Musculoskeletal: Study Set 3 Flashcards by Madelynn Kahl

What are the anterior hip THA precautions

no hip extension, lateral adduction, and external rotation

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What are the posterior THA precautions

no hip flexion beyond 90, medial rotation, and adduction

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during lateral ankle reconstruction, what graft is commonly utilized

peroneal brevis

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a positive thompson test is indicative of what MSK pathology

achilles tendon rupture

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True of False

The achilles tendon is the largest and strongest tendon in the body

true

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What patient population has the highest risk of rupturing the achilles tendon

thirty to fifty during recreational activities
pt with corticosteroid use history

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If your pt ruptures their achilles, what diagnostic imaging would you expect them to have

x ray to rule out aversion fracture
mri to locate presence and severity of the rupture

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True or False

women are more likely to rupture the achilles tendon than men are

false, men are, especially if they are a weekend warrior type and not consistently active

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what is another name for adhesive capsulitis

frozen shoulder

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What is the clinical presentation of adhesive capsulitis

loss of ROM in the capsular pattern of lateral rotation, abduction, medial rotation

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True or False

Adhesive capsulitis effects women more than men

true

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What are normal synovial fluid levels in the glenohumeral joint vs the fluid levels when adhesive capsulitis is present

normally 6-20 oz
decreases to 5-10oz

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Your patient is coming in today due to an ankle sprain. Is it more likely to be a lateral or medial ankle sprain

lateral

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If your pt has a lateral ankle sprain, what structures could be damaged

ATFL - anterior talofibular lig.
CFL - calcaneofibular lig.
PTFL - posterior talofibular lig

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if your pt has a medial ankle sprain, what structures could be damaged

the deltoid ligament

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What special tests should be performed and what is being tested if a lateral ankle sprain is present

ankle anterior drawer for ATFL
talar tilt for CFL.

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What patient population has the highest probability of rupturing their ACL

14-29 y/o females

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What is the clinical presentation of lateral epicondylitis?

px/inflammation of extensor tendons behind lateral epicondyle
pain with wrist flexion and elbow ext. together
pain with resisted wrist ext, and pain with resisted radial deviation
decreased grip strength

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What patient population has the highest probability of developing lateral epicondylitis

30-40 y/o males

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What diagnostic imaging is usually performed with lateral epicondylitis

none

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What patient population has the highest probability of developing osteoarthritis

55 y/o females

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True or False

The short head of the biceps is the source of pain and inflammation with bicipital tendonitis

false

long head of biceps

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What is the clinical presentation of bicipital tendonitis

deep ache at front and top of shoulder
pain/tender with palpation of bicipital groove
OH athletes with repetitive ER and abduction

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What special tests would be used to rule in bicipital tendonitis

Yergason’s test, speed’s test, biceps resistance test

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How long can you expect to treat lateral epicondylitis

2-3 months

How long can you expect to treat an MCL sprain

4-8 weeks

How does primary anterior compartment syndrome typically happen

trauma to the anterior tib, EDL, EHL, and peroneal muscles

What is the difference between primary and secondary anterior compartment syndrome.

primary is life threatening, secondary is due athletic exertion and is not threatening

What is a colles fracture and what is the common MOI

a distal radius fracture by FOOSH

what diagnostic imaging is used to diagnose a colles fracture

x ray

What is congenital hip dysplasia

malalignment of the femoral head within the acetabulum that develops during the last trimester

What special tests are used to diagnose congenital hip dysplasia

barlows and ortolani

What muscle is affected with congenital torticollis and at what age will this condition come on by

SCM and two months

When is surgical intervention appropriate for congenital torticollis

if PT management fails and the child is over 1 year old

What is a clinical presentation of De Quervain's Tenosynovitis

pain at the base of the thumb due to inflammation of the abductor pollicis longus and the extensor pollicis brevis. usually with repetitive motions in racquet sports

True or False The tendons that are involved with De Quervain's do not pass through the extensor retinaculum

false, they pass through the tunnel so inflammation in the tunnel will cause pain and other symptoms

What special test should be used when diagnosing De Quervains

finkelstein's

What causes myositis ossificans and how long does it take for the bone to grow

this is when bone grows in a muscle belly following a contusion. Bone starts growing 2W-4 weeks after injury and matures within 3-6 months

What is the clinical presentation of myositis ossificans

hard lump in the muscle belly, an increase in pain, and a decrease in range of motion that had previously been improving

Explain the pathology behind a bulging disk

a bulging disk occurs when the inner nucleus bulges past the exterior of the annulus fibrosis. Disks are more likely to bulge at the posterolateral aspect bc they are its weakest there. The disks often compress nerve roots which cause pain

What diagnostic imaging should be used to diagnose a bulging disc

MRI

What is the clinical presentation of a bulging disk

low back pain with unilateral radicular symptoms. symptoms will worsen with anything pretty much and anything that increase intraabdominal pressure

What interventions are used to treat a bulging disk

lumbar stabilization exercises, traction, and modalities for pain. add extension exercises when tolerated

What is duchenne muscular dystrophy and what causes it

DMD is a progressive disorder in which the body does not produce dystrophin or nebulin. This causes the muscles to be replaced by fat and connective tissue, leading a pt to die from cardiopulmonary failure prior to age 25

How are the genetics of duchenne muscular dystrophy passed on

The mother carries a recessive gene that is passed on to sons only

At what age of DMD do effects start showing

between two and five years old

True or False posterior shoulder dislocation is the most common

false, anterior is most common with abduction and lateral rotational movements

Explain shoulder impingement syndrome

Typically causes by repetitive OH athletes, the humeral head and associated rotator cuff attachments migrate proximally and impinge under the acromion

What are the signs and symptoms of shoulder impingement

deep shoulder pain, pain with OH activities, painful arc of motion between seventy and one hundred twenty degrees, and tenderness over greater tuberosity

What is juvenile rheumatoid arthritis

an autoimmune disorder in which the immune cells mistakenly attack joint and organs causing effects throughout the body

What are the different subtypes of juvenile RA

Pauciarticular - four or less joints polyarticular - more than four joints

What are the likely signs and symptoms of pauciarticular juvenile RA

asymmetric and mild associated with eye disease

What are the likely signs and symptoms of systemic juvenile RA

fever rash, chills that lasts for weeks.

What are the likely signs and symptoms of polyarticular juvenile RA

asymmetric associated with joints of hands and feet as well as larger joints

True or False lateral epicondylitis effects the flexor muscles

false - extensor muscles

what is the common term used to describe lateral epicondylitis

tennis elbow

what is the main muscle that is effected by tennis elbow

extensor carpi radialis brevis

what is legg-calve-perthes disease

degeneration of the femoral head due to a disturbance in the blood supply or avascular necrosis

what are the four stages of legg calve perthes disease

condensation, fragmentation, re-ossification, and remodeling

does a varus or valgus force injure the MCL

valgus

what the medical term for golfers elbow

medial epicondylitis

what muscle groups and what nerve are most effected by golfer's elbow

wrist and finger flexors and forearm pronators. the ulnar nerve should be checked as well.

is the medial or lateral meniscus more likely to be injured and why

medial meniscus because it is more firmly attached to the tibia

what are the three special tests used to diagnose a meniscus tear

appley's compression, mcmurray's, and thessaly's

what diagnostic imaging should be used to diagnose a meniscus tear

MRI