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Therapeutic Exercise > Mod 2: Hip/Knee/Sports Med > Flashcards

Mod 2: Hip/Knee/Sports Med Flashcards

1
Q

fxn of iliofemoral ligament:
“ ischiofemoral ligament
“ pubofemoral ligament
(what do they restrict)

A

restrict ext/ER/add
restrict IR/add (on posterior side)
restrict ext/ABd

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2
Q

3 nerves of the hip

A

femoral
obturator
sciatic (becomes tibial & common fibular)

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3
Q

hip angle of inclination: outward angle that’s greater than normal (limb is longer)

A

coxa valga

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4
Q

hip angle of inclination: inward angle that’s less than normal (limb is shorter)

A

coxa vara

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5
Q

angle of inclination of hip is in what plane?

A

frontal plane (norm 125*)

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6
Q

angle of torsion of hip is in what plane?

A

transverse plane
(relationship between head & shaft of femur)

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7
Q

femoral head forward or internal femoral torsion

A

anteversion/toe in
>35*

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8
Q

femoral head back or external femoral torsion

A

retroversion/toe out
>45*

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9
Q

HIp special test: for femoral anteversion/retroversion

A

Craig test (find parallel greater trochanter)

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10
Q

HIp special test: iliopsoas contracture/labral tear, if leg doesn’t touch table supine

A

Thomas/Modified Thomas

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11
Q

Hip special test: flexibility of rectus femoris in prone (pos if hip flex or pelvic anterior rotation early)

A

Ely’s Test

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12
Q

Hip special test: flexibility of ITB/TFL (pos if doesn’t touch table in Add)

A

Ober Test

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13
Q

Hip special test: flexibility of hamstrings (pos if 20* or > from straight knee)

A

90/90 SLR Test

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14
Q

Hip special test: weak gluteus medius & hip drop of unsupported side

A

Trendelenburg

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15
Q

Hip special test: OA/labral pathology (use ABD/ER & ADD/IR)

A

Scour test

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16
Q

Hip special test: hamstring tightness (pos w/ extension of trunk when extending knee in seated)

A

Tripod sign

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17
Q

Hip special test: piriformis tightness/ compression of sciatic nerve

A

Piriformis test

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18
Q

Hip special test: iliopsoas, SI, hip or lumbar pathology

A

FABER (Figure 4/Patrick’s Test)

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19
Q

which glide to improve flexion & IR?
which other glide to improve flexion?

A

posterior glide
inferior glide

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20
Q

which glide to improve extension & ER?

A

anterior glide

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21
Q

limitation in passive hip ext d/t lack of extensibility of mm or ligaments of hip
-adapted shortened position

A

hip flexion contracture

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22
Q

pain w/ passive stretching or active contraction
d/t trauma, overuse, overstretch, forceful contraction

A

MM strain

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23
Q

sharp to dull pain over region
-ex: trochanteric, iliopectineal, ischial

A

Hip Bursitis

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24
Q

sharp s/s w/ activities that stress the tendon
-dull ache at rest

A

hip tendinopathy

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25
Q

early & excessive contact of femoral head & acetabular rim (pincer, cam, combo)
-anterior hip/groin pain from structural abnormalities or labral tear

A

femoral acetabular impingement (FAI)

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26
Q

type of FAI: acetabular over coverage of femoral head that damages labrum & delaminates cartilage

A

Pincer

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27
Q

type of FAI: deformity of femoral head which causes shear forces on articular surfaces during flexion and cartilage delamination

A

Cam

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28
Q

S/S:
– Pain in the groin and hip
– Locking, stiffness of hip joint
– Limited range of motion
– Often after a forceful injury
– Otherwise long term faulty mechanics cause
wearing away at the joint surface
– Very similar to FAI

A

Labral Tear

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29
Q

focal loss of cartilage
s/s: jt pain/stiffness, related to activity, gradual onset, limited mobility, butt/groin/thigh/knee pain

A

Hip Osteoarthritis

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30
Q

explain difference between total & hemi THA

A

total: replaces femoral head & acetabulum
hemi: replace femoral head

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31
Q

WB status of cemented THA vs. non-cemented THA

A

cemented: WBAT (unless ST repair or ORIF)
noncemented: TTWB or NWB

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32
Q

THA Posterolateral precautions

A

no ADD, IR, flexion > 90*
& combo of all 3

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33
Q

THA Anterolateral Precautions

A

no ER, ext, ADD, flexion > 90*
& combo of flex/ABD/ER

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34
Q

pelvic fracture: unstable vs. stable tx

A

unstable: surgery, NWB 6-8 wks, UE strength
stable: pain as guide, WBAT w/ AD, CKC movement

35
Q

3 areas of hip fracture

A

intertrochanteric
subtrochanteric
femoral neck

36
Q

complications of hip fractures (2)

A

avascular necrosis
DVT

37
Q

flattening of femoral head at WB surface d/t AVN
s/s: limp, pain in groin/hip/thigh, shortened LE, dragging leg, mm atrophy
common in young boys

A

Legg-Calve-Perthes Disease

38
Q

sudden/gradual anterior displacement of femoral neck from the capital femoral epiphysis
-adolescents common

A

slipped capital femoral epiphysis

39
Q

what type of gait?
weak hip flexors
tight hip flexors

A

forward trunk
poor hip ext, forward trunk & inc. lordosis

40
Q

what type of gait?
weak hip extensors
tight hip extensors

A

posterior trunk & heel strike
ER leg in terminal stance

41
Q

what type of gait?
weak hip abductors

A

trunk shift to weak side or Trendelenburg

42
Q

Which directions do knee ligaments resist?
ACL
PCL
MCL
LCL

A

resist anterior tib translation
resist posterior tib translation
resist valgus
resist varus

43
Q

which nerve innervates the knee? how does it split?

A

sciatic nerve becomes tibial & common fibular nerve

44
Q

screw home mechanism bone orientation

A

tibia ER
femur IR
(OKC extension)

45
Q

what factors may increase the lateral pull of the patella by quads in knee ext?

A

inc. Q angle
tight lateral structures (ITB)
weak medial structures (VMO)
dec. hip strength causes valgus

46
Q

what type of gait?
weak quads

A

knee buckles during stance
forward trunk @ heel strike

47
Q

what type of gait?
weak hams
tight hams

A

dec. control in terminal swing; hyperext stance
knee flexion in stance

48
Q

2 Tests for ACL tear/instability

A

Anterior Drawer Test
Lachman Test

49
Q

Knee test for anterolateral instability if shift/clunk between 20-40* flexion (dec tibia on femur)

A

Lateral Pivot Shift Test

50
Q

2 Tests for PCL tear/instability

A

Posterior Drawer Test
Posterior Sag Sign

51
Q

Knee special test:
Valgus vs. Varus Stress Tests?

A

Valgus: MCL sprain/tear/unstable, PCL or posterior medial capsule
Varus: LCL sprain/tear/unstable, PCL etc.

52
Q

3 Tests for Meniscal lesions
(pain, clicking over joint line)

A

Apley’s Compression Test
McMurray Test
Thessaly Test

53
Q

2 Tests for knee joint effusion

A

Brush Test
Patellar Tap Test

54
Q

Knee special test for chondromalacia/PFPS/DJD
-pt perform quad set & pain/crunch/inhibition at distal quad/patella

A

Patellar Grind Test/Clarke’s Sign

55
Q

glide to increase flexion
-at patellar jt
-at tibiofemoral jt

A

distal glide of patella
posterior glide of tibia on femur

56
Q

glide to increase extension
-at patellar jt
-at tibiofemoral jt

A

proximal glide of patella
anterior glide of tibia on femur
(also posterior glide of femur on tibia)

57
Q

Types/Locations of Tendinopathy of the Knee

A

Patellar (jumper’s knee)
quads
hamstrings

58
Q

pain over lateral femoral condyle @ 30* flex d/t overuse, repetitive trauma, or friction (poor biomechanics)
s/s: sharp pain on outside of knee, pop/ snapping

A

ITB Friction Syndrome

59
Q

MOI: noncontact, deceleration, planted foot, valgus stress, tibial IR, knee hyperext

A

ACL injuries

60
Q

ACL grafts (autograft) come from which tendons? (2)

A

Hamstring
patellar

61
Q

exercises to avoid s/p ACL surgery

A

OKC exercises
w/ ankle resistance especially

62
Q

initial phase (0-2 wks) s/p ACL goals

A

achieve full knee extension
quad control
dec pain/swelling
knee flexion ROM
patellar mobs
gait mechanics

63
Q

MOI: forced posterior movement of tibia on femur; MVA; landing on flexed knee, hyperflexion w/ foot planted

A

PCL injury

64
Q

MOI: valgus stress, deceleration, cut/pivot motions
-feels unstable

A

MCL injury

65
Q

MOI: trauma w/ knee flexed, rotation, shear compression
-d/t degeneration or repetitive overuse
s/s: pain, lock/catch, swell, buckle, functional impairment

A

Meniscal Injury

66
Q

what does the unhappy triad damage?
d/t valgus stress to knee

A

tearing of medial meniscus, ACL, MCL

67
Q

MOI: trauma or planting w/ sudden change of direction
s/s: audible pop, intense sharp pain, swell, difficult WB
common in females

A

Knee Dislocation/Subluxationq

68
Q

Tx options for articular cartilage defects

A

-debridement (smooth surfaces)
-microfracture (small holes in subchondral bone to inc. blood supply)
-autologous chondrocyte implantation (restore cartilage)
-osteochondral autograft transfer (OAT)- relocates cartilage in the knee

69
Q

s/s: pain around/behind patella, w/ stairs, w/ prolonged posture, @ end range flex/ext, crunch/pop w/ patellar movement

A

Patellofemoral Pain Syndrome

70
Q

musculoskeletal weaknesses that contribute to PFPS
-what is tight?

A

arch drop/pronation
weak hip abductors & ER
weak VMOs
tight lateral structures (ITB, TFL, & hams)

71
Q

loss of articular cartilage in medial/lateral compartment or patellar femoral

A

tibiofemoral Osteoarthritis

72
Q

WB status for TKA: cemented vs noncemented/porous ingrowth

A

cemented: WBAT
non: TTWB 6-8 wks

73
Q

other knee related fx sites (3)

A

patellar
supracondylar
tibial plateau

74
Q

traction apophysitis @ tibial tuberosity
-related to microtrauma in adolescents
s/s: pain/edema over tibial tuberosity; general tightness in hip/knee

A

Osgood-Schlatter Disease

75
Q

traction apophysitis @ inferior pole of patella
-similar to Osgood Schlatters

A

Sinding Larsen Johansson

76
Q

cracks in articular cartilage & underlying subchondral bone
d/t vascular deprivation, fragmented cartilage & bone
s/s: pain, catching sensation

A

Juvenile Osteochondritis Dissecans

77
Q

Areas of PT influence for athletic injury prevention

A

healthy nutrition education
correct gear/fit
time off/active rest/cross training
proper technique
warming up
strength & flexibility training

78
Q

Acute stage of healing for sports rehab

A

Immobilization/Protection

79
Q

Subacute stage of healing for sports rehab

A

Rehabilitaiton

80
Q

Chronic stage of healing for sports rehab

A

Function

81
Q

POLICE for rehab

A

Protect, Optimal Loading, Ice, compression, elevation

82
Q

when activity exceeds the body’s ___ & ___ = net tissue damage

A

tolerance & capacity

83
Q
A

Therapeutic Exercise (10 decks)

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