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0
Q

Strain tears to small number of fibres, localised pain, no loss of function

A

GRADE I

Strain/tear

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1
Q

Amenorrhea

A

Absence of menstral period

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2
Q

Strain or tear to a significant number of fibres, associated pain and swelling. Pain produced on muscle contraction, reduced strength and limited ROM

A

GRADE II

Muscle strain/tear

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3
Q

Complete tear of muscle

A

GRADE III

Muscle injury

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4
Q

What is a Stryker device

A

Used to measure the intracompartmentalise pressure

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5
Q

Normal intracompartmental pressure

A

0 - 4mmHg (some consider 10mmHg)

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6
Q

When using a Stryker device what do you inject into the appropriate compartment?

A

Saline solution

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11
Q

Contraindications for soft tissue manipulation

A 
Acute inflammation, 
infection, 
endangerment sites 
Nerve/blood vessels/lymph
Varicose veins (cause thromboemboli)
Areas of skin conditions
Tumours (could cause metastasis)
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14
Q

Unhappy female athlete triad

A

Low energy
Amenorrhea
Low bone mineral density

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15
Q

Components of treatment

A 
Initial treatment
Immobilisation
Therapeutic drugs
Heat and cold
Manual therapy
Others (electro therapy/surgery)
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16
Q

When is immobilisation indicated

A

Fractures

Severe soft tissue (grade 3 lig tear)

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17
Q

Rigid braces, air splints, plaster cast, fibreglass cast - these rigid structures are indicated for

A

Immobilisation

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18
Q

When is heat contraindicated in treatment?

A

At least the first 48 hours

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19
Q

Laser treatment MOA

A

Physiological changes to tissue

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20
Q

Transcutaneous electrical nerve stimulation (TENS)

A

Selective depolarisation of peripheral nerve fibres.

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21
Q

Ultrasound electro therapy MOA

A

Hearing through vibration of tissues encourage tissue growth and remodelling (better evidence for fractures)

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22
Q

First phase of seyles GAS

A

Shock/soreness

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23
Q

Second phase of seyles GAS

A

Adaption to stimulus

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24
Q

Third phase of seyles GAS

A

Staleness

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25
Q

Seyles GAS

A

General adaption syndrome (3 phases)

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26
Q

Gas in bone is indicative of

A

Gangrene

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27
Q

Five stages of bone remodelling

A 
Quiescence
Activation
Resorption
Reversal
Formation
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28
Q

Bone remodels in response to mechanical stresses:

A

Wolffs law

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29
Q

Common sites for acute articulate damage

A

Superior articulate surface of the talus
Femoral condyle a
Patella

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30
Q

Chondroplasty

A

Smoothing of loose edges of the cartilage

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31
Q

Treatment for a stress fracture on the anterior cortex of the tibia

A

Immobilisation (non Wb cast for 6wks) or surgery

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32
Q

Treatment for a stress fracture on the medial malleolus

A

Pneumatic cast (6wks) or surgical screw fixation

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33
Q

Treatment for a stress fracture on the lateral process of the talus

A

Immobilisation (non-WB cast 6wks) or surgery

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34
Q

Treatment for a stress fracture of the navicular

A

Immobilisation (non WB 6-8wks) or surgery

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35
Q

5th met stress fracture treatment

A

Cast immobilisation or surgical screw fixation

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36
Q

Treatment for a stress fracture to the sesamoids (hallux)

A

Non wb for 4wks

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37
Q

Osteitis

A

Inflammation of pubic symphysis

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38
Q

Periostitis/tenoperiostitis

A

Pain and inflammation at te tendinous attachment to the bone e.g. Medial tibial stress syndrome

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39
Q

Apophysis

A

Bony pertuberences

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40
Q

DOMS

A

Delayed onset muscle soreness

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41
Q

Three main types of radio pharmaceuticals used in bone scan

A

Technetium-99m
Gallium66
Indium111

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42
Q

Phase one of a bone scan

A

Flow study (2-3seconds for 30secpnds)

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43
Q

Blood pool study

A

Phase 2 approximately 5mins

Tracer has entered extra vascular space

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44
Q

Phase 2 of a bone scan

A

Blood pool phase

Indicative of soft tissue inflammation or infection

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45
Q

Phase 3 of a bone scan

A

Delayed phase
2-4hrs post injection
Concentration now on the bone

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46
Q

Gallium scan 67ga is absorbed by?

A

White blood cells

Therefore shows infecting very well.

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47
Q

Why perform a 67Ga & a 99mTc

A

To differentiate reactive & inflammatory bone lesions

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48
Q

Advantages of bone scans

A

Immediate picture of bone activity
High sensitivity
Different chemical for different pathologies
Cheaper than MRI/CT

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49
Q

Disadvantages of bone scan

A

Poor specificity
High radiation dose
Time consuming

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50
Q

Most common mode of bone scan

A

99mTc

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51
Q

Bone scan is highly sensitive but not specific true or false

A

True

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52
Q

Bone scan is specific but not very sensitive t/f

A

False

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53
Q

Why are gallium and indium bone scans commonly used?

A

As Adjunctive diagnostic tool

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54
Q

Purpose of a scout view

A

Make sure the region of interest is included
Check exposure technique
As a baseline prior to administration of contrast material

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55
Q

A preliminary image obtained prior to performing the major portion of a particular study

A

Scout view

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56
Q

Contraindications of CT scans

A

Allergy
Pregnancy
Metformin

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57
Q

Advantages of CT scan

A 
No superimposition of bones
Demonstrates soft tissue better than X-ray
Gives 3D image
Any body plane
Distance between images can be varied
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58
Q

Disadvantages to a CT scan

A

Increased radiation dose

Cost

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59
Q

5main criteria of diagnosing myofascial pain syndrome

A
  • Regional pain
  • Taut band of skeletal muscle
  • Exquisite spot of tenderness in taut band
  • Pain or altered sensation in expected distribution of referred pain from tender spot
  • Some restriction of ROM
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60
Q

Active trigger point

A

Source of ongoing pain

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61
Q

Latent trigger point

A

Only painful when compressed

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62
Q

Satellite trigger point

A

Formation of another TrP in zone of referred pain

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63
Q

Techniques of soft tissue therapy (massage)

A

Effleurage
Friction
Petrissage
Digital ischaemic compression

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64
Q

Effleurage

A

Gliding

E.g muscle relaxation/strain, lymphoedema

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65
Q

Friction therapy is indicated for

A

Disrupt lesions, analgesia

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66
Q

Petrissage

A

Kneading

Reduce muscle tension

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67
Q

Digital ischaemic compression is indicated

A

To release trigger points

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68
Q

What affects does increasing the axial load have on core stability?

A

Stimulate trunk muscle activity. Increases to IV stiffness and improved spinal stability

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69
Q

What represents the largest contribution of muscle activity to spinal stability?

A

Hip & trunk stiffness

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70
Q

Inner core muscles

A

Stabilisation with a TONIC contraction

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71
Q

Outer core muscles

A

Produce movement and some are secondary stabilisers through PHASIC contraction

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72
Q

Secondary stabilisation in the Sagittal plane

A

Rectus abdominis
Erector Spinae
Gluteus maximus
Hamstrings

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73
Q

Sagittal plane secondary stabilisers are responsible for what movement?

A

Flexion/extension

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74
Q

Secondary stabilisation in the frontal plane

A

Glut med
Glut min
Quadratus lumborum
Hip adductors

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75
Q

Hip adductors

A

Magnus
longus
brevis
pectineus

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76
Q

Primary lateral hip stabilisers

A

Glut med and glut min

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77
Q

Trunk rotation is produced and stabilised by:

A

Internal/external obliques

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78
Q

What is the most important passive structure involved in stabilising the lumbar spine and abdominal musculature?

A

Posterior thoraco-lumbar fascia

79
Q

Which muscles are at peak periods of activation associated with foot strike?

A

All

80
Q

Transversus abdominis is tonically or phasically active throughout the gait cycle?

A

Tonically

81
Q

Which muscles are phasically active?

A

Superficial abdominal muscles and all paraspinal muscles

82
Q

What gait pathologies is hip abductor weakness associated with?

A

Trendelenberge gait

Dynamic knee valgus

83
Q

How would you confirm a sacral stress fracture?

A

MRI

84
Q

When is intermediate treatment for osteitis pub is appropriate

A

When patient is pain free

85
Q

What muscles group do you focus on for treatment of an osteitis pubis?

A

Adductors

86
Q

ACL injuries commonly occur in

A

Hyper extension

Tibia moving forward under the femur

87
Q

PCL injuries commonly occur

A

Hyper flexion with internal tibial rotation

88
Q

What type of force causes acute MCL injury

A

Valgus force

89
Q

What type of force causes acute LCL injury?

A

Varus force

90
Q

Clinical tests for the ACL

A

Lachmans test
Anterior drawer test
Pivot shift test

91
Q

Clinical testing for PCL

A

Posterior sag
Reverse lachmans test
Posterior drawer test
External rotation active and passive

92
Q

Clinical assessments for the patella

A

Medial and lateral translation

Patella apprehension test

93
Q

Functional test to do a clinical assessment of the knee

A

Squats and hops

94
Q

Jumpers knee

A

Localised anterior knee pain - inferior pole of the patella

Patella tendinopathy

95
Q

Features of patella tendinopathy

A 
No inflammation
Loss of collagen continuity
Increase in ground substance 
increase in vascularity
Increase in cellularity
96
Q

Muscles most likely to be the cause of MTSS

A

FDL &/or Soleus

97
Q

What is the likely reason for the FDL & Soleus muscle involvement in MTSS

A

Based in the muscle attachments

98
Q

Signs of acute compartment syndrome

A 
Pain
Pallor
Paralysis
Parenthesis
Pulselessness
99
Q

Type of pain for compartment syndrome

A

Severe cramping, diffuse pain and tightness

100
Q

Type of pain for MTSS

A

Diffuse along lower two thirds of tibial border

101
Q

Type of pain for stress fracture

A

Localised deep, nagging with minimal radiation

102
Q

Type of pain for tumour

A

Deep nagging (bone) with some radiation

103
Q

Pain at rest for compartment syndrome

A

Decreases or disappears

104
Q

Pain at rest for MTSS

A

Decreases or disappears

105
Q

Pain at rest for stress fracture

A

Present, especially night pain

106
Q

Pain at rest for tumour

A

Present, often night pain

107
Q

Pain with activity for compartment syndrome

A

Increases

108
Q

Pain with activity for MTSS

A

Increases

109
Q

Pain with activity for stress fracture

A

Present, may increase

110
Q

Pain with activity for tumour

A

PResent

111
Q

Pain with warm up for compartment syndrome

A

May become present, may increase

112
Q

Pain with warm up for MTSS

A

May disappear

113
Q

Pain with warm up for stress fracture

A

Unaltered

114
Q

Pain with warm up for tumour

A

Unaltered

115
Q

ROM for compartment syndrome

A

Limited in acute phase

116
Q

ROM for MTSS

A

Limited ROM

117
Q

ROM for stress fracture

A

Normal

118
Q

ROM for tumour

A

Normal

119
Q

Onset for compartment syndrome

A

Gradual to sudden

120
Q

Onset for MTSS

A

Gradual

121
Q

Onset for stress fracture

A

Gradual

122
Q

Onset for tumour?

A

Unknown?

123
Q

Affect of stretching on compartment syndrome

A

Increases pain

124
Q

Affect of stretching on MTSS

A

Increases pain

125
Q

Affect of stretching on stress fracture

A

Minimal pain alteration

126
Q

Affect of stretching on tumour

A

No increase in pain

127
Q

Affect of palpating on compartment syndrome

A

Tender, right compartment

128
Q

Affect of palpating on MTSS

A

Diffuse tenderness

129
Q

Affect of palpating on stress fracture

A

Point tenderness

130
Q

Affect of palpating on tumour

A

Point or diffuse tenderness

131
Q

What position is the ankle least stable?

A

Plantar flexed and inverted

132
Q

What is the biggest risk factor for ankle injury

A

Previous injury

133
Q

Bone injury imaging in trauma

A

X-ray
Ct
MRI
Bone scan

134
Q

Imaging for soft tissue in trauma

A

Ultrasound

MRI

135
Q

Vascular injury imaging in trauma

A

Duplex ultrasound

Angiogram/arteriography

136
Q

A nuclear scanning test that detects areas of increased or decreased bone metabolism

A

Bone scan

137
Q

3main radio pharmaceuticals used in bone scan

A

Technetium 99m
Gallium 67
Indium 111

138
Q

Phase 1 of a bone scan

A

Flow study

Picks up areas of increased vascularity- inflammation shows up quickly

139
Q

Phase 2 of a bone scan

A

Blood pool phase
Extra vascular space
Soft tissue infection or inflammation

140
Q

Phase 3 of a bone scan

A

Delayed (bone) phase

2-4hrs post injection

141
Q

Disadvantages of a bone scan

A

Poor specificity
High radiation dose
Time consuming

142
Q

In podiatry CT scans are used for

A

Fractures & stress fractures of the talar dome, calc & nav
Osteochondritis dissecans
Tarsal coalition
Bone cysts and tumours

143
Q

Purpose of a scout view

A

Make sure the region of interest is included
Check the exposure technique
Baseline prior to administration of contrast materials

144
Q

Contraindications of a computed tomography

A

Allergy to contrast agents
Pregnancy
Metformin

145
Q

Disadvantages of CT

A

Increase in radiation dose

Cost

146
Q

Briefly describe the process of an MRI

A

Magnetic pulses excite mobile hydrogen ions
Different number of ions for different tissue & state
As hydrogen returns to baseline it emits a magnetic signal which is interpreted by a computer

147
Q

Longitudinal relaxation time for an MRI

A

T1 relaxation time

148
Q

Transverse relaxation time

A

T2 relaxation

149
Q

A measure of how long transverse magnetisation would last in a perfectly uniform external magnetic field

A

T2 relaxation

150
Q

The time required for a substance to become magnetised after first being placed in a magnetic field

A

T1 relaxation

151
Q

Which image weighting demonstrates normal anatomy?

A

T1

152
Q

Fluid is high intensity white in which image weighting?

A

T2

153
Q

Contraindications for MRI

A 
Bain aneurysm clip
Implanted neural stimulator
Implanted cardiac pacemaker or defibrillator
Cochlear implant
Ocular foreign body (metal shavings)
Implanted medical devices
Insulin pump
Metal shrapnel/bullet
Heavy metal ink tattoo
154
Q

Consider exclusion for MRI for

A

Pregnant women
Patients where the presence of metal clips cannot be excluded
Patients with unstable angina

155
Q

Contraindications for MRI contrast agents

A

Lactating women
Renal disease
Haemoglobonopathies

156
Q

Indications for MRI

A

Musculoskeletal system

Good soft tissue contrast

157
Q 
Tendon pathology
Infection
Neoplasm
Avascular necrosis
Ligament damage
Neuromas 
tarsal coalition
Plantar fasciitis
Fracture stress fracture
Osteochrondritis dissecans
A

MRI

158
Q

Disadvantages of MRI

A 
Cost
Number of absolute contraindications
Claustrophobia
Prolonged imaging time
Availability
159
Q

Briefly describe the process of ultrasound production

A

Passing a current through a piezoelectric transducer producing a waveform

160
Q

Advantages of ultrasound

A

No radiation
Low cost
Dynamic capabilities

161
Q

Traditional ultrasound

A

Uses sound waves that bounce off blood vessels to create pictures

162
Q

Doppler ultrasound

A

Uses sound waves reflecting off moving objects such as blood, to measure their speed and aspects of flow

163
Q

PET

A

Combination of modalities

164
Q

What would you test for dynamic postural control

A

Star excursion balance test

165
Q

Lower back and hip assessment

A

Lumbar spine assessment
ROM
Gross symmetry
Palpating

166
Q

Positive signs for kemps test

A

When low back pain radiates into the lower extremity, indication facet syndrome, fracture or disc involvement

167
Q

Pt experiences pain when examiner lifts leg to between 30-70degrees with the knee straight

A

Positive sign for a straight leg raise

Indicative of ridiculopathy

168
Q

Slump test positive sign

A

Reduction of symptoms following cervical flexion release

Indicative of neural involvement

169
Q

Positive test for fortins finger test

A

Pt indicates pain in area medial to the PSIS - which is indicative f a sacroiliac joint dysfunction

170
Q

Gaenslen’s test positive sign

A

Increased pain from the pelvis

171
Q

Gaenslen’s test positive sign

A

Increase in pain from the pelvis

172
Q

Valsalva test

A

Increase in intrathoracic pressure resulting in increase in cervical pain when of coughs, bears down, laughs, sneeze

173
Q

What does fabers test for

A

Flexion
ABduction
External
Rotation

174
Q

Positive fabers

A

Increasing hip/groin pain as pressure is applied indicates hip joint pathology. Increasing deep unilateral pain around SIJ indicates sacroiliac pathology.

175
Q

Clarkes sign positive sign

A

Positive test is when pain is reproduced indicative of patellofemoral joint dysfunction

176
Q

Obers test positive sign

A

Leg remains abducted and does not drop

177
Q

Soft tissue therapy contraindications

A 
Acute inflammation 
Infection
Endangerment sites
Varicose veins
Avoid areas of skin conditions
Tumours
178
Q

Joint Mobilisation

A

Passive movement applied which the patient is able to prevent within the elastic barrier of joint resistance

179
Q

Manipulation

A

Sudden thrust of small amplitude but high velocity, which your patient is not able to prevent, within or beyond the elastic barrier

180
Q

Contraindications of joint mobilisation and manipulation

A

Tumours
Infections
Fractures

181
Q

ACL reconstruction what muscles may be inhibited?

A

Quads (VMO)

182
Q

Principles of injury prevention

A 
Warm up 
Stretching
Taping/bracing
Protective equipment
Suitable equipment
Appropriate training
Appropriate recovery
183
Q

What is alredsons prescription?

A

3 sets of 15 2x daily; 7 days a week for 12 weeks

184
Q

What is tarsal tunnel syndrome

A

Entrapment of the tibial nerve under the flexor retinaculum

185
Q

Treatment of a mortons neuroma

A 
Footwear
Met some
Antipronatory device
NSAIDs 
Corticosteroid injection
LA
Surgery

Sports Pod (4 decks)

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