Pathology 7 - MSK Flashcards
Patellofemoral Syndrome - what is it
pain or discomfort in the anterior knee
Patellofemoral Syndrome - other term
chondromalacia patella
Patellofemoral Syndrome - is due to what
rep overuse disorder resulting from the increased force at the patellafemoral joint
abnormal tracking of the patella between the femoral condyles - leads to misdirected forces between the patella and the femur
Patellofemoral Syndrome - factors assiociated with increase patellofemoral force include
decreased quad strength - vastus medialis
decreased LE flexibility - quads, hamsrings, gastroc, iliopsoas
patellar instability
increased tibial torsion or femoral anterversion
excessive pronation
knee valgus
femoral anteversion and tibial torsion
internal tibial torsion - IR
Patellofemoral Syndrome - risk factors
increase sport participation
females
growth spurt
overweight
runner who have recently increased their milage
Patellofemoral Syndrome - electromyography based feedback
should be avoids to augment Vastus medialis actvity
what is electromyography based feedback
EMG
based feedback is a technique that uses electrodes to record and display muscle activity in real time
Patellofemoral Syndrome - visual feed back
should be avoid when trying to correct leg alignment
Patellofemoral Syndrome - biophysical agents
US, cyrotherapy, phonophoresus, iontophorese, ESTIM
should be avoided
Patellofemoral Syndrome - what is normally happening to the patella during knee extenion
the patella is being pulled too laterally
Patellofemoral Syndrome - older population
normally associated with OA
Patellofemoral Syndrome - signs and sym
gradual onset of anterior knee pain - increase in activity
retropetellar pain
worse with activity that increae patella femoral force - flexion - and static positioning
point tenderness of the lateral border of the patella
crepitus
visable quad atrophy - vastus med
what is retro-patellar
behind the patella
does medial or lateral glide normally help pt with PFPS
medial glide
the lateral structure are normally tight
PFPS is seen most with what kind of sports
jumping sports
Piriformis Syndrome - physiological causes
compressive irration to the proximal sciatic nerve 2/2 the prirformis muscle inflammation, spasm, or contracture
Piriformis Syndrome - is a common etiology of what
low back pain
what is etiology
the cause of a disease
what is the function of the piriformis
abd and ER the hip
Piriformis Syndrome - external causes
trauma
abnormal gait mechanics
lumbar lordosis
periods of long sitting
Physical activity participation
Piriformis Syndrome - clinical presentation
local of pain in imprecise - midbutt area and progress to radicular complaints in the sciatic nerve distribution
Piriformis Syndrome - sym are normally exberated with what position
prolonged sitting
activities that combine add and medial and IR or the hip
Piriformis Syndrome - pain reproduction
palpation
resistance testing during lateral rotation and abd
radicular sym increased with SLR and decreased with traction of the LE
Piriformis Syndrome - imgaing
considered a clinical diagnosis of exclusion therefore no specific imaging is used
Piriformis Syndrome - and pregnacy
durin preg the piriformis may shorten or spasm due to postural changes and hip ER during walking
Plantar Fasciitis - what is it
refers to the inflammation of the PF at the proximal insertion on the medial tubercle of the calcaneus
excessive tension over time creates chronic inflammation and mircotears at proximal insertion
Plantar Fasciitis - where does the fascia run
calcaneus to the met heads
Plantar Fasciitis - age group
40 - 60 years of age
Plantar Fasciitis - signs and sym
tenderness at the insertion of the PF
presence of a heel spur
pain that is worse in the morning or after periods of prolonged inactivity
pain with prolonged standing
pain when walking bare foot
Plantar Fasciitis - tapping should or shuold not
should
Plantar Fasciitis - shoulds
tapping
stretching of the PF
night splint
mobs
foot orothisis - to support the medial long arch
Plantar Fasciitis - chronic or acute
chronic overuse condition
Plantar Fasciitis - pronation or supination
pronation during the loading phase of gait
what muscle orginate on the medial tubercle of the calcaneus
add hallucis
flexor digitorum brevis
quadratus plantae
thee can become inflamed and irritated with plantar fascitis
Plantar Fasciitis - risk factors
pronation during gait
tightness of the foot and calf muscles
obesity
high arch
endurance sports
prolonged walking or standing job
what is apophysitis
a condition that causes inflammation in a growth plate where a muscle attaches
Plantar Fasciitis - why do pt have pain in the morning
this is when the tendon is stiff, contracted, and cold
Plantar Fasciitis - pain presentation
subside for a few hours during the day but increases with prolonged activity or when the pt has been non-weightbearing and resumes the WB posture
Plantar Fasciitis - bilateral or unilateral
unilateral
Plantar Fasciitis - when do we get a MRI
after 6-8 weeks of pt without improvement
this is used to confirm diagnosis
what is the special test for plantar fascia
windlass mechanism
tarsal tunnel syndrome - what is this
the area of the:
- post tib
- flexor hallicus
- flexor digitorm
- Post tibial nerve
- tibial art
between the medial mall and the calcaneus
what does the tibial nerve split into
the medial and alteral pantar nerces
tarsal tunnel syndrome - presentation compared to PF
pain with WB but not with palpation to the PF
tarsal tunnel syndrome - signs and sym
numbness
burning
tingling
parathesia at the heel
tarsal tunnel syndrome - what is the cause
entrapment and compression of the post tib nerve within the tarsal tunnel
