Musculoskeletal: Study Set 3 Flashcards
What are the anterior hip THA precautions
no hip extension, lateral adduction, and external rotation
What are the posterior THA precautions
no hip flexion beyond 90, medial rotation, and adduction
during lateral ankle reconstruction, what graft is commonly utilized
peroneal brevis
a positive thompson test is indicative of what MSK pathology
achilles tendon rupture
True of False
The achilles tendon is the largest and strongest tendon in the body
true
What patient population has the highest risk of rupturing the achilles tendon
thirty to fifty during recreational activities
pt with corticosteroid use history
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
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
what is another name for adhesive capsulitis
frozen shoulder
What is the clinical presentation of adhesive capsulitis
loss of ROM in the capsular pattern of lateral rotation, abduction, medial rotation
True or False
Adhesive capsulitis effects women more than men
true
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
Your patient is coming in today due to an ankle sprain. Is it more likely to be a lateral or medial ankle sprain
lateral
If your pt has a lateral ankle sprain, what structures could be damaged
ATFL - anterior talofibular lig.
CFL - calcaneofibular lig.
PTFL - posterior talofibular lig
if your pt has a medial ankle sprain, what structures could be damaged
the deltoid ligament
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.
What patient population has the highest probability of rupturing their ACL
14-29 y/o females
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
What patient population has the highest probability of developing lateral epicondylitis
30-40 y/o males
What diagnostic imaging is usually performed with lateral epicondylitis
none
What patient population has the highest probability of developing osteoarthritis
55 y/o females
True or False
The short head of the biceps is the source of pain and inflammation with bicipital tendonitis
false
long head of biceps
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
What special tests would be used to rule in bicipital tendonitis
Yergason’s test, speed’s test, biceps resistance test
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
