Medical act 1.4 Flashcards by Anete Berzina

with positive ottawa ankle rule, what do you do?

send patient for Xray examination

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does Ottawa ankle rule have high specificity or sensitivity?

specificity: rule in

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name criteria for OAR

ankle: pain in 6cm above malleolus, 6cm above lateral malleolus,inability to weightbear

foot xray: pain in metatarsal 5th, navicular, inability to weightbear

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name types of traumas

contusion, wound, sprain, strain, rupture, fracture

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name 7 fracture classifications

transverse; linear; nondisplaced; displaced; spiral; greenstick comminuted

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name a long term complication of a fracture

necrosis: cell death

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name generic red flags

recent trauma; prolonged fever, weight loss, long term use of corticosteroids, constant pain, cancer, feeling unwell, noctural pain, severe neurological signs (eg radiating pain)

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functions of meniscus

shares and distributes load over bigger surface; shock absorption; stress reduction, increases joint surface

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loss of meniscus can lead to what - regarding the amount of force on the cartilage/joint?

largely increased (20% loss meniscus - increase of 350% in contact force); lower shock absorption

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function of intervertebral disc?

allows spinal motion, stability, links vertebral bodies, shock absorption

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by what mechanism are the vertebras stabilized? how do they stay mobile and are able to absorb shock?

compression of the intervertebral discs (from above and below)

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if menisci have no pain fibers, why do we feel pain during meniscal tear?

due to surrounding tissues

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name the 3 different meniscal tear types

longitudinal (vertical/bucket handle tear); radial (parrot beak tear); horizontal (flap tear)

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what is the main complication after meniscal tear and meniscectomy?

higher risk for osteoarthritis ( acceleration of degeneration) / articular cartilage injuries

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what are some important signs and symptoms of discopathy?

pain (bilateral more common); nerve root compression (if disc is building and compressing a spinal root, causing eg burning pain) ; muscle weakness, loss of sensation and reflexes

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signs and symptoms of a hamstring injury

pain/tenderness, swelling, hematoma (localized bleeding, 24-48hrs), limited ROM, functional loss, palpable defect

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hardly pain but total functional loss- what type of rupture is this?

full rupture

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which cells produce collagen and form scar tissue

satellite cells which turn into myoblasts and fibroblasts

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recovery of tissue after muscle injury: duration?

4-6 weeks (plyometrics only after)

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in medical imaging pictures, what is the white area?

damage, drops or blood

with muscle regeneration, whats the steps to get to formation of new fibers

satellite cells activation, proliferation, differentiation, fusion, then formation of new fibers

whats fibrosis? and what does it lead to?

scar tissue; leads to loss of function

cervical facet joint problems: name each vertebrae couple and where the pain is felt

C2/3: posterior skull
C3/4: neck pain
C4/5: trapezius
C5/6: trapezius
C6/7: scapula

whats neuropathic pain exactly

damage or dysfunction of nervous system

what are dermatomes

skin areas related to spinal root nerve (eg if pain in legs, lumbar spine nerve might be damaged

whats peripheral damage

eg pain in elbow displaying pain in hand (different to dermatoma, more related to peripheral nerves)

for mild/moderate nociceptive pain, which drug do you use? for severe nociceptive pain, which drug do you use?

paracetamol, NSAIDs; severe pain: weak opioids eg tramadol, codeine

for neuropathic pain which drug do you use

antidepressants, SSRIs, opioids, ketamine

with ankle sprains/strains, whats treatment in first 4 weeks

2wks paracetamol + advise. if not helping, then NSAIDs

which part of human body does tramadol affect the most? and which side effects dies it lead to

GI tract; vomiting, constipation

after the use of which drug are you not allowed to drive? and why?

afte lyrica; because insomnia/dizziness/headaches/confusion is a side effect

2 huge side effects of using NSAIDs in endurance sports?

GI problems; renal failure

the nucleus pulpusos (middle) has the most water and least collagen compared to fibrous annulosus and endplate: true or false?

true

symptoms of meniscal tear

locking swelling pain

osteoarthritis is a complication of which injury?

meniscal tear of knee

in patients with disc related problems, is unilateral or bilateral pain more common?

bilateral

patients with discopathy avoid what type of activity?

static standing/posture. they prefer to walk

whats an avulsion fracture

lig or tendon completely separated from their bony attachment

what happens when theres a forceful impact but its not strong enough to break the bone? + symptoms

bone bruising long lasting pain, swelling, hematoma,

when does bone bruising cause intra articular swelling?

if its location is near to a joint

what does bleeding in a joint do to the joint and its structures?

damage the cartilage and the capsule

what type of trauma limit ROM and strength and cause instability?

sprains and strains

describe difference between sprain, partial rupture and full rupture

sprain: some tearing of ligamentous fibers (mild pain) partial rupture: some tearing and seperation of ligamentous fibers full rupture: total rupture of ligaments

what is granulation phase in tear healing

when the separated fibers try to reattach, reconnect

what structure links a tendon/ligament after a tear (healing process of a tear)?

collagen fibers

regarding MLPP and CPP, which is the most stable position of the bone and why?

CPP close packed position; concave/convex in complete congruence- surfaces touching entirely

in which position does talus get stuck in the syndesmosis (ankle joint)?

in CPP, dorsiflexion

which muscle inserts at 5th metatarsal and at navicular tuberosity

fibularis (peroneus) brevis and longus