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MS/Rheum > Sports Medicine: Lower Extremity Injuries > Flashcards

Sports Medicine: Lower Extremity Injuries Flashcards

1
Q

What is an Avulsion Fracture?

A

strong muscle contraction causes a tendon to pull off a piece of immature bone

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2
Q

What are the common sites of an avulsion fracture and what muscle is involved?

A

ASIS - sartorius
AIIS - rectus femoris
Ischial Tuberosity - hamstrings

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3
Q

What lower extremity injury is documented to have occurred in dinosaurs?

A

avulsion fracture

not kidding, its on the wiki page for it… and now I’m picturing a limping T rex

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4
Q

groin pain + clicking or snapping of hip joint with limited range of motion

A

labral tear

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5
Q

Where on the labrum are tears most common?

A

anterior and superior

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6
Q

What is the C sign?

A

the patient places their index finger over the anterior aspect of the hip and thumb over the posterior trochanteric region to indicate the location of their pain

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7
Q

Where is the pain usually found with a labral tear?

A

groin

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8
Q

This condition is characterized by abnormal contact between the proximal femur and rim of the acetabulum.

WHat does this abnormal contact lead to?

A

Femoroacetabular Impingement

shearing of the cartilage with hip flexion –> arthritis in the hips by 40s

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9
Q

What are the different types of FAI?

A
  1. Cam = mass at neck of femur)
  2. Pincher = bony mass on ox coxae adj to acetabulum
  3. combined
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10
Q

platelet rich plasma

A

spin down pts blood to get the plasma with all the platelets and growth factors… inject it into them to speed up healing process after a hamstring or quad tear

**only rich athletes do this

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11
Q

What are the 4 types of meniscal injury?

A
  1. longitudinal (peripheral)
  2. bucket handle (flip into joint)
  3. flap (nub of cartiladge)
  4. radial
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12
Q

Why is the longitudinal type of meniscal tear usually repaired surgically?

A

the tear in the periphery where there in a increased vascularization (need to repair there it to heal in this location? or something along those lines?)

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13
Q

“I heard/felt a pop, the knee feels hyperextended and comes in and out of place” + swelling + difficult to walk

A

ACL tear

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14
Q

herarthrosis

A

assc with ACL and accounts for the swelling in the joint which is due to accumulation of blood

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15
Q

What are the test you would perform to check for an ACL tear?

A

Lachman Test

  • -The knee is flexed at 30 degrees
  • -pull on the tibia to assess the amount of anterior motion of the tibia in comparison to the femur
  • -An ACL-deficient knee will lack a firm endpoint!
  • –be sure to test the opposite leg too
  • Best test for ACL*
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16
Q

What are the characteristic bone bruises assc with an ACL tear?

A

mid 1/3 lateral femoral condyle (LFC)

post 1/3 lateral tibial plateau (LTP)

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17
Q

What ligament is most commonly torn with an ACL injury?

A

MCL

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18
Q

What are the test you would perform to check for a MCL tear?

A

Pivot Shift:

  • -patient must be completely relaxed (easier to elicit under anesthesia)
  • -extension to flexion: mimics the actual pathologic motion/event (i.e. they will only let you do it once)
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19
Q

ACL tears are more common in men or women? Why?

A

WOMEN

  • body movement
  • muscle strength
  • hormones
  • joint laxity
  • ligament size
  • limb alignment
  • notch dimensions
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20
Q

How must a pt be postioned during an MRI to see an ACL injury?

A

knee externally rotated 15 degrees

  • can visualize ACL, menisci, collateral ligs, and chondyles in one frame
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21
Q

treatment of an ACL injury?

A

low demand pts = non-operative

active pts = surgical repair

22
Q

see posterior sag of the knee

A

PCL tear

23
Q

What are the 3 ways the PCL usually gets torn?

A
  1. direct trauma to tibia (dashboard)
  2. fall on flexed knee (usually with foot plantar flexed)
  3. hyperextension
24
Q

Treatment of PCL tear?

A

usually non-operative due to inc risk to develop arthritis

25
Q

valgus blow to the knee could cause an ____ injury

A

MCL

26
Q

Is an MCL or an LCL injury more common?

A

MCL

27
Q

non-contact with pivoting, awkard landing, and sliding into base

A

MCL

28
Q

Treatment for MCL/LCL injury

A

usually do not operate unless assc with another ligament injury

29
Q

How do pts typically dislocate their knee?

A

high velocity fall = MVA or fall > 5ft
low velocity fall = sports or fall < 5 ft
ultra low velocity fall = obese person

30
Q

Why must a knee dislocation be caught quickly?

A

get injury to popliteal N (which can be permanent) and to popliteal artery
–> AMPUTATION if >8 hr delay

31
Q

What determines the timing of surgery with a knee dislocation?

A

which ligaments are torn

Delayed if collaterals are intact or ACL/PCL/MCL
All other combos immediate (i.e <10-14 days)

32
Q

Fulkerson osteotomy or MPFL reconstruction

A

operative treatments of patellar instability

33
Q

What is the test to determine patellar instability

A

patellar apprehension sign

patella dislocated laterally?

34
Q

high riding patella

A

petella tendon hear

35
Q

How does the patella look with a quad tendon rupture

A

normal

36
Q

Treatment of petellar or quad tendon rupture

A

surgical bc will not heal on its own

37
Q

Knee joint popping/locking, weakness, dec ROM, swelling, tenderness

A

osteochondral defect (OCD) or chondral knee injury

38
Q

What is the cause of OCD/chondral knee injury?

A

vascular, trauma, and/or genetic

39
Q

treatment for OCD/chondral knee injury

A

microfracture
fixation of fragment
OATs (bone plug ~ hair plug)

40
Q

What tendons rupture in …
20-30 yo
30-40 yo
40-50 yo

A

20-30 yo = achilles
30-40 yo = petellar
40-50 yo = quad

**pandout said differently, but I went with that the prof said

41
Q

syndemosis

A

high ankle sprain (ligs that connect tibia and fibula)

42
Q

inversion of the foot will sprain the ankle at what ligaments?

A

lateral

  • anterio tibiofibualr
  • calcaneal

**will heal on their own

43
Q

Which ligaments will not heal on their own when the ankle is sprained?

A

medial ligament = deltoid ligament

44
Q

What is the difference between a jones and a pseudo-jones fracture?

A

pseudo-jones = an avulsion fracture of 5th metatarsal caused by pull from the peroneus brevis = HEALS

jones = a fracture of the diaphysis of the fifth metatarsal of the foot (at the proximal end) = DOES NOT HEAL without immobilization or surgery

45
Q

change in exercise routine a few weeks before onset of leg pain + dreaded black line on Xray

Tx?

A

stress fracture

black line = severe = insert rod
others = rest, but hard to heal

46
Q

tibial stress fractures occur (anteriorly, posteriorly)

A

anteriorly

47
Q

mid foot sprain due to dorsal dislocation of 2nd metatarsal

Tx?

A

lisfranc injury

surgery

48
Q

extreme dorsal flexion of big toe

A

turf toe

49
Q

pop/snap follwed by pain ~ to being kicked/hit in heel. Cannot stand on their toes on affected side

A

achilles tendon rupture

50
Q

What test is used for an achilles tendon rupture?

A

thompson = squeeze gastrocnemius, if the foot does not plantar flex = positive test = Achilles tendon rupture

51
Q

T or F: a pt with a torn achilles tendon can plantar flex on their own

A

T: their posterior tibialis is still intact

MS/Rheum (23 decks)

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