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KNPE 331 > Final > Flashcards

Final Flashcards

1
Q

Plica

A

-fibrous tissue extnending from the joint capsule that is supposed to reabsorb during growth & development

-these tissue bands can sometimes be left over & get in the way of a joint mimicking a meniscus injury

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2
Q

Key structures of hip and pelvis

A

-Iliac crest
-ASIS
-AIIS
-PSIS
-ischial tubersoity
-Pubic symphysis
-Hip joint

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3
Q

External oblique origin

A

outer surface of ribs 5-12

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4
Q

external oblique insertion

A

inferiorly onto anterior 1/2 of iliac crest & medially into linea alba

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5
Q

external oblique action

A

trunk rotation, flexion, side bending, compress abdominal viscera

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6
Q

Hip FLexors

A

-Psoas
-Iliacus
-Sartorius
-Rectus Femoris
-Pectineus
-Tensor Fascia Latae

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7
Q

important palpation point of hips

A

AIIS where rectus femoris originates (this is the only quad muscle doing hip flexion

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8
Q

quad muscles

A

-rectus femoris
-vastus lateralis, medialis, intermedius

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9
Q

quad muscle insertion

A

quad tendon onto patella

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10
Q

Medial hamstrings

A

-semimembranosis
-semitendonosis

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11
Q

Lateral hamstrings

A

-biceps femoris

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12
Q

Gooses foot

A

-semitendonosis
-gracillis
-sartorius

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13
Q

Adductors

A

-Pectineus
-Adductor longus
-Adductor brevis
-Adductor magnus
-Gracillis

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14
Q

Sartorius origin

A

ASIS

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15
Q

sartorius insertion

A

Medial aspect of proximal tibia

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16
Q

Acetabular Labrum

A

-fibrous cartilage
-rims the acetabulum
-deepens the socket
-increases joint stability

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17
Q

Acetabular labrum healing

A

base of labrum that attaches to the bone has some capacity to heal from blood supply from bone; free edge has limited blood supply and doesnt heal well

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18
Q

Hip pointer

A

contusion of iliac crest

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19
Q

Hip pointer MOI

A

blunt trauma to iliac crest

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20
Q

Hip pointer S&S

A

pain with trunk flexion, rotation, side bending or hip flexion, bruising, swelling over iliac crest, muscle spasam

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21
Q

other structures affected by hip pointer

A

-EO
-tensor fascia latae

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22
Q

what do athletes report with hip pointer

A

pain with forced exhalation, pain with bowel movements (functions of EO)

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23
Q

Acute management hip pointer

A

-PIER
-lymph drainage
-donut pad with cover for RTP

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24
Q

Acetabular Labral tears MOI

A

acute plant & twist or hyperabduction or overuse degeneration

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25
Q

Acetabular Labral tears S&S

A

pain, clicking/catching in hip/groin, decrease ROM, audible pop at injury time

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26
Q

“c” sign

A

common descriptor of pain with acetabular labral tear

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27
Q

Acetabular labral tear special test

A

scour test

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28
Q

Acetabular labral tear acute management

A

ice, rest, pain management, correct mechanics (stable base, core & hip stability), proprioception, refer

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29
Q

Scour test

A

-very sensitive but lacks specificity
-good indicator of pathology in joint itself

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30
Q

what does scour test test for

A

-labrum tears
-Capsulitis
-Osteochondral defects
-acetabular defects
-osteoarthritis
-avascular necrosis
-Femoral acetabular impingement syndrome

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31
Q

ITB frinction syndrome MOI

A

friction over lat femoral condyle

-overuse
-biomec problem
-common in sports with continuous knee flexion & ext

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32
Q

ITB acute management

A

-biomechanic assessment
-footwear
-strengthen glute medius
-decrease adhesion to increase mobility

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33
Q

Thomas test tests

A

rectus femoris

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34
Q

Hip flexor tendonitis MOI

A

overuse, repetitive flexion

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35
Q

Hip flexor tendonitis S&S

A

-pain with active and resisted hip flexion
-TOP affected tendon
-stretch pain with passive hip ext

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36
Q

hip flexor tendonitis acute management

A

ice, rest/altered activity, hip flexor wrap

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37
Q

Hip flexors strains MOI

A

forceful hip flexion, leg caught in hip ext (or combo)

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38
Q

Quads strain MOI

A

forceful quad contraction, hip ext with knee flexion (or combo)

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39
Q

Hamstrings strain MOI

A

excessive hip flexion with extended knee, in sprinting - eccentric hams contraction in late stance phase

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40
Q

Adductor strains MOI

A

quick cutting (overstretch with forceful contraction), splits type motion

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41
Q

Strains of Hip & Thigh S&S

A

pull or pop sensation, weakness (gr 2&3), bruising due to high blood supply (gr 2&3)

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42
Q

Strains of Hip & Thigh acute management

A

PIER, pressure pad, educate, NWB, lymph drainage

*easily reinjured

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43
Q

Thigh contusions MOI

A

blunt trauma

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44
Q

Thigh contusions S&S

A

discolourationm muscle weakness

**risk of myositis ossificans

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45
Q

Thigh contusions acute management

A

-lymph drainage
-ice
-NO MASSAGE
-protective padding
-possible RTP

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46
Q

features of the spine

A

-facet joints
-vertebral body
-disc
-nerve roots
-spinous processes
-transverse processes

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47
Q

what is in the right upper quadrant of the abdomen

A

-liver
-gallbladder
-duodenum
-head of pancreas
-right kidney and adrenal gland
-hepatic flexure of colon
-transverse ad ascending colon

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48
Q

Left upper quadrant of abdomen

A

-stomach
-spleen
-left lobe of liver
-pancreas
-left kidney and adrenal gland
-splenic flexure of colon
-trandverse and ascending colon

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49
Q

right lover quadrant of abdomen

A

-caecum
-appendix
-right ovary and tube
-right ureter

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50
Q

left lower quadrant of abdomen

A

-part of descending colon
-sigmoid colon
-left ovary and tube
-left ureter

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51
Q

palpation of the abdomen

A

-palpate the 4 quadrants
-start superficial and gradually increase pressure

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52
Q

Sports hernias

A

fascial weakness in the abdominal wall, where the abdominals & adductors attach into pubic bone
**dont typically result in bulge but can progress to that

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53
Q

sports hernias MOI

A

repetitive strain to area
*common in hockey, football, soccer, sprinters & rugby

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54
Q

sports hernias S&S

A

-pain with sitting up, quick cutting, sprinting, coughing

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55
Q

Special test for sports hernia

A

resisted sit up

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56
Q

sports hernia acute management

A

PIER, adductor wrap, conservative treatment for 4-6wks, easily reirritated

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57
Q

visceral structures affected in sport

A

-kidney contusions
-spleen rupture; mono?
-Lungs; pneumothorax
-Bladder rupture; empty bladder
-Testicular contusions
-heart

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58
Q

abdominal injuries MOI

A

direct blow, fall from height

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59
Q

abdomial injuries S&S

A

-pain
-rigidity in abdomen
-feeling unwell
-cullen sign
-grey turner sign

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60
Q

Cullen sign

A

umbilicus discolouration

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61
Q

Grey Turner Sign

A

flank discolouration

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62
Q

acute management of abdominal injuries

A

-quadrant palpation
-call 911
-rest
-treat for shock
-reassure

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63
Q

Kidney injury MOI

A

blow to the back

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64
Q

Kidney injury S&S

A

-pain in lower back
-peeing blood
-feeling unwell
-refer

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65
Q
A
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66
Q

causes of sudden death in athletes

A

-usually cardiac disease
-congenital abnormalities of coronary arteries
-hypertrophic cardiomyopathy

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67
Q

Hypertrophic cardiomyopathy

A

-genetic condition causing thickening of heart muscle
-leading cause of sudden death in athletes
-altered rhythm (reduced flow)

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68
Q

warning signs of hypertrophic cardiomyopathy

A

-fainting/seizure
-dizzy
-chest pain
-quick/irregular/pounding heart beat
-shortness of breath

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69
Q

emerging causes of acquired heart disease in young athletes

A

-anabolic steroids
-peptide (ex. growth) hormone
-stimulants (ex. caffeine)

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70
Q

Blow to solar plexus

A

-spasam of diaphragm

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71
Q

blow to solar plexus MOI

A

blow to abdomen or chest, fall on butt or back

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72
Q

blow to solar plexus S&S

A

pain, difficulty breathing, panicking

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73
Q

blow to solar plexus acute management

A

-bring knees towards chest, guided breathing, diaphragmatic breathing
-able to RTP once symptoms resolve

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74
Q

Facet Joint sprains MOI

A

forced rotation

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75
Q

Facet joint sprains S&S

A

-hear/feel pop
-sharp localized pain
-pain with motions that open the joint, muscle guarding
*contact sports common
*common in c-spine due to large ROM (ligaments taken beyond available length)

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76
Q

facet joint sprains special test

A

quadrant test (+ve if pain on opposite side)

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77
Q

facet joint sprains acute management

A

-PIER, refer for treatment

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78
Q

Facet Joint Effusion

A

irritation of facet joint

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79
Q

Facet joint effusion MOI

A

-sudden episode of extreme ROM

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80
Q

Facet joint effusion special test

A

quadrant test (+ve if pain on same side)

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81
Q

Facet joint effusion acute management

A

-PIER, refer for treatment.

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82
Q

Disc Protrusions MOI

A

-acute or chronic compression through disc, often in flexed

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83
Q

Disc protrusions

A

-results in a bulge in the disc resulting in changes to myotomes and dermatomes

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84
Q

Disc protrusions S&S

A

-pain with repeat forward bending
-relief with extension
-pain with cough/sneeze

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85
Q

DIsc Protrusions management

A

refer for conservative treatment

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86
Q

Dermatomes

A

-sensory areas of the skin that are inmervated by specific nerve roots
-sensations can be tingling, numbness, pain, pressure

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87
Q

Myotome testing cervical & lumbosacral nerve root involvement

A

resisted tests are performed 5x bilaterally (look for weakening)

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88
Q

which reflexes will be dampened if there is pressure: C5

A

Biceps

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89
Q

which reflexes will be dampened if there is pressure: C6

A

brachioradialis

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90
Q

which reflexes will be dampened if there is pressure: C7

A

Triceps

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91
Q

which reflexes will be dampened if there is pressure: L3, L4

A

Patellar tendon

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92
Q

which reflexes will be dampened if there is pressure: S1

A

Achilles Tendon

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93
Q

Muscle strains of neck and back MOI

A

overstretch or ecentric load (loading muscle while forward bending), rotation at high velocity, may have external force

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94
Q

Muscle strains of the neck and back S&S

A

abrupt “pull” pain, protective spasam, divot (large strains)

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95
Q

Muscle strains of neck and back acute management

A

Pier (but never to anterior neck bc major vessels), altered activity

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96
Q

Rib & scapula fracture MOI

A

direct blow, compression (ribs)

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97
Q

rib fracture S&S

A

pain with deep breath (shallow breathing), pain with compression & TOP area of fracture

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98
Q

Scapula fracture S&S

A

TOP, pain with movement of shoulder

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99
Q

Rib & Scapula fracture acute management

A

stabilize the segments with padding & tensor, tube sling for scap fracture, send for imaging

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100
Q

4 spondys of spine

A
  1. Pars interarticularis
  2. Spondlolyysis
  3. Spondylolisthesis
  4. Spondylitis
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101
Q

Spinal fractures MOI

A

axial load, compression through spine

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102
Q

SPinal fractures S&S

A

central pain, tingling, numbness, unwillingness to move, spasam
*can put pressure on spinal cord or nerve roots in paralysis

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103
Q

SPinal fractures

A

C spine = quadriplegia
T spine, L spine = paraplegia

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104
Q

Larynx

A

connects throat to trachea and prevents food from entering trachea while breathing

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105
Q

trachea

A

brings air from throat to lungs

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106
Q

esophagus

A

brings food from throat to stomach

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107
Q

important vessels in the neck

A

-carotid artery
-jugular vein
-subclavian artery & vein
-vagus nerve

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108
Q

Temporomandibular joint

A

-joint between temporal bone and mandible
-articular disc within joint

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109
Q

muscles that act on TMJ

A

-temporalis
-Pterygoids (medial and lateral)
-masseter

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110
Q

injuries to anterior neck MOI

A

blunt force to anterior neck/throat by stick, puck, ball, opponent etc

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111
Q

S&S anterior neck injury

A

pressure, difficults swallowing “feels thick”, difficulty breathing, panicky

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112
Q

risks of anterior injury to neck

A

risk of larynx fracture

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113
Q

Major bleeds MOI

A

skate, stick, contact with boards -> lasceration of carotid artery, jugular vein, subclavian vein

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114
Q

acute managements of major bleeds

A

pressure, rapid EMS call, treat for shock
* requires vascular surgical team to repair damaged vessels

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115
Q

prevention of major bleeds

A

neck guards

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116
Q

regulations of neck guards

A

-not mandatory for NHL
-international Ice hockey Federation accounced impending mandate (inc. olympics & world juniors)

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117
Q

types of facial injuries

A

-eye poke
-fractures
-auricular hematomas
-lacerations
-TMJ conditions
-Dental injuries

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118
Q

eye poke injuries most commonly result in

A

-subconjunctival hemorrhage - bright red bleeding/spot on white of eye from broken blood vessels
-corneal abrasion - scratch on surface of eye

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119
Q

S&S eye poke injuries

A

mild discomfort & irritation

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120
Q

acute management eye poke injuries

A

-cold compress
-refer for eye exam
**vision changes, shadows, floaters, pressure, pain should be urgent referral

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121
Q

facial fractures MOI

A

direct trauma via opponent, puck, ball

122
Q

types of facial fractures

A

ulilateral zygomatic-maxillary-orbital, isolated mandibular, & nasal fractures most common

123
Q

S&S facial fractures

A

TOP fracture site, raccoon eyes, swelling divots, deformities

124
Q

acute management facial fractures

A

PIER if tolerated, refer

125
Q

Auricular Hematoma MOI

A

blunt trauma, repetitive friction

126
Q

auricular hematoma S&S

A

pain, swelling, bruising

127
Q

what is auricular hematoma

A

-blood accumulates between connective tissue & cartilage of the ear, results in pressure
-resulting in contusion to ear
-can lead to necrosis of the cartilage from blood supply being cut off

128
Q

what happens if auricular hematoma is not drained

A

the cartilage can become deformed resulting in cauliflower ear

129
Q

acute management of auricular hematoma

A

PIER, add pressure by packing ear with folded gauze to prevent fluid accumulation

130
Q

Lacerations MOI

A

blunt trauma, sharp object

131
Q

lacerations acute management

A

lots of bleeding requires firm pressure, face requires stitches, others require steri strips

132
Q

what type of joint is the TMJ joint

133
Q

MOI TMJ injury

A

direct trauma to mandible, cumulative repeat impacts

134
Q

TMJ conditions can result in

A

-dislocations
-sprains
-articular disc injuries
-muscle tension/strains
-clicking/altered joint mechanics
-headaches

135
Q

dental injuries MOI

A

direct blow

136
Q

common sports related dental injuries

A

-tooth (crown) fractures
-tooth intrusion
-tooth extrusion
-tooth avulsion

137
Q

tooth intrusion

A

tooth gets forced into the bone

138
Q

tooth extrusions

A

tooth gets forced out of the bone

139
Q

tooth avulsion

A

complete removal from socket

140
Q

acute management dental injury

A

-ensure broken teeth removed from mouth
-rule out concussion & spinal
-refer to dentist
-rolled gauze to control bleeding

141
Q

prevention of dental injury

A

mouth guards

142
Q

types of headaches seen in sport

A

-dehydration
-cervicogenic
-concussion

143
Q

dehydration headache

A

-approx 90% of headaches are due to dehydration

144
Q

cervicogenic headaches

A

-muscle tension: referred pain patterns
-joint dysfunction

145
Q

concussions (mTBI) MOI

A

direct blow or indirect (land on bum, wiplash, mechanism)

146
Q

concussions are a

A

FUNCTIONAL injury

147
Q

what are concussions

A

a transient change of neurological function

148
Q

cause of concussion

A

stretch and shearing of axons, ion exchange, depolarization of AP (electrical storm)

149
Q

what causes concussions to be long term

A

inflammationa and cell loss

150
Q

SIGNS of a concussion

A

-vomitting
-disorientation
-memory loss
-loss of consciousness

151
Q

sympotms of concussions

A

-headache
-pressure
-difficulty following instruction
-dizzy
-decrease coordination
-nausea
-fatigue
-foggy
-mood swings

152
Q

types of concussion assessment

A

interviews, physical exams, testing

153
Q

two common assessment tools for concussions

A
  1. SCAT6
  2. ImPACT
154
Q

SCAT6

A

-standardized tool for concussion evaluation
-sideline or clinical
-takes 10-15mins
-designed for health care professions and athletes over 13

155
Q

ImPACT

A

-computerized objective tool
-requires basline test
-measure memory, attention span, visual & verbal problem solving
-clinical only

156
Q

5 components of SCAT6 ON FIELD

A
  1. observable signs (behaviour/MOI)
  2. Glasgow Coma Scale (eye/verbal/motor response)
  3. C-spine Assessment
  4. Coordination & oculomotor screen (visual, vestibular)
  5. Memory assessment maddocks questions (cognitive)
157
Q

6 components of SCAT 6 OFF FIELD

A
  1. athlete background
  2. Sympotm evaluation
  3. Cognitive screening (orientation, immediate memory, concentration)
  4. Coordination & balance test
  5. Delayed recall
  6. decision
158
Q

post concussion syndrome

A

-time frames can vary
-threat this proactively

159
Q

concussion testing & rehab tools

A

-helps zero in on primary issues limiting recovery:
– visual
– vestibular
– physiologic
– cervicogenic
– psychological

  • focus on establishing fucntional neural pathways
160
Q

what not to do with concussion

A

complete rest with no stimulation

161
Q

chronic traumatic encephalopathy

A

progressive degenerative brain disorder caused by repeat head injuries

162
Q

S&S CTE

A

-memory loss
-confusion
-headache
-irritable mood
-aggression
-depression
-slurred speech
-unsteady/altered motor control

163
Q

concussion prevention

A

-mouthguards
-proper fitting helmet
-safe technique
-concussion education

164
Q

the 4 joints of the shoulder

A

-glenohumoral
-acromioclavicular
-sternoclavicular
-scapulothoracic

165
Q

pectoral muscles

A

-pec major
-pec minor

166
Q

muscles acting on the scapula

A

-levator scapulae
-rhomboid minor
-rhomboid major
-trapezius
latissimus dorsi

167
Q

rotator cuff muscles

A

-supraspinatus
-infraspinatus
-teres minor
-subscapularis

168
Q

supraspinatus

A

major dynamic stabilizer of the shoulder

169
Q

dislocation

A

head of humereus translates completely out of the glenoid

170
Q

subluxation

A

a partial or incomplete dislocation of the GH joint

171
Q

shoulder dislocations

A

-anterior (most common)
-posterior
-inferior (rare)

172
Q

special test for anterior GH dislocation

A

apprehension test

173
Q

superior labrum anterior and posterior (SLAP) leasions/tears

A

-injury to superior aspect of labrum from anterior to posterior
-biceps tendon can also be injured
-4 types

174
Q

SLAP lesions MOI

A

repetitive overhead movements, Fall on Out Stretched Hand, sudden traction to the arm, dislocation of GH

175
Q

SLAP lesions S&S

A

clicking/catching/popping, pain moving arm overhead, pain lifting heavy objects, pain deep in joint or in back of joint, anterior shoulder pain if biceps involved

176
Q

Bankart Lesion

A

-an injury to the anterior inferior glenoid labrum
-secondary to anterior dislocation

177
Q

Bankart Lesion S&S

A

pain & limited ROM with ost shoulder movements, clicking, catching, grinding, popping, subluxation

177
Q

Hills-Sachs Lesion

A

-a divot-type fracture of the head of the humerus following a dislocation
-head of humerus gets compressed against the rim of glenoid

177
Q

rotator cuff injuries

A

-IMpingement
-tendonitis or osis
-rotator cuff tears

**one can lead to the next or they can happen independantly

178
Q

impingement MOI

A

overuse, poor mechanics

179
Q

tendonitis or osis MOI

A

overuse, poor mechanics

180
Q

ROtator cuff tear MOI

A

acute or overuse

181
Q

AC sprain MOI

A

fall on outstretched hand, fall/tackle - landing on side of shoulder, checked into boards

182
Q

AC sprain MOI

A

pain, step deformity at AC, weakness in shoulder/arm

183
Q

acute management AC sprain

A

PIER, sling, swath, severe deformities need to be referred, AC tape job

184
Q

Rockwood classification: Type I pathology

A

Sprained AC ligaments , normal CC ligamnets

185
Q

Rockwood classification: Type II pathology

A

disruption of AC ligaments, sprained CC ligaments

186
Q

Rockwood classification: Type III pathology

A

disruption of the AC and CC ligaments

187
Q

Rockwood classification: Type IV pathology

A

posterior displacement into or through the trapezius muscle

188
Q

Rockwood classification: Type V pathology

A

rupture of the deltotrapezial fascia

189
Q

Rockwood classification: Type VI pathology

A

inferior displacement of the distal clavicle under conjoined tendon

190
Q

treatment of acute shoulder injuries

A

-pier, sling for support, rehab to pormote tissue healing and regain stability

191
Q

when is surgery considered for acute shoulder injuries

A

-middle third clavicle fractures
-type III AC sprains in active people
-types IV, V & VI AC sprains
-first-time GH dislocation in young athletes
-full-thickness rotator cuff tears
-displaces or unstable proximal humerus fractures
-urgent surgical referral for posterior sternoclavicular dislocations

192
Q

Subacrominal Implingement syndrome MOI

A

overuse, biomechanical imbalances

193
Q

what is subacrominal impingement.

A

pinching and subsequent inflammation of structures under the coracoacromial ligamnent

194
Q

shoulder impingment may include one or all of

A

-supraspinatus tendon
-long head biceps tendon
-subacromial bursa

195
Q

shoulder impingement S&S

A

pain & weakness in painful arc of abduction (reaching), catching/clicking, pain with sleeping on affected side, pain putting jacket on

196
Q

special test shoulder impingement

A

painful arc

197
Q

positive test shoulder impingement

A

pain during GH abduction between 60-120 degrees and pain clears beyond 120*referred pain in supraspinatus pattern down middle deltoid

198
Q

Humerus fractures MOI

A

high-energy direct blow

199
Q

humerus fracuture S&S

A

pain, swelling, brusing, unable to move arm/grinding

200
Q

most common site of humerus fracture

A

surgical neck

201
Q

humerus fracture tendancy

A

aprrox 80% non displaces = non surgical

202
Q

acute management humerus fracture

A

PIER, sling, treat for shock, send to emerg if stable, or call EMS

203
Q

humerus fracture management

A

sling, pain management, start treatment early to avoid frozen shoulder

204
Q

Scapula fracture MOI

A

high-energy blunt trauma, fall from height

205
Q

scapula fracture S&S

A

extreme pain with arm movements, localized swelling, bruising

206
Q

scapula fracture Management:

207
Q

when scapula fractures are surgical

A

-displaced fractures of glenoid,
-displaced fracrure at neck of scapula
-acromion fractures causing impingement

208
Q

Clavicle fracture MOI

A

force to lateral shoulder, direct trauma

209
Q

clavicle fracture S&S

A

severe pain & swelling over site, deformity, unwillingness to move arm

210
Q

clavicle fracture acute management

A

tube sling, PIER

211
Q

clavicle fracture treatment

A

-sling or figure 8 brace
-PIER
-pain management
-alleviate assoc spasam

212
Q

important considerations for the shoulder girdle

A

-thoracic spine mobility
-scapular mobility
-scapular stability
-upper limb proprioception

213
Q

ROM of shoulder joint

A

-abduction
-adduction
-flexion
-extension
-IR
-ER
-Horizontal adduction
-horizontal abduction

214
Q

accessory movements

A

roll, spin, glide

215
Q

joints of the elbow

A

-ulnohumoral joint
-radiohumoral joint
-proximal radioulnar joint

216
Q

ELbow ligaments

A

-ulnar (medial) collateral ligament
-Radial (lateral) collateral ligament

217
Q

Joints of the wrist and hand

A

-caropmetacarpal
-metacarophalangeal
-proximal & distal interphalangeal joint

218
Q

Ligaments of the hand/wrist

A
  1. Collateral Ligaments of wrist and finger
    - Ulnar collateral ligament
    - Radial collateral ligament
  2. Collateral ligaments of fingers
  3. Intercarpal ligaments
  4. triangular fibrocartilage complex (TFCC)
219
Q

Triangular Fibrocartilage complex (aka triangular disc)

A

-complex made up of load-bearing triangular fibrocartilage articular disc & ligaments on medial aspect of wrist

220
Q

purpose of triangular disc

A

disperses axial load from carpals -> ulna

221
Q

wha tis the TFCC thickened by

A

ulnar collateral ligament medially

222
Q

TFCC is a major stabilizer of

A

-ulnocarpal joint
-distal radioulnar joint

223
Q

what facilitates articulations at the wrist joint

A

triangular disc

224
Q

Nerves of elbow and wrist

A

-ulnar nerve at elbow and wrist
-median nerve under flexor retinaculum

225
Q

Elbow flexors

A

-Biceps brachii (long & short)
-brachialis
-brachioradialis

226
Q

actions of biceps brachii

A

-elbow flexion
-shoulder flexion

227
Q

Elbow extensors

A

-triceps brachii
-anconeus

228
Q

common flexor tendon origin

A

medial epicondyle

229
Q

common extensor tendon origin

A

lateral epicondyle

230
Q

carpal tunnel

A

median nerve is compressed under transverse carpal ligament

231
Q

elbow ROM

A

-flexion
-extension
pronation
-supination

232
Q

wrist ROM

A

-flexion
-extension
-radial deviation
-ulnar deviation

233
Q

Digits

A

-flexion
-extension
-abduction
-adduction
-opposition/reposition

234
Q

Lateral Epicondylitis (tennis elbow) MOI

A

overuse of forearm extensors

235
Q

most common lateral epicondylitis extensors affected

A

-extensor carpi radialis longus
-extensor carpi radialis brevis

236
Q

S&S lateral epicondylitis

A

TOP common extensor origin (lateral epicondyle), pain & weak wrist extension

237
Q

acute management lateral epicondylitis

A

stretch wrist extensors (in elbow ext and flexion), PIER (if its itis), brace
*eccentric training for forearm extensors

238
Q

Medial Epicondylitis (aka golfers elbow) MOI

A

overuse of wrist flexors

239
Q

most common flexors affected with medial epicondylitis

A

-flexor carpi radialis (FCR)
-Pronator teres

240
Q

Medial epicondylitis S&S

A

TOP common flexor origin (medial epicondyle), pain & weakness with wrist flexion

241
Q

acute care medial epicondylitis

A

PIER< stretch forearm flexors

242
Q

Ruptured Biceps MOI

A

sudden lengthening od contracting muscle (eccentric)
eg. suden load when lifting or catching heavy load

243
Q

what tendon is most common with ruptured biceps

A

distal biceps tendon

244
Q

biceps rupture S&S

A

musclee balled, bruising, pain near insertion of bicpes into radial tuberosity, pain & weakness with elbow flexion & supination (complete rupture may be painless)

245
Q

acute management bicpes rupture

A

PIER, pressure pad to approximate any remaining fibers, shorten biceps in sling to remove tension, surgical repaire for first few weeks in active people

246
Q

DeQuervains Syndrome Tenosynovitis MOI

A

overuse of thumb due to gripping/wringing

247
Q

DeQuervains Syndrome Tenosynovitis

A

inflammation of the tendons and sheath around the thumb tendons (Extensor pollicus brevis, abductor pollicus longus)

248
Q

DeQuervains Syndrome Tenosynovitis S&S

A

pain over tendons of thumb, weakness with thumb abduction or extensioon, pain with gripping

249
Q

DeQuervains Syndrome Tenosynovitis special test

A

Finklestein Test

250
Q

DeQuervains Syndrome Tenosynovitis Acute Management

A

PIER, thumb spica brace

251
Q

DeQuervains Syndrome Tenosynovitis if left untreated

A

progress to thickening/scarring & reduced ROM

252
Q

Facet Joint Effusion S&S

A

-click or sharp pain
-localized pain
-spasam around inflamed joint
-nerve root can become irritated
-closing joint can become painful

253
Q

Elbow hyperextension MOI

A

landing on an extended elbow

254
Q

elbow hyperextension S&S

A

anterior elbow pain & swelling from ligament/capsule sprain and/or muscle strain, posterior elbow pain from osteocondral lesion

255
Q

what do you need to rule out with elbow hyperextension

A

olencranon fracture

256
Q

acute management elbow hyperextension

A

PIER, shorten injured tissues (sling), tape job

257
Q

UCL sprin MOI

A

FOOSH, overuse by repeat valgus force on the elbow

258
Q

UCL sprain S&S

A

pain &b laxity in joint

259
Q

TOmmy John Surgery

A

reconstructs UCL using graft tendon - palmaris longus, semitendinosis or gracilis

260
Q

Collateral ligament sprains of the wrist MOI

A

FOOSH, forced forearm rotation
UCL - valgus
RCL - varus

261
Q

COllateral ligament sprains of the wrist S&S

A

pain, swelling & instability on medial (UCL) or lateral (RCL) wrist

262
Q

collateral ligament sprians of the wrist special tests

A

UCL (MCL): valgus stress
RCL (LCL): varus stress

263
Q

collateral ligament sprians of the wrist acute managment

A

PIER, wrist wrap, wrist tape for RTP

264
Q

UCL sprain of thumb (skiers thumb/gamekeepers thumb) MOI

A

traumatic or overuse hyperabduction of the thumb

traumatic=skiers thumb, thumb gets caught, FOOSH

overuse= gamekeepers thumb, repeat grip/twist

265
Q

UCL sprain of thumb (skiers thumb/gamekeepers thumb) can result in…

A

avulsion fracture

266
Q

UCL sprain of thumb (skiers thumb/gamekeepers thumb) S&S

A

pain, swelling& instability at 1st MCP Joint

267
Q

when is surgery reccomended for thumb UCL sprain

A

reccomended for instability to stabilize joint & prevents osteoarthritis term

268
Q

thumb UCL sprain acute management

A

PIER, possible x-ray to rule out avulsion, brace for healing/tape

269
Q

Thumb tape job

A

-consider if you are preventing hyperextension or abduction
-be mindful of ribbon and hood direction

270
Q

thumb special tests

A

-1st MCP instability glide into ext
-Valgus stress

271
Q

Triangular Fibrocartilage Complex (TFCC) Tear MOI

A

acute: FOOSH, forced forearm rotation
overuse: repetitive wrist motions

272
Q

Triangular Fibrocartilage Complex (TFCC) Tear S&S

A

medial wrist pain, pain with ulnar deviation & loading through wrist, popping/clicking, wrist weakness

273
Q

Triangular Fibrocartilage Complex (TFCC) Tear Special Test

A

TFCC compression test (passive ulnar deviation with axial compression)

274
Q

Triangular Fibrocartilage Complex (TFCC) Tear acute management

A

PIER, brace, anti-inflamm injections if needed, surgery if persistent

275
Q

ELbow dislocations MOI

276
Q

elbow dislocation S&S

A

deformity, pain, holding elbow, tingling/numbness, shock

277
Q

ELbow dislocation acute care

A

stabilize, splint, monitor/treat for shock, EMS

278
Q

elbow fracture MOI

A

direct trauma/fall

279
Q

elbow fracture S&S

A

pain, unable or unwilling to move elbow

280
Q

bow fracture acute care

A

splint, monitor for shock, ER for x-rays/surgical referral

281
Q

surgical approach to elbow fracture

A

ORIF: Open Reduction Internal Fixation

282
Q

Colles fracture(distal radius fracture) MOI

A

FOOSH causing distal radius displaced posteriorly

283
Q

Colles fracrue (distal radius fracture) S&S

A

deformity, pain, numbness

*no testing as deformity is obvious

284
Q

colles fracture (distal radius fracture) acute management

A

splint, monitor for shock, emerge for xrays, possible surgery

285
Q

Scaphoid fractures MOI

286
Q

scaphoid fracture S&S

A

TOP of anatomical snuffbox

287
Q

ability of scaphoid to heal

A

poor because very little BS

288
Q

waht is important with scaphoid fracture

A

identify early & immobilize via cast or brace

289
Q

Metacarpal & figure fractures MOI

A

axial compression (jammed), direct trauma, being stepped on

290
Q

metacarpal & finger fractures S&S

A

localized pain, swelling, unable to grip

291
Q

metacarpal & finger fractures acute care

A

fingers: buddy tape to stabilize
Hand: SAM splint

292
Q

what can happen to Metacarpal & finger fractures

A

avulsion fractures - tendon pulls off piece of bone (immobilize or surgical

293
Q

Cyclist Palsy MOI

A

compression from handlebars

294
Q

Cyclist Palsy S&S

A

tingling/numbness/nerve pain, decreased muscle strength of 5th digit, hand cramping

295
Q

cyclist palsy Prevention

A

avoid hyperextension on wrist handlebars, proper bike fit

296
Q

cyclist palsey acute care

A

PIER, splint, may require NSAIDs

297
Q

Carapl TUnnel MOI

A

overuse of wrist flexor tensons causing pressure on median nerve

298
Q

Carpal tunnel S&S

A

burning/tingling/numbness in anterior wrist & hand, decreased grip strength

299
Q

Carpal Tunnel acute care

A

bracing, PIER, anti-inflamm treatment, proper ergonomic set up, steroid injection, surgery possible

KNPE 331 (2 decks)

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