Lower Extremity

Question 1

Most commonly involved muscle in hamstring strains with running? with kicking?

Answer 1

running = Biceps femoris (b/c this mm incurs the most stretch, occurs at aponeurosis = shorter rehab). kicking = SemiMem (at proximal free tendon = longer rehab, maybe surgery). Generally, the more proximal location of pain, the time needed for rehab.

Question 2

Diff b/w sports hernia and inguinal hernia

Answer 2

Sports hernia is a weakening of the posterior inguinal wall, causing dull diffuse pain around the groin that radiates to the inner thigh or perineum. Can progress to inguinal (overt) hernia. Sports hernia is progressive and can be bilateral or unilateral.

Question 3

What is a hip pointer?

Answer 3

direct blow to iliac crest

Question 4

4 types of labral tears

Answer 4

radial flap, radial fibrillated, longitudinal peripheral, abnormally mobile (partially detached),

Question 5

What motions to avoid with labral repair?

Answer 5

early flexion and ABD

Question 6

what is coxa saltans?

Answer 6

snapping hip

Question 7

what is meralgia paresthetica?

Answer 7

compression of lateral femoral cutaneous nerve that causes extreme burning down the thigh

Question 8

SCFE vs LCP

Answer 8

SCFE = 10-17 y/o obese male with groin or knee pain, insidious onset. Medical emergency! Place on crutches+ NWB. LCP = 4-8 year old male, limping, decreased ROM.

Question 9

Most causative factor of adductor strain?

Answer 9

adductor weakness

Question 10

Most common location of hip labral tears? Mechanism?

Answer 10

anterior - loaded rotation

Question 11

What arc of motion does the patellofemoral joint experience the most compression with OKC exercise? What ROM should be worked in for TherEx?

Answer 11

full extension, work in 50-90 degrees of flexion

Question 12

What arc of motion does the patellofemoral joint experience the most compression with CKC exercise? What ROM should be worked in for TherEx?

Answer 12

increased flexion, work in 0-50 degrees

Question 13

If posterior lachman is positive at 30, what should you suspect? Positive at 90? Positive at both 30 and 90?

Answer 13

(+) at 30= suspect post lateral corner,; (+) at 90= suspect PCL; (+) at both 30 and 90= suspect PCL

Question 14

What is Ege’s test?

Answer 14

used to detect meniscal tear. Pt can IR (to diagnose lateral mm) or ER (to diagnose medial mm)

Question 15

Microfracture of the knee is used for chrondral lesions less than ____ mm? What type of cartilage is formed after wards and why is this important?

Answer 15

4mm. A fibrocartilaginous cap is formed, which is less resilient and has less stiffness than type II hyaline cartilage

Question 16

Loss of ROM after ACL may be due to surgical error? If the femoral tunnel is placed too anterior? If the tibial tunnel is placed too anterior?

Answer 16

Femoral too anterior = pt may lose flexion. Tibial tunnel too anterior = pt may lose extension.

Question 17

What does tape do for patellar tracking?

Answer 17

Nothing! But it may decrease pain by applying a low load to the lateral structures of the knee. So you do not need to evaluate tracking pre/post tape.

Question 18

Step and Twist mechanism with immediate swelling? Step and twist with delayed swelling?

Answer 18

ACL, Meniscus

Question 19

Unahppy triad?

Answer 19

ACL, MCL, lateral meniscus

Question 20

When does the inferior patellar pole make contract with the superior trochlea?

Answer 20

20 degrees of flexion

Question 21

Mechanism for PLRI? Structures involved (6)? Special Tests (7)?

Answer 21

mech: hyperextension. Structures: LCL, arcuate ligament, fabofabellar ligament, PL capsule, IT band, biceps femoris, popliteus. Tests: post drawer, posterior lachman, dial at 30 & 90, reverse pivot shift, posterolateral drawer, posterolateral ER test, ER recurvatum

Question 22

Most common rotatory instability?

Answer 22

AMRI. This is the most frequent cause of ACL disruption

Question 23

Mechanism of ALRI?

Answer 23

IR + varus

Question 24

Mechanism of PMRI?

Answer 24

valgus + hyperextension

Question 25

Phase of healing that lasts 4-6 weeks and focuses on decreasing swelling, gradually restoring PROM & WB, and enhancing volitional control of the quad

Answer 25

Proliferation phase

Question 26

5 weeks post op BTPB, what OKC range is inappropriate?

Answer 26

60-30 degrees of flexion

Question 27

OKC range that is safe to work into after ACLR?

Answer 27

70-90

Question 28

ACL experiences the most stress in what range?

Answer 28

0-50 degrees

Question 29

When the knee is flexed, what fibers of the ACL are stressed the most? What special test will stress these fibers?

Answer 29

anterior bundle, anterior drawer

Question 30

What causes turf toe?

Answer 30

repetitive 1st MTP extension

Question 31

What is a jone’s fx?

Answer 31

fx at base of 5th metatarsal

Question 32

syndesmotic injury mechanism?

Answer 32

ER + DF

Question 33

Why does compliance decrease with foot orthoses?

Answer 33

irritation of skin, decreased performance, discomfort of brace

Question 34

critical stress fx sites of Lower leg

Answer 34

anterior tibia, mediall mall, navicular

Question 35

sinus tarsi syndrome

Answer 35

compression of tibial nerve or it’s branches

Question 36

Common locations of compartment syndrome in young athletes?

Answer 36

thigh, lower leg, medial compartment of foot

Question 37

With syndesmotic injury you want to avoid what?

Answer 37

DF! As this will increase the tib-fib joint space and exacerbate the injury