Pathologies Flashcards
What degree of ligament injury at the AC joint presents with AC ligament rupture and Coracoclavicular ligament stretched?
Second degree
What degree of ligament injury at the AC joint presents with AC ligament stretched?
First degree
What degree of ligament injury at the AC joint presents with AC ligament and Coracoclavicular ligament ruptured?
Third degree
Most commonly broken bone in children. Usually result from a fall into the lateral aspect of the shoulder or on the outstretched hand. Fracture occurs in its mid-portion.
Clavicular fracture
What is another injury caused by fall on the outstretched hand. Common in the elderly and is usually an impacted fracture?
Humeral neck fracture
This fracture is often caused by a direct blow or twisting force. Spiral fractures in this region increase the risk of a radial nerve injury, as the nerve passes next to the bone
Midhumeral fracture
Fracture caused by benign tumors or metastatic carcinoma from primary sites such as the lung, breast, kidney, and prostate
Pathological fractures
What is caused by a forced shoulder abduction and external rotation causing the humeral head to slide anteriorly out of the glenoid fossa
Anterior shoulder dislocation
This is commonly seen in individuals who have hemiplegia, usually from a CVA. Paralysis of the shoulder muscles leaves them no longer able to fold the head of the humerus in the glenoid fossa. Paralysis combined with the pull of gravity and the weight of the arm over time causes this partial dislocation.
Glenohumeral subluxation
This overuse condition that involves compression between the acromial arch, humeral head, and soft tissue structures such as the coracoacromial ligament, rotator cuff muscles, long head of the biceps, and subacromial bursa
Impingement syndrome
Refers to the inflammation and fibrosis of the shoulder joint capsule, which leads to pain and loss of shoulder ROM. Frozen shoulder
Adhesive capsulitis
Involves the distal tendinous insertion of the supraspinatus, infraspinatus, teres minor, and subscapularis on the greater/lesser tubercle area of the humerus. Tears can be a result of acute trauma or gradual degeneration
torn rotator cuff
This is caused by chronic inflammation of the supraspinatus tendon accumulation of mineral deposits. Can be asymptomatic or quite painful
calcific tendonitis
This pathology involves the long head of the biceps proximally as it crosses the humeral head, changes direction, and descends into the bicipital groove. The biceps long head tendon commonly ruptures during repetitive or forceful overhead positions. Irritation as it slides in the groove can lead to subluxing of the biceps tendon. Overloading the muscle in an abducted and externally rotated position tends to be the force subluxing the tendon out of the bicipital groove.
Bicipital tendonitis
Tennis elbow
Common overuse condition that affects the common extensor tendon where it inserts into the lateral epicondyle of the humerus.
The extensor carpi radialis brevis is particularly affected. Common in racquet sports and other repetitive wrist extension activitites.
Lateral epicondylitis
Occurs when a great deal of force is applied to an elbow that is in a slightly flexed position. This causes the ulna to slide posterior to the distal end of the humerus
Elbow dislocation
Common fractures in children
Caused by falling on the outstretched hand.
Distal end of the humerus fractures just above the condyles. The great danger of this fracture as well as the elbow dislocation is the potential damage to the brachial artery because of close proximity. Can lead to Volkmann’s ischemic contracture, a rare but potentially devastating ischemic necrosis of the forearm muscles.
Supracondylar fractures
Golfer’s elbow Inflammation of the common flexor tendon that inserts into the medial epicondyle. Overuse condition that results in tenderness over the medial epicondyle and pain on resisted wrist flexion
Medial epicondylitis
Seen in young children under the age of 5 years who have experienced a sudden strong traction force on the arm. This force causes the radial head to sublux out from under the annular ligament
Pulled elbow/Nursemaid’s elbow
Overuse injury of the medial epicondyle, usually caused by a repetitive throwing motion. Seen in young baseball players who have not reached skeletal maturity. Throwing motion places a valgus stress on the elbow, causing lateral compression and medial distraction on the joint
Little league elbow
Common injury of the elderly
Resulting from a fall on an outstretched hand. Transverse fracture of the distal radius includes a POSTERIOR displacement of the distal fragment
Colles’ fracture
Benign tumor mass commonly seen as a bump on the dorsal surface of the wrist
Ganglion cyst
Incomplete fracture, usually of the radius and more proximal than a Colles’ fracture. More common in children
Greenstick fracture
Caused by a fall on the back of the hand.
The distal fragment is displaced ANTERIORLY
Smith’s fracture
Caused by compression of the median nerve within the carpal tunnel. Symptoms include numbness and tingling in the hand, which often begins at night. Tingling, pain, weakness in the hand, particularly in the thumb, index, and middle fingers. Tapping over the carpal tunnel produces symptoms. Some fibers of the transverse carpal ligament are often surgically cut to relieve symptoms
Carpal Tunnel syndrome
Inflammation and thickening of the sheath containing the extensor pollicis brevis and abductor pollicis longus, resulting in pain on the radial side of the wrist. Inflammation of tendons and surrounding sheaths> tenosynovitis. Making a fist with your thumb inside and then moving the wrist into ulnar deviation can elicit pain in those tendons and is considered a positive test > can cause discomfort in a normal wrist
DeQuervain’s disease
occurs when the palmar aponeurosis undergoes a nodular thickening. Most common in the area of the palm in line with the ring and pinky fingers > will often develop flexion contractures.
Depuytren’s contracture
“Trigger finger” is a problem with the sliding mechanism of a tendon within its sheath. When a nodule or swelling of the sheath lining or tendon develops, the tendon can no longer slide in and out smoothly. It may pass into the sheath when the finger flexes, but it becomes stuck as the finger attempts to extend. Finger can become locked in that position and must be manually extended. Flexor tendons of middle and ring fingers are most commonly involved.
Stenosing tenosynovitis
Acute tear of the ulnar collateral ligament of the thumb
Skier’s thumb
A stretching injury of the ulnar collateral ligament from twisting the necks of small game.
Gamekeeper’s thumb
characterized by flexion of the MCP joint, (hyper)extension of the PIP joint, and flexion of the DIP joint
Swan neck deformity
deformity in the opposite direction as swan neck- extension of the MCP joint, flexion of the PIP joint, and extension of the DIP joint
Boutonnere deformity
results in ulnar deviation of the fingers at the MCP joints
Ulnar drift
caused by disruption of the extensor mechanism of the DIP joint, either because the tendon was severed or because the portion of bone where the tendon attached has avulsed from the distal phalanx. In either case, the distal phalanx remains in a flexed position and cannot be extended.
Mallet finger
most frequently injured carpal bone. Usually results from a fall onto an outstretched hand by a younger person. Because of poor vascular supply, has a high incidence of avascular necrosis.
Scaphoid fracture
necrosis of the lunate, which may develop after trauma
Kiernbock’s disease
occurs when an unusually shallow acetabulum causes the femoral head to slide upward. The joint capsule remains intact, through stretched.
Congenital hip dislocation/dysplasia
femoral head undergoes necrosis. Usually seen in children between the ages of 5-10. During the course of the disease, may take 2-4 years for the head to die, revascularize, and then remodel.
Legg-Calve-Perthes disease/coxa plana
seen in children during the growth spurt years. Proximal epiphysis slips from its normal position on the femoral head
slipped capital femoral epiphysis
neck-shaft angle of greater than 125 degrees. “Straighter” angle > tends to make the limb longer, placing it in an adducted position during weight bearing
Coxa valga
increased angle of torsion (greater than 25 degrees) forces the hip joint into a more medially rotated position and causes the person to walk more “toed in.”
Anteversion
degeneration of the articular cartilage of the joint. May result from trauma or wear and tear, and is typically seen later in life. Commonly treated with a THR
Osteoarthritis
Deformity in which the neck-shaft angle is less than the normal 125 degrees. More “bent” tends to make the involved limb shorter, dropping the pelvis on that side during weight bearing
Coxa vara
Common among the elderly, usually a result of falls. MVA might cause hip fractures in younger individuals
Hip fractures
Intertrochanteric/ femoral neck
Decreased angle of torsion (less than 15 degrees) forces the hip joint into a more laterally rotated position and causes the person to walk more “toed out.”
Retroversion
overuse injury causing lateral knee pain. Commonly seen in runners and cyclists. Believed to result from repeated friction of the band that slides over the lateral femoral epicondyle during knee motion. Caused by muscle tightness, worn down shoes, and running on uneven surfaces.
IT band syndrome
results of either acute trauma or overuse. Can be seen in runners/cyclists or in someone with a leg-length discrepancy, or can be caused by other factors that put repeated stress on the greater trochanter.
Trochanteric bursitis
May result from overload of the muscle or trying to move the muscle too fast. Can occur at attachment site or anywhere along the muscle
Strain
occurs at the pelvis, not the hip. Severe bruise caused by direct trauma to the iliac crest. Commonly associated with football
hip pointer
“bowlegs” is an alignment problems where the distal segments are positioned more medially than normal. Ankles tend to touch while the knees are apart. Seen in conjunction with coxa valgus.
Genu varum
“jumper’s knee” is characterized by tenderness at the patellar tendon and results from the overuse stress or sudden impact overloading associated with jumping. Commonly seen in basketball players, high jumpers, and hurdlers.
Patellar tendonitis
“back knees” is the positioning of the tibiofemoral joint in which range of motion goes beyond 0 degrees of extension.
Genu recurvatum
common overuse injury among adolescents. Involves the traction-type epiphysis on the tibial tuberosity of growing bone where the tendon of the quadriceps muscle attaches.
Osgood-Schlatter disease
“Baker’s cyst” is actually not a cyst. Refers to any synovial hernia or bursitis involving the posterior aspect of the knee.
Popliteal cyst
“knock knees” is an alignment of the lower extremity in which the distal segments (ankles) are positioned more laterally than normal. Knees tend to touch while the ankles are apart. Seen in conjunction with coxa varus
Genu valgum
No universal agreement on terminology and causation. Generally refers to a common problem causing diffuse anterior knee pain. Considered the result of a variety of alignment factors such as increased Q angle, patella alta (high-riding patella), quadriceps weakness or tightness, weakness of hip lateral rotators, and excessive foot pronation.
Patellofemoral pain syndrome
softening and regeneration of the cartilage on the posterior aspect of the patella, causing anterior knee pain. Abnormal tracking of the patella within the patellofemoral groove causes the patellar articular cartilage to become inflamed, leading to it’s degeneration.
Chondromalacia patella
“housemaid’s knee” occurs when there is constant pressure between the skin and the patella. Commonly seen in carpet layers and is the result of repeated direct blows or sheering stresses on the knee.
Prepatellar bursitis
knee injury caused by a single blow to the knee and involves tears to the ACL, MCL, and medial meniscus.
Terrible triad
a general term given to exercise-induced pain along the medial edge of the tibia, usually a few inches above the ankle midway up the tibia. Most commonly, inflammation of the periosteum causes the pain. Overuse injury that can result from running on hard surfaces, running on tiptoes, and playing sports that involve a lot of jumping
Shin splints
is an alignment problem of the lower extremity involving increased anteversion of the femoral head and is associated with genu valgus, increased tibial torsion, and a pronated flat foot.
Miserable malalignment syndrome
more specific term that includes anterior leg pain not associated with a stress fracture.
Medial tibial stress syndrome
“horse’s foot” means the hindfoot is fixed in plantar flexion
Equnis foot
foot is fixed in dorsiflexion
Calcaneus foot
refers to an abnormally high arch
Pes cavus
loss of the medial longitudinal arch > flat foot
Pes planus
PIP is flexed, DIP extended. MTP hyperextended
Hammer toe
Caused by pathological changes in which the great toes develops a valgus deformity (distal end pointed laterally)
Hallux valgus
general term referring to pain around the metatarsal heads. Individual often describes the pain as a bruise, or like “walking on pebbles.” Pain usually becomes worse with increased activity.
Metatarsalgia
degenerative condition of the first MTP joint associated with pain and diminished ROM.
Hallux rigidus
PIP is extended, DIP is flexed. MTP hyperextended
Mallet toe
caused by forced hyperextension of the great toe at the MTP joint. Commonly seen in football, baseball, or soccer players
Turf toe
caused by abnormal pressure on the plantar digital nerves commonly at the web space between the third and fourth metatarsals. This pressure can result in pain and numbness in the toe area that gets worse with activity, such as running.
Morton’s neuroma
flexed PIP and DIP. MTP hyperextended
Claw toe
Inversion sprains occur when the foot lands in a plantar-flexed and inverted position.
What structures are damaged?
One or more of the lateral ligaments’s three parts may be stretched or torn
Common overuse injury resulting in pain in the heel. Pain is usually located at the point where the fascia attaches to the calcaneus on the plantar surface
Plantar faciitis
Plantar fascia helps maintain which arch?
medial longitudinal arch
The medial longitudinal arch acts as a ______________?
Shock absorber during weight bearing
What is the most frequently injured ankle ligament?
Lateral ligament
often occurs when the person trips over an unexpected obstacle or falls from a height, and it usually involves a twisting component to the ankle. Lateral malleolus is most commonly involved
Ankle fracture
What is a trimalleolar fracture?
involves both malleoli and the posterior lip of the tibia.
What is a bimalleolar fracture?
involves both malleoli
Inflammation of that gastroc-soleus tendon?
Achilles tendonitis
Achilles tendonitis is sometimes a precursor to this pathology when individual loses the ability to plantar flex the ankle?
Ruptured Achilles tendon
How do you determine if the tendon is intact?
have the individual lie prone with the feet off the edge of the table. Squeeze the muscle belly of the gastroc. If the tendon is intact, slight plantar flexion will occur. If no motion occurs, the tendon is ruptured
A surgical procedure that fuses the talocalcaneal, calcaneocuboid, and talonavicular joints. Provides medial-lateral stability of the foot and relives pain at the subtalar
Triple arthrodesis
