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MSK Pathophysiology > Ligaments > Flashcards

Ligaments Flashcards

1
Q

What is involved in a high ankle sprain?

A

Talus - wider anterior than posterior
Anterior, posterior and transverse inferior tibiofibula ligament
Interosseous membrane and ligament

Connection of the distal tibia and fibula
The talus moves between the two bones during external rotation and DF spreading the tin and fib apart

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2
Q

What are the symptoms of a high ankle sprain?

A

Loss of rom
Instability
Pain and unable to weight bear
Bruising due to im involvement

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3
Q

How does a high ankle sprain occur?

A

Extreme external rotation or DF
Forces apart the bony Mortis

Talus is forced between the distal tib and fib putting a strain on the ligaments

There can also be fractures of the tibia but more commonly the fibula

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4
Q

How would you test for a high ankle sprain?

A

Squeeze test

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5
Q

What structures are involved in a medial ankle sprain?

A

Medial deltoid ligament
- tibionavicular
- Tibiocalcaneal
- anterior tibiotaler
- posterior tibiotaler

Bony Mortis
- fibula
Talus
Tibia

Medial mal and talus provide stability and reduce ankle sprain risk

Fibula restricts the foot from everting too far

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6
Q

What are the symptoms of a medial ankle sprain?

A

Instability
Medial ankle pain
Lateral ankle pain
Swelling

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7
Q

How does a medial ankle sprain occur?

A

Sudden Eversion of the ankle
Pots fracture to fibula - foot everts too far
Ligament sprains

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8
Q

How do you test for a medial ankle sprain?

A

Eversion stress test

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9
Q

What structures are involved in a lateral ankle sprain?

A

Anterior talo fibula ligament
Posterior talo fibula ligament
Calcaneo fibula ligament

Resists inversion and pf of ankle
Stabilise ankle
Active control from peroneals
Foot most unstable in pf

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10
Q

What are the symptoms of lateral ankle sprain?

A

Pain especially when weight bearing
Bruising redness and swelling
Limited rom

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11
Q

How does a lateral ankle sprain occur?

A

Forceful pf and inversion of the foot
Walking on uneven surface
Weak peroneals
Landing from a jump
Blow to medial lower leg before landing

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12
Q

What tests will be used to diagnose a lateral ankle sprain?

A

Anterior draw
Inversion stress test
Taler tilt for cfl

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13
Q

What is involved in an acl tear?

A

ACl
Prevents excessive anterior translation of the tibia from the femur
Provides stability during rotation
Prevents tibial rotation during knee extension

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14
Q

What are the symptoms of an ACL tear?

A

Pain in the knee
Instability
Swelling
Loss of rom

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15
Q

How does an ACL year occur?

A

Rapid deceleration - weak hamstrings and strong quads means the tibia is pulled forward

Landing with knee valgus and not enough flexion

Planted foot bent knee and sudden rotation

Direct blow to the lateral knee with foot planted

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16
Q

How would you test for ACL sprain?

A

Anterior draw

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17
Q

What is involved in a PCL sprain?

A

PCL ligament
Thicker and stronger than ACL
Main knee stabiliser
Resists posterior translation of the tibia from the femur
Prevents excessive rotation of the tibia during flexion

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18
Q

What are the symptoms of a PCL tear?

A

Swelling not a lot
Pain
Pain on Palpation
Instability
Stiffness

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19
Q

How does a PCL sprain occur?

A

Excessive external trauma - dashboard injury
Direct blow to the anterior tibia
Falling into a flexed knee

20
Q

How would you test for a PCL tear)

A

Posterior sag
Posterior draw

21
Q

What is involved in an MCL sprain?

A

MCL
Attaches to medial meniscus
Stabilises the knee during external rotation at 30 flexion
Resists valgus force
Provides knee stability
Stabilises the knee when moving from extension to flexion

22
Q

What are the symptoms of MCL sprain?

A

Medial knee pain
Instability
Stiffness
Pain
Pain on Palpation

23
Q

How does an MCL tear occur?

A

Direct blow to the lateral knee when foot is planted
Can occur with ACL and meniscus injury

24
Q

How would you test for MCL sprain?

A

Valgus stress test

25
Q

What is involved in an LCL sprain?

A

LCL
Thinner than MCL
Popliteus seperate the lateral meniscus and LCL
Stabilises the knee
Resists Varus force
Steps in for acl and PCL when torn
Stretched during extension

26
Q

What are the symptoms of LCL sprain?

A

Swelling
Pain
Locking and catching
Instability
Pain on lateral knee

27
Q

How does an LCL occur?

A

Direct blow to anyerior medial knee
Sudden twisting of the knee
Sudden hyper extension of the knee

28
Q

How do you test for LCL sprain?

A

Varus stress test

29
Q

What’s involved in radial ligament sprain?

A

Radial lateral ligament of elbow
Blends with the ulna ligament
Inserts into the annular ligament of radius

Stabilised the elbow
Resists Varus forces

30
Q

How does a radial ligament sprain occur?

A

Following dislocation
Forceful Varus

Elbow instability allowing the proximal radius and ulna to externally rotate away from the humerus during supination

31
Q

What test would you use for radial ligament sprain?

A

Varus stress test

32
Q

What is involved in an ulna medialigament sprain?

A

Medial ulna collateral elbow ligament
Fan shaped
Stabilises the ulna and radial humeral joints
Resists valgus force
Anterior resists extension
Posterior resists flexion

33
Q

What are the symptoms of a medial ulna ligament sprain?

A

Medial elbow pain
Instability
Pain when throwing

34
Q

How does a medial elbow sprain occur?

A

Overhead throwing
Valgus on elbow during late cocking and early acceleration
FOOSH
Forced twisting of the arm with palm planted

35
Q

How would you test for medial ulna ligament sprain?

A

Vagus stress test

36
Q

What is involved in posterior ankle impingement?

A

Flexor hallucis longus
Posterior talo fibula ligament
Posterior tibiotaler ligament

Ankle stability
Eversion prevention
Tow flexion

37
Q

What are the symptoms of posterior ankle impingement?

A

Pain at posterior medial ankle
Pain with inversion and pf
Posterior lateral ankle locking

38
Q

How does posterior ankle impingement occur?

A

Thickening of FHL tendon - can be impinged between calcaneus and tibia during PF

Swelling of tibiotaler ligament due to acute injury - can impinge between medial talus and medial melleolus

39
Q

How would you test for posterior ankle impingement?

A

Limited DF
Palpation if FHL

40
Q

What is involved in posteriolateral corner injury?

A

LCL
Popliteus tendon
Popliteofibula ligament
Faifibular ligament
Bicep femoris tendon
ITB

Prevents hyper extension of knee
Prevents tibial external rotation
Prevents Varus force
Provides stability to posterior and lateral knee

41
Q

What symptoms would you see with a postlat corner injury?

A

Knee instability
Bruising and swelling peroneal nerve symptoms

42
Q

How does a postlat corner Injury occur?

A

External tibial rotation and hyper extension
Accompanies ACL and PCL tear
Ligament and tendon damage
Peroneal nerve damage
Fibula head avulsion

43
Q

How would you test for POSat corner Injury?

A

Dial test

44
Q

What are the structures involved in posterolateral rotatory instability?

A

Radial and medial lateral collateral ligament
Radial head
Coronoid process
Lateral epicondyle

Prevents posterolateral laxity of elbow
Coronoid process prevents posterior displacement of the ulna from humerus
Brachialis biceps and triceps stabilise elbow

45
Q

What are the symptoms of posteriolateral rotatory instability?

A

Lateral elbow pain
Instability with load

46
Q

Why does the rotatory instability occur?

A

Trauma to any anatomical structures involved

FOOSH elbow dislocation
Lateral epicondylitis can lead to laxity of LCL
Steroid injections

47
Q

How to test for rotatory instability

A

Chair push up test

MSK Pathophysiology (6 decks)

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