are common

True

9

What indicates that laxity is an issue?

If there is pain associated with it

10

what are the three major extrinsic factors in shoulder joint pain?

Intensity
Duration
Frequency

11

what is the major intrinsic factor in shoulder pain?

Skeletal immaturity

12

Where do the long and short heads of the bicep tendon attach to?

Long head = supraglenoid tubercle
Short head = Coracoid process

13

Which head of the biceps is usually affected?

Long head

14

What causes the pain with biceps tendonitis?

tendon becomes inflamed in the bicipital groove

15

What is Yergason's test?

Supinate arm against resistance to check for bicipital tendonitis

16

What is Speed's test?

tests for bicipital tendonitis or superior labral tears
-hold hand fully out and supinated. Pain in the bicipital groove

17

How reliable is pain in locating the pathology of shoulder pain?

Poor

18

What are the two muscles that are likely injured with lateral shoulder pain?

Supraspinatus
Infraspinatus

19

What is the muscle that is likely injured with anterior shoulder pain?

Subscapularis

20

What are the history bits that are common to shoulder muscle tears?

Pain when rolling onto that side at night

21

What is the full can test, and what does it assess for?

Supraspinatus

22

What is the correct way to test the supraspinatus with empty can test?

arms in 45 degree abduction

23

What is the bear hug test, and what does it assess for?

-Examiner tries to pull the patient's hand from the shoulder contralateral shoulder
-Positive test = weakness of the subscapularis

24

What is the external rotation test, and what does it assess for?

elbow at side and flexed to 90. Resisted external rotation weakness = Infraspinatus / teres minor

25

What is Patte's test, and what does it assess for?

hornblower's sign
-external rotation against resistance weakness/pain = infraspinatus / teres minor issue

26

What are the two tests for subacromial bursitis?

Neer's test
Hawkin's test

27

What is the treatment for subacromial bursitis?

PT
NSAIDs
Ice

28

What are the primary and secondary causes of subacromial bursitis?

-Primary - overuse
-Secondary - shoulder instability in young athletes

29

What is the usual cause of olecranon bursitis?

Trauma to the olecranon

30

What are the s/sx of olecranon bursitis?

boggy, non-tender mass over the olecranon

31

What is the treatment for olecranon bursitis?

-RICE
-Steroid injection
-Surgery

32

What is the cause of lateral epicondylitis?

Insidious onset from repetitive supination

33

What are the s/sx of lateral epicondylitis?

Pain and decreased grip strength with resisted supination
-TTP (tenderness to palpation) near lateral epicondylitis

34

What is the treatment for lateral epicondylitis?

-RICE
-PT
-Steroid injections

35

What is the test for lateral epicondylitis?

-Resistance against supination pain
-Extension against resistance

36

What is the OMM nonsense for lateral epicondylitis?

Anterior/posterior radial head SDs

37

What are the s/sx of medial epicondylitis?

-TTP over flexor masses
-Pain with resisted pronation

38

What is mallet finger?

Object striking the finger, creating a forceful flexion of extended DIP, and tearing the extensor digitorum tendon

39

What are the exam findings of mallet finger?

-TTP over the dorsal aspect of the DIP
-No active extension at the DIP

40

What is the treatment for mallet finger?

Splint the DIP continuously for 6 weeks

41

When is referral for mallet finger indicated?

-If avulsion of more than 30%
-If passive extension is not achieved.

42

what are the three views that should be obtained with any orthopedic complain?

AP
Lateral
Oblique

43

What is jersey finger?

Forced extension of the DIP during active flexion tears the flexor digitorum profundus

44

What are the exam findings of Jersey finger?

-TTP
-Inability to flex the DIP joint

45

What is the treatment for Jersey finger?

Splint and refer to ortho

46

What is the central slip extensor tendon injury?

PIP joint is forcibly flexed while actively extended, causing central slip rupture and a resulting boutonniere's deformity

47

What are the exam findings with central slip extensor tendon injuries?

-TTP at dorsal PIP
-Inability to actively extend

48

What is the treatment for central slip extensor tendon injuries?

Splint PIP joint in full extension for 6 weeks

49

What are the two indications for referral to ortho with slip tendon injuries?

-Avulsion of more than 30% of joint
-Full passive extension is not achieved

50

What is a "jammed" finger?

Forced ulnar or radial deviation of a finger causing partial or complete collateral ligament tears

51

What joint is usually affected with jammed fingers?

PIP

52

What are the exam findings of Jammed fingers?

TTP at the collateral ligaments

53

What is the treatment for jammed fingers?

Stabilize joint and buddy tape weeks

54

When is referral indicated for jammed fingers?

Unstable joint or child with injury

55

What is the best way to assess for a jammed finger (rupture collateral ligament)? Why?

Flexion of 30 degrees to remove the stabilization effect of the MCP joint

56

What is the correct way to buddy tape fingers?

do not leave 5th finger exposed

57

What is a volar plate injury?

Forced hyperextension of the (usually at the PIP joint) causes a rupture of the volar plate

58

What are the exam findings of volar plate injuries?

TTP at the volar aspect of the involved joint

59

What are the two tests that should be done with volar plate injuries?

-Full flexion and extension
-Collateral ligament stability

60

What is the treatment for volar plate injuries?

Splint 30 degrees of flexion and progressively increase extension for 2-4 weeks

61

When is referral indicated for volar plate injury?

Avulsion or unstable joint

62

What is skier's thumb?

Disruption of the ulnar collateral ligament by forced abduction of the MCP joint (partial/complete tears, with/without avulsion)

63

What are the exam findings of skier's thumb? How do you isolate the ulnar collateral ligament?

-TTP over the UCL at MCP joint
-Stress to full flexion to isolate ligament

64

What is the treatment for Skier's thumb?

Splinting for 6 weeks

65

When should Skier's thumb be referred to ortho? (3)

-Fracture or avulsion fracture
-More than 35 degree of joint opening
-No clear end point

66

What is a Stener's lesion?

Complication from Skier's thumb, where the proximal end of the UCL becomes trapped outside of the adduct aponeurosis
-Presents with joint instability and tender mass

67

What is the treatment for a Stener's lesion?

Surgical

68

Who usually gets trochanteric bursitis?

-Runners
-Over pronators
-ballerinas and figure skaters

69

What are the s/sx of trochanteric bursitis?

Pain over the lateral hip, with TTP over the greater trochanter

70

What is the treatment for trochanteric bursitis?

-RICE
-NSAIDs
-Gentle hip stretching
-Steroid injections

71

What in particular should be stretched with trochanteric bursitis?

IT band

72

What are the attachments of the IT band?

Gerdy's tubercle and lateral femoral condyle

73

What is snapping hip?

acute trochanteric bursitis associated with pain over or just posterior to the trochanter that presents as a snap that appears every time they snap their hip

74

Who usually gets a snapping hip?

Athletes who repetitively flex and extend their hip

75

What is the treatment for a snapping hip?

-Topical anti-inflammatory
-IT band rehab
-Injection of trochanteric bursae

76

what is an internal snapping hip?

-Iliopsoas tendon rubbing over the iliopectineal ligament eminence of the pelvic brim
-Presents as a deep anterior snapping sensation with hip flexion

77

What is the treatment for an internal snapping hip?

-Stretching
-PT
-bursa injections

78

What is iliotibial band friction syndrome?

Inflammation of the IT band due to overuse, that classically presents with TTP along the lateral femoral condyle

79

What is the treatment for iliotibial band friction syndrome?

-Stretching
-Massage
-Foam rollers

80

What is the thomas test for iliotibial band friction syndrome?

Flex hip and see if contralateral leg externally rotates--indicates a tight iliopsoas

81

What is the largest and most complicated joint in the body? What type of joint is it?

Knee
Ginglymus

82

What does the stability of the knee depend on?

-Strength and support of muscle and tendons
-Ligaments connecting the femur and the tibia

83

what is the motion of the knee?

Screw--external/lateral rotation of the tibia on the femur

84

What is the purpose of the screw motion of the knee?

Medial femoral condyle is longer than the lateral femoral condyle

85

Which is stronger: the ACL or the PCL?

PCL

86

What is the role of the patellar ligament, relative to the quads?

Holds the quad forward

87

Which knee meniscus is C shaped? Which is O shaped?

C = Medial
O = lateral

88

Which meniscus of the knee is attached to its overlying collateral ligament?

Medial to the MCL

89

Why is the lateral meniscus of the knee less frequently injured than the medial?

Fibular head protection
Not attached to the LCL

90

What usually causes ACL injuries?

Valgus stress with acute hyperextension

91

What are the components of the unhappy triad?

Injury to the MCL, ACL, and the medial meniscus

92

What is the treatment for the unhappy triad?

Surgical

93

How is the PCL commonly injured?

Acute hyperflexion--"dashboard knee"

94

What are grades I - III of PCL tears?

I = mild laxity
II = moderate laxity
III complete tear

95

What is the treatment for PCL tears?

Operative

96

What is the treatment for meniscal tears?

Depends on severity of the symptoms--pain control and rehab vs surgery

97

What is patellofemoral syndrome?

Patellar tracking syndrome of chondromalacia--abnormal tracking through the trochlear groove d/t degeneration in the articular cartilage

98

what is the treatment for patellofemoral syndrome?

PT
OT
Patellar taping or band

99

What is Hoffa's syndrome?

fat pad in the deep infrapatellar space leads to anterior knee pain that is worse with taping

100

What is osteochondritis dissecans?

Fragmentation of the articular cartilage that may eventually progress to necrosis

101

What is the treatment for osteochondritis dissecans?

If immature skeleton = avoid running and jumping for 8 months

Mature = skeleton

102

What is osgood-Schlatter's syndrome ("apophysitis")?

-Overuse injury with avulsion of the patellar tendon leading to pain
-Usually seen in adolescents

103

What is the treatment for osgood-schlatter's syndrome?

RICE
Isometric stretches
PRP

104

What is patellar tendonitis? Treatment?

-"Jumper knee"
-Overuse injury that is a risk for OS
-RICE

105

What is a baker's cyst?

Posterior popliteal cyst that is a complication of chronic inflammation of the knee

106

What is the treatment for a Baker's cyst?

RICE
NSAIDs
Aspiration if necessary

107

What is housemaid's knee?

Prepatellar bursitis from kneeling for long periods

108

What is Clergyman's knee?

Superficial infrapatellar bursitis that is commonly seen in roofers

109

What is deep infrapatellar bursitis?

Inflammation between the patellar ligament and the tibia

110

What is the risk of injection and/or aspiration of bursa?

All connected so increased risk of infection spreading

111

What ways does the fibular head move?

Anterolateral and posteromedial

112

What is the treatment for fibular head abnormalities?

Anti-inflammatories

113

What nerve may be associated with fibular head abnormalities?

Peroneal nerve

114

What is tibial torsion? How is it treated?

External or internal torsion of the tibia that usually occurs in children. Usually treated with ME

115

What is the ligament that is on the medial side of the ankle?

Deltoid ligament

116

What are the ligaments that are on the lateral side of the ankle, from anterior to posterior (3)?

-Anterior tibiotalar
-Calcaneofibular ligament
-Posterior talofibular ligament

117

Should you evaluate the gait with an ankle injury?

Yes

118

What is Morton's toe?

Long second toe

119

What is the functional test for arch assessment?

Forward squat test--keep heels on the ground
-If arches roll inward = pronation

120

Which ligament is being assessed for with the anterior drawer test?

Anterior talofibular ligament

121

Which ligament is being assessed for with the talar tilt test? What does a positive test indicate?

-Calcaneofibular ligament
-Increased motion and/or lack of endpoint

122

Which ligament is being assessed with the reverse talar tilt?

Deltoid ligament

123

What is the external rotation test of the ankle, and what does it assess for?

Forceful external rotation of the foot
-If affected side opens more than 15 degrees compared to other, then indicates a high ankle sprain

124

Where on the leg is the squeeze test performed?

Mid leg

125

What are the components of the ottawa ankle rules?

TTP over:
-Lateral malleolus
-Medial malleolus
-base of the 5th metatarsal
-navicular

or inability to bear weight

126

What is the swing test?

Keep plantar aspect of the foot parallel to the ground while passively flexing the knee
-Positive test is when RROM is felt