WEEK 11 Plasma and Hip

Question 1

What is the norm range of platelets?

Answer 1

150k-400k/uL

Question 2

Platelets have many secretory granules (50-80 per cell) involved in regulated secretion that help with what process?

Answer 2

Aggregation

Question 3

What do platelets release along with adhesion molecules to mediate a variety of cellular interactions?

Answer 3

Platelet growth factors

Question 4

What is PRP used for today?

Answer 4

• Orthopedic procedures
• Cardiac surgery
• Sports injuries
• Plastic surgery
• Gynecology
• Urology
• Medical aesthetics

Question 5

What condition has the strongest clinical evidence between PRP and rehab?

Answer 5

Knee OA

Question 6

Which greater troch bursa lies above and slightly anterior to the proximal and superior part of greater troch?

Answer 6

Glute min

Question 7

Which greater troch bursa lies beneath glute med muscle, posterior and superior to proximal greater troch?

Answer 7

Subglute med

Question 8

Which greater troch bursa is lateral to greater troch, lying between glute med and converging fibers of glute max and TFL?

Answer 8

Subglute max

Question 9

What are the two most common age groups for trochanteric pain?

Answer 9

• Middle-aged women (4th decade)
• Elderly (6th decade)

Question 10

Which tendon is more commonly found to be a pathologic structure in greater troch pain?

Answer 10

Glute med

Question 11

If greater troch pain syndrome is due to trauma, how does it occur?

Answer 11

• Hyperadduction of hip
• Direct blow/fall on lateral hip

Question 12

cause of trochanteric pain from ITB rubbing over ___ tendon

Answer 12

glute medius

repetitive microtrauma

Question 13

more common MOI for greater troch pain syndrome is

Answer 13

overuse of hip structures for stabilization that causes repetitive microtrauma

Question 14

contributing factors of greater troch pain syndrome

-poor walk or run mechanics
-an occupation that requires sit or stand
-lumbar or SI pathology
-leg length discrepancy
-poor activation of
-tight muscle groups esp ___,____,___

Answer 14

lumbar muscle groups-multifidus and TA
hip flexor, adductors, and hamstrings

Question 15

Greater troch pain is at posterior lateral hip and buttock and can extend down which part of the thigh?

Answer 15

Lateral

note: rarely pain extend beyond knee and into posterior thigh and is usually chronic and intermittent

Question 16

where might pt report numbness for greater troch pain syndrome

Answer 16

upper thigh and snapping sensation near greater troch

Question 17

What level nerve roots can refer pain to greater troch region and part of thigh?

Answer 17

L2-L4 (L5 more posterior but still can refer to lateral thigh)

Question 18

Which two hip movements aggravate greater troch pain?

Answer 18

• ER
• Abd

Question 19

What two positions should a patient lay in to ease greater troch pain?

Answer 19

• Supine
• Contra side lying with pillow between knees

note: ipsilateral sidelying is PAINFUL

Question 20

What early intervention is used to improve ITB mobility without placing a lot of stress over greater troch?

Answer 20

STM

Question 21

True or False: Concentric glute exercises help tendon healing and strengthening as well as contribute to dynamic pelvic stability.

Answer 21

F (eccentric)

Question 22

tendon pathology that actuely involves microtears and inflammation and chronically involves degeneration and cellular and collagen abnormalities

Answer 22

hamstring tendinopathy

Question 23

tissue deformation in response to stress of bicep femoris, semimem, semiten, ocurring at musculotendinous junction or muscle belly

Answer 23

hamstring strain

Question 24

Which hamstring muscle is the most commonly strained muscle?

Answer 24

Biceps femoris

Question 25

True or False: Strains most commonly occur at hamstring muscle belly.

Answer 25

F (musculotendinous junction especially proximal to ischial tub)

Question 26

Hamstrings are commonly injured with noncontact activities that are eccentric or concentric?

Answer 26

Eccentric

Question 27

-rapid acceleration of running speeds -repetitve hip stretching exercises that require larger ROMs -fall during sporting event -jump -kick or lunge

Answer 27

hamstring strin,tendinopathy

Question 28

What position of hip and knee eases hamstring pain along with posterior pelvic tilt and lumbar spine flexion?

Answer 28

- Neutral hip - Flexed knee

Question 29

Highly active individuals in which age group have a higher prevalence of labral tears?

Answer 29

20-40

Question 30

labral tears and fraying in pt older than 60 occur because of

Answer 30

degenerative changes

Question 31

a tear may cause fluid to leak increasing ____

Answer 31

friction of femoral head on acetabulum

Question 32

occur from direction of force and extent of trauma to labrum

Answer 32

traumatic force

Question 33

What is the most common type of labral tear that has disruption of the free margin of labrum?

Answer 33

Radial flap

Question 34

Which type of labral tear is fraying of the free margin and is associated with degenerative joint disease?

Answer 34

Radial fibrillation

Question 35

Which type of labral tear is a detached labrum similar to Bankart of shoulder?

Answer 35

Abnormally mobile

Question 36

Which type of labral tear is least common and is a tear in longitudinal direction in peripheral aspect of labrum?

Answer 36

Longitudinal peripheral

Question 37

Labral tears are most common in an anterior or posterior and which location of the inner aspect of labrum?

Answer 37

Anterior and anterosuperior

Question 38

Which contributing factor to labral tears involves decreased joint clearance between femur and acetabulum?

Answer 38

FAI (femoroacetabular impingement)

Question 39

A tear in labrum decreases the ability to stabilize the joint which puts greater force on which ligament?

Answer 39

Iliofemoral

Question 40

Which contributing factor to labral tears involves a shallow acetabular socket?

Answer 40

Dysplasia

Question 41

locking, clicking or sensation in the hip joint

Answer 41

labral tear

Question 42

Labral tears commonly refer pain to which region?

Answer 42

Anterior groin region

Question 43

Myofascial pain occurs from local trauma that causes what formation followed by adhesion formation?

Answer 43

Hematoma

Question 44

rest in open pack position and hip distraction easing for

Answer 44

labral tear

Question 45

rehab for labral tears include stretching of ___,____,___

Answer 45

ER, adductors, hip flexors

Question 46

compresion of sciatic nerve

Answer 46

piriformis syndrome

Question 47

Is this primary or secondary piriformis syndrome?

Answer 47

Primary

Question 48

nerve entrapment/impingement occur when

Answer 48

sciatic nerve pierces through piriformis muscle creating neural irritation and inflammation of sciatic nerve when piriformis muscle is compressed

Question 49

all pathology intrinistic to piriformis muscle secondary to an inciting event such as trauma is included

Answer 49

primary piriformis syndrome

Question 50

all other causes in which symptoms of posterior butt pain with or wihtout radiation down leg depend on location of pathology in relation to structures adjacent to sciatic notch procided that spine is excluded

Answer 50

secondary

Question 51

What muscle groups are weak with piriformis syndrome?

Answer 51

- Glutes - Core stabilizers

Question 52

Increased lumbar what contributes to piriformis?

Answer 52

Lordosis

Question 53

What is the term for when piriformis syndrome has radicular-type symptoms into lower extremity posterior thigh and calf following sciatic nerve pattern?

Answer 53

Wallet sign

Question 54

palapable spindle or sausage shaped mass tender to palpation

Answer 54

pirformis syndrome

Question 55

pain with bowl movements intolerance to sitting dyspareunia gluetal atrophy positive lasegue sign acute pain from lifting pain in butt

Answer 55

piriformis syndrome

Question 56

which hip motions are aggravatiing for piriformis

Answer 56

hip adduciton and internal rotation

Question 57

Which stretch position of piriformis is the most easing?

Answer 57

Supine with lower extremity external rotation