Sprains

Question 1

What is gait?

Answer 1

refereed to as walking

Question 2

you need how many degrees of flexion during the swing phase?

Answer 2

60 degrees

Question 3

when maximally hyper extend you need up to how many degrees at heel off?

Answer 3

10 degrees

Question 4

with the screw home mechanism, what happens to the tibial?

Answer 4

ER

Question 5

if the knee doesn’t reach full extension what happens to the ankle?

Answer 5

it becomes hypermobile

SN; THE HIP WILL NOT COMPENSATE BC IT NEEDS TO IR WHEN KNEE ER AT THE HEEL

Question 6

Descending from stairs you need how many degrees of flexion

Answer 6

90 degrees, but may need up to 120 degrees of flexion

Question 7

Doing a sit-to-stand from a toilet or chair you need how many degrees of flexion?

Answer 7

105 degrees of flexion

Question 8

How many degrees of flexion for cycling do you need?

Answer 8

120 degrees

Question 9

what is the goal with a total knee arthroplasty?

Answer 9

120 degrees of flexion

Question 10

when kneeling and going into a deep squat you need?

Answer 10

full flexion and arthrokinematic from 120-150 degrees of flexion

Question 11

going into a squat the femoral will?

Answer 11

ER, posterior glide, and lateral glide

anything of the motions sound different.

Question 12

Knee flexion the tibia is?

Answer 12

IR

Question 13

knee extension the tibia is?

Answer 13

ER

Question 14

what is a sprain?

Answer 14

stretching or tearing of a ligament

Question 15

Stretching or tearing of a ligament may lead to what?

Answer 15

joint laxity and dysfunction

Question 16

what is increased accessory motion and inadequate neuromuscular function

Answer 16

joint instability

Question 17

what is functional instability?

Answer 17

able to offset laxity through neuromuscular function

Question 18

what is mechanical instability?

Answer 18

unable to offset laxity and likely requires surgery

Question 19

mild S&S, activity may continue, fibers are stretched but NOT torn so minimal to no change during ligamentous special test

Answer 19

Grade 1- 1st degree sprain

Question 20

Moderate S&S, activity stops, fibers stretched and torn so increased laxity with softer late empty end feel during ligamentous test

Answer 20

Grade 2-2nd degree sprain

Question 21

Severe S&S, Activity stops; fibers torn completely with possible avulsion, significant increased in laxity with empty end feels during ligamentous tests

Answer 21

Grade 3-3rd degree sprain

Question 22

Ligaments and capsule

Answer 22

-dense connective tissue
-type 1 collagen-resist tension
-low elastin, better joint stabilization
-fibrocytes

Question 23

Ligament are more multi-directional fibers than tendons

Question 24

mid substance area of a ligament is

Answer 24

hypovascular
hyponeural

Question 25

the insertional end of the ligament is?

Answer 25

-Hypervascular: high metabolic activity for greater healing capacity Hyperneural: for proprioception or position sense

Question 26

Extraarticular (exterior to the joint)

Answer 26

Blend with capsule and often heals without surgery.

Question 27

Intraarticular

Answer 27

within the joint space often needs surgery for repair due to dilution from synovial fluid SN; ACL and PCL

Question 28

What are the symptoms of a sprain?

Answer 28

Traumatic onset swelling likely reduce function

Question 29

what are observations of a sprain?

Answer 29

Antalgic and asymmetrical gait swollen joint

Question 30

Sprain observations

Answer 30

ROM: likely impaired and painful(not all directions) Resisted/MMT: possibly weak and painful Combined Motions: likely inconsistent blocks Stress tests: distraction positive, compression relief Palpation TTP

Question 31

Healing of sprains

Answer 31

Initial tensile strength at 3-5 weeks Dense connective tissue by 12 weeks 10 to 12 months to normal strength postoperatively

Question 32

what should be some ultimate purpose needing to be achieved following a sprain?

Answer 32

Tissue proliferation and integrity and stabilization.

Question 33

Distinctive RX of a sprain

Answer 33

Policed assistive device and external support protecting ligament in shortened position for better long term stability.

Question 34

MET primarily for sprains?

Answer 34

tissue proliferation and integrity and stabilization