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Ortho > Lecture Exam 3 > Flashcards

Lecture Exam 3 Flashcards

1
Q

which ROM value of the hip is this?

0-120 degrees

A

flexion

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2
Q

which ROM value of the hip is this?

0-20 degrees

A

hyperextension

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3
Q

which ROM value of the hip is this?

0-40 degrees

A

abduction

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4
Q

which ROM valueS of the hip is this?

0 -45 degrees

A

LR & MR

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5
Q

the end feel for hip flexion is…

A

soft tissue

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6
Q

the end feel for all motions of the hip (except flexion) is…

A

firm (joint capsule)

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7
Q

the following is the open pack position of what joint?

30 degrees abduction
30 degrees flexion
slight ER

A

hip joint

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8
Q

the following is the closed pack position of what joint?

IR
extension
abduction

A

hip joint

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9
Q

which special test is being described?

  • Purpose: hip flexor tightness test
  • Position: pt in supine with legs off of table; flex opposite knee to chest
  • Force: passively extend hip being tested
    • sign: thigh suspended above table = tightness
A

thomas test

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10
Q

which special test is being described?

  • Purpose: general hip pathology
  • Position: pt in supine with leg in Flexion, ABduction, and ER
  • Force: drape testing foot on knee of opposite leg & push down
    • sign: reproduce symptoms/pain
A

FABER test

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11
Q

which special test is being described?

  • Purpose: femoral anteversion (MR)
  • Position: pt in prone; knee flexed to 90 degrees & palpate greater trochanter
  • Force: MR & LR until greater trochanter is in most lateral position (protruding the most)
    • sign: greater than 8-15 degrees of anteversion
A

craig’s test

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11
Q

which special test is being described?

  • Purpose: IT band tightness
  • Position: pt in sidelying; lower leg flexed for stability & upper leg is abducted & hyperextended
  • Force: stabilize pelvis & passively/slowly allow leg to drop
    • sign: doesn’t drop below level of the hip
A

ober’s test

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12
Q

which special test is being described?

  • Purpose: vertebral disc pathology
  • Position: pt in supine with both legs extended
  • Force: with a hand under the heel of the involved side, passively flex the hip while keeping the knee in full extension
    • sign: reproduce pain in low back/leg
A

wells SLR

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13
Q

which special test is being described?

  • Purpose: hamstring length
  • Position: pt in supine
  • Force: passive straight leg raise
    • sign: has more than 29 degrees of KNEE flexion
A

90/90 SLR

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14
Q

what pathology of the hip is being described?

  • most common in geriatric population
  • 90% occur due to fall
  • associated with loss of mobility
  • classified by location & severity
  • morality rate in 1st year: 12-36%
A

hip fracture

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15
Q

what procedure is being described?

  • replaces femoral head & acetabulum
  • post-op results 98% with a lifespan of 15-20 years
  • 2 types of fixation: cemented & cementeless
  • approaches: posterior/posterolateral, direct lateral, anterior/anterolateral
A

total hip replacement (THA/THR)

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16
Q

which THA fixation type is being described?

  • allows for early WBAT day 1
A

cemented

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17
Q

which THA fixation type is being described?

  • porous covered prostheses that allows osseous growth into surfaces of the implant
  • ingrowth occurs over 3-6 months
  • delayed/limited WB orders
  • chosen for those <60 who are active with good bone quality
A

cementless

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18
Q

which approach to THR is being described?

  • incision usually 15-25cm long
  • glute max is divided, med is retracted, and min is divided from capsule

precautions:
- no adduction/IR past neutral
- no hip flexion beyond 90 degrees
- no combination of these actions

A

posterior/posterolateral approach

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19
Q

which approach to THR is being described?

  • preserves insertion of glute med/min
  • decreases antalgic gait

precautions:
- no hip extension/add/ER past neutral
- no flexion beyond 90 degrees
- no combined ext/abd/ER
- no leg crossing
- do NOT step THROUGH in early ambulation

A

direct lateral approach

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20
Q

which approach to THR is being described?

  • no mm are detached
  • incisions are anterior & distal to ASIS
  • anterior capsulotomy & repair
  • fast WB post-op & rapid recovery of mm strength

precautions:
- no hip extension/add/ER past neutral
- no flexion beyond 90 degrees
- no combined ext/abd/ER
- no leg crossing
- do NOT step THROUGH in early ambulation

A

direct anterior/anterolateral approach

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21
Q

what procedure is being described?

  • used for younger, thinner, healthier patients
  • less blood, pain, cost, and time of hospital stay
  • “appealing” scar; small incisions (10cm or less); 1-2 incisions
A

minimally invasive hip replacement (MIS THA)

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22
Q

what procedure is being described?

  • replacement of the damaged femoral head with a bipolar prosthesis
  • posterolateral approach commonly used

precautions:
- avoid exercises that compress or shear hip joint to prevent erosion of acetabular cartilage
- follow WB orders & progress strength slowly

A

hemiarthroplasty

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23
Q

what impairment is being described?

  • 40-90% of patients taking prophylactic meds develop this after hip surgery
  • typically involves deep veins of legs & calf
  • can become dislodged & travel as an embolus
A

DVT

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24
Q

what impairment is being described?

trochanteric:
- irritation/inflammation due to trauma/compression/friction of IT band over bursa
- pain is in lateral hip (thigh to knee)

ischial:
- pain over ischial tuberosity
- caused by direct contusion or extended periods of sitting

A

bursitis

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25
Q

what impairment of the hamstrings is being described?

  • injury at origin due to forceful contraction or decelerating the lower leg against a concentric quad mm activity
A

hamstring strain

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26
Q

what impairment of the hip flexors is being described?

  • iliopsoas injury
  • sudden, forceful hip extension/flexion against resistance
A

hip flexor strain

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27
Q

which impairment of the adductors is being described?

  • “groin pull”
A

adductor strain

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28
Q

which ROM of the knee is this?

0-150 degrees

A

knee flexion

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29
Q

which ROM of the knee is this?

0 degrees

A

knee extension

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30
Q

the following is the open pack position of what joint?

25 degrees of flexion

A

knee

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31
Q

the following is the closed pack position of what joint?

full extension with ER

A

knee

32
Q

the following is the capsular pattern for what joint?

flexion > extension

A

knee

33
Q

which special test of the knee is being described?

isolates posterolateral bundle since knee is flexed (most common)

A

Lachman’s test

34
Q

which special test of the knee is being described?

senses tears of ACL in anteromedial bundle

A

anterior drawer test

35
Q

which special test of the knee is being described?

multidirectional rotational test

A

pivot shift test

36
Q

what ligament injury is being described?

contact:
- blow to lateral side of knee (valgus force)
- may involved MCL & medial meniscus (unholy triad)

non-contact:
- deceleration activity (78% occur when tibia is externally rotated on a planted foot)
- women sustain this injury 3x more than men

A

ACL injury

37
Q

what ligament procedure is being described?

  • intraairticular tissue graft is used to refabricate function of damaged ligament to restrain the knee
  • autograft, allograft, or synthetic graft can be used
A

ACL reconstruction

38
Q

what ligament injury is being described?

  • not common
  • usually involves injury of another knee structure
  • blow to anterior tibia with knee flexed
A

PCL injury

39
Q

what ligament injury is being described?

  • this ligament is blended with the medial meniscus, so injury here often involves other knee structures

contact:
- valgus force applied to lateral knee

non-contact:
- lower leg is fixed
- tibia is ER & a valgus force is applied to lateral knee

A

MCL

40
Q

what ligament injury is being described?

  • due to varus force across the knee
  • not common
  • other structures may be involved
A

LCL injury

41
Q

what type of meniscal injury is being described?

foot is fixed on ground & femur is internally rotated

A

medial meniscus injury

42
Q

what type of meniscal injury is being described?

LR of femur on a fixed tibia

A

lateral meniscus injury

43
Q

what meniscal procedure is being described?

removal of torn cartilage from an isolated meniscus injury (arthroscopic procedure)

A

subtotal/partial meniscectomy

44
Q

what meniscal procedure is being described?

suturing the torn meniscus back together (arthroscopic procedure)

A

meniscal repair

45
Q

a larger Q angle pulls the patella in what direction?

A

a lateral direction

46
Q

true or false?

the larger the Q angle, the lower the odds of patellofemoral compression, lateral tracking, lateral dislocation, and degeneration

A

false

47
Q

the following types of compartments are associated with what surgical procedure of the knee?

unicompartmental
bicompartmental
tricompartmental

A

TKA

48
Q

which type of compartment (for TKA) is being described?

medial or lateral surface is replaced

A

unicompartmental

49
Q

which type of compartment (for TKA) is being described?

entire femoral & tibial surfaces are replaced

A

bicompartmental

50
Q

which type of compartment (for TKA) is being described?

femoral, tibial, and patellar surfaces are replaced

A

tricompartmental

51
Q

which type of TKA fixation is being described?

  • use of acrylic cement
  • most common
  • may see loosening overtime
A

cemented

52
Q

which type of TKA fixation is being described?

  • rapid growth of bone into the surface of a porous/beaded implant
  • higher rate of loosening
A

cementless

53
Q

which type of TKA fixation is being described?

cemented fixation of tibia part of knee & uncemented fixation of femoral part of knee

A

hybrid

54
Q

what grade sprain of the knee is being described?

no joint instability (incomplete stretching of ligament fibers)

A

grade l sprain

55
Q

what grade sprain of the knee is being described?

some loss of joint stability (moderate sprain, some fibers are torn)

A

grade ll sprain

56
Q

what grade sprain of the knee is being described?

loss of joint stability (rupture, all (or almost all) fibers are torn)

A

grade lll sprain

57
Q

which ROM value of the ankle is this?

0-20 degrees

A

DF

58
Q

which ROM value of the ankle is this?

0-50 degrees

A

plantar flexion

59
Q

which ROM value of the ankle is this?

0-35

A

IN

60
Q

which ROM value of the ankle is this?

0-15

A

EV

61
Q

DF/PF occur at what joint?

A

talocrural joint

62
Q

IN/EV occur at which joints?

A

subtalar & transverse tarsal joints

63
Q

IN, abduction, & PF create what movement of the ankle/foot?

A

supination

64
Q

EV, abduction, & DF create what movement of the ankle/foot?

A

pronation

65
Q

what is the capsular pattern of the ankle?

A

PF > DF

66
Q

what is the open pack position of the ankle?

A

10 degrees PF
mid IN/EV

67
Q

what is the closed pack position of the ankle?

A

full DF

68
Q

which special test of the ankle is being described?

tests to see if ankle ligament is intact

A

anterior drawer test

69
Q

which special test of the ankle is being described?

tests ankle ligament’s resistance to maximal IN stress

A

talar tilt test

70
Q

what pathology of the ankle is being described?

  • occurs secondary to IN stress
  • common pathology
A

lateral ankle sprain

71
Q

what pathology of the ankle is being described?

  • rare for these structures to be injured
  • occurs due to MASSIVE EV stress
  • common to occur WITH an ankle fracture
A

deltoid ligament sprain

72
Q

what pathology of the achilles is being described?

  • repetitive overloading/overuse of tendon
  • pain at mid part
  • may see with switch from high to low heels or due to athletics
A

achilles tendonitis

73
Q

what pathology of the achilles is being described?

  • forceful PF contraction with acceleration or deceleration
  • men > women
  • pain, swelling, palpable defect
  • positive thompson test
A

achilles rupture

74
Q

what pathology of the ankle is being described?

  • acute or chronic increased tissue pressure in a fascial space
  • leads to occlusion of vessels & reduced neuromuscular function
A

compartment syndromes

75
Q

what type of ankle/foot fracture is being described?

vertical or axial loads that compress tibia into talus

A

pilon fracture

76
Q

what type of ankle/foot fracture is being described?

  • intraarticular depression fracture
  • most common fx
A

calcaneal fracture

77
Q

what pathology of the ankle/foot is being described?

  • activity-induced leg pain along the posterior medial/anterior lateral area of 2/3 of the tibia

anterior:
overuse of weak tibialis anterior
hypomobile gastroc/soleus
foot pronation
pain with DF & passive stretching into PF

posterior:
posterior medial pain
tight gastric/soleus
weak tibialis posterior
foot pronation
pain with DF/EV

A

shin splints

78
Q

what pathology of the ankle/foot is being described?

  • very common
  • inflammation of plantar aponeurosis
  • excessive subtalar pronation
  • limits gait at heel strike
A

plantar fasciitis

Ortho (5 decks)

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