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Injuries and medical problems in sport > Pathology > Flashcards

Pathology Flashcards

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Sports Trivia flashcards USMLE® Step 1 flashcards
1
Q

Types of bone fracture

A
  • Transverse
  • Spiral
  • Oblique
  • Comminuted
  • Avulsion
  • Open/closed
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2
Q

Clinical features fractures

A
  • pain
  • deformity
  • reduced ROM
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3
Q

Cause of periosteal injury

A

direct blow, bleeding under the periosteum

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4
Q

Wolff Law

A

Bone remodels in direct response to the force applied

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5
Q

Define stress fracture

A

microfracture due to repetitive loading that, over time, exceeds bone’s intrinsic ability to repair itself

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6
Q

2 mechanisms for bone overload

A
  • Impact forces e.g. metatarsal in marching

- muscle pull e.g. neck of femur in runner

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7
Q

Function of cartilage

A
  • Joint lubricator

- shock absorber

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8
Q

3 types of cartilage

A
  • Hyaline cartilage (covers joint surfaces)
  • Fibrocartilage (knee meniscus, vertebral disc)
  • elastic cartilage (outer ear)
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9
Q

What is osteochondral injury

A

Damage to articular cartilage +/- subchondral bone

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10
Q

What is the issue with osteochondral injury?

A

Poor healing capacity because of inadequate blood flow (nutrition via diffusion from synovium, aided by joint loading)

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11
Q

Articular cartilage overuse sequence

A

Microscopic inflammation –> softening –> fibrillation –> fissuring –> gross disruption

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12
Q

What is osteochondritis dessecans

A

Separation of bone + cartilage from normal surrounding bone and cartilage

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13
Q

Types of muscle contraction

A
  • concentric = activity while muscle is shortening
  • eccentric = activity whilst muscle in lengthening
  • isometric = activity with no change in muscle length
  • isotonic = movement occurring at equal force throughout range
  • isokinetic = movement occurring at equal speed throughout range
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14
Q

How are muscle strains/tears classified?

A

Grade 1-3

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15
Q

Grade 1 muscle strain- pathology

A
  • small number of muscle fibres torn
  • fascia intact
  • minimal bleeding
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16
Q

Grade 1 muscle strain- clinical signs

A
  • mild pain
  • full ROM
  • full strength
17
Q

Grade 2 muscle strain- pathology

A
  • significant number of muscle fibres torn

- increased bleeding

18
Q

most common joint overuse injury

A

osteochondritis dessicans

19
Q

most common joint overuse injury

A

osteochondritis dessicans

20
Q

grade 2 muscle sprain/tear- clinical signs

A
  • increased pain
  • swelling
  • decreased ROM + strength
  • palpable haematoma
21
Q

Grade 3 muscle tear- pathology

A

complete tear, usually at the musculotendinous junction

22
Q

Grade 3 muscle tear- clinical signs

A

+++ bleeding and swelling

no active contraction

23
Q

What is a contusion

A

direct blow causes bleeding and haematoma formation (ie a bruise)- eg thigh contusion common in football

24
Q

what can repeated quad contusions lead to?

A

myositis ossificans

25
Q

3 common muscle overuse injuries

A

1) Focal fibrosis- repetitive
2) Chronic exertional compartment syndrome (CECS)
3) DOMS

26
Q

Focal fibrosis- aeitiology

A

microtrauma –> chronic inflammation + adhesions

27
Q

chronic exertional compartment syndrome- aeitiology

A

exercise –> increases intra-compartment pressure (build up of metabolites) –> tight fascia limits expansion –> impaired blood supply –> ischaemia –> pain

28
Q

DOMS- aetiology

A

eccentric exercise –> inflammatory cell/metabolite build up

29
Q

Clinical signs of myofascial pain

A
  • v tender point in taught band of muscle
  • hardening of muscle upon trigger point palpation- hard nots beneath the skin
  • subjective weakness of involved muscle
  • referred pain from trigger points

(note- shared symptoms with fibromyalgia but this is usually also associated with fatigue)

30
Q

Classic history CECS

A
  • Squeezing/cramping/aching/burning, typically begins within 15-20 minutes of an exertional type activity
  • Well-localised to a specific compartment
  • often bilateral
  • Pain/symptoms disappear quickly after the cessation of activity.
  • Focal neurological findings, i.e., decreased sensation, paresthesias, or weakness
31
Q

How is CECS diagnosed?

A
  • Hx- clinical examination is normal

- 1o = measurement of Intra-compartment pressure

32
Q

Mx of CECS

A

NSAIDs
Botulinum toxin injections
Gait training
Open fasciotomy if refractory to treatment

33
Q

2 most common sites for tendon rupture

A
  • site of least blood supply- eg 2cm above achilles tendon insertion
  • musculotendinous junction
34
Q

3 commonest forms of tendinopathy + an example of each

A
  • Tendinosis- collagen degeneration, neovascularisation eg patella/achilles
  • Tendinitis- inflammation of tendon eg inflammatory arthritides
  • Paratenonitis- inflammation of connective sheath
    eg de Quervain’s tenosynovitis in rowers
35
Q

bursa function

A

facilitate movement of tendon over bony surface

36
Q

2 categories of bursitis

A
  • acute/traumatic- due to direct knock. causing bleeding into bursa
  • overuse - eg subdeltoid bursitis, prepatellar bursitis
37
Q

bursitis clinical findings

A

localised pain and tenderness over a bursa

may be swelling if the bursa is superficial

38
Q

Tx bursitis

A
  • conservative- rest, analgesia
  • corticosteroid injections if Rx
  • excision of bursa is still Rx
39
Q

3 common nerve injuries in sport

A
  • Acute- neuropraxia- due to direct trauma- tingling, parasthesia, pain, weakness
  • Acute/chronic- entrapment eg from prolapsed intervertebral disc impinging on nerve root
  • Chronic- adverse neural tension- irritation of nerve due to local inflammation causing pain or stretching of nerve
    eg RSI/carpal tunnel

Injuries and medical problems in sport (17 decks)

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