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Sports Medicine > Peds > Flashcards

Peds Flashcards

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Sports Trivia flashcards
0
Q

Most common epiphyseal fracture is?

A

Distal radius

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1
Q

What is the nemonic for Salter-Harris fractures?

A 
S-separation 
A-above
L-lower
T-through
ER-compression
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2
Q

What Salter-Harris fractures need anatomical reduction?

A

3-5

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3
Q

Most common Salter-Harris fx?

A

2

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4
Q

What percent of SCFE are bilateral and how is it treated?

A

30-40% bilateral.

Age 11-13. Obese. African American

Treat-immediate NWB, then ORIF

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5
Q

What is medial epicondyle apophyseal avulsion fx and how do you treat it?

A

Ulnar collateral ligament and wrist flexor tendons.

Long arm splint or cast. Surgery if displacement > 5mm

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6
Q

What muscle inserts at iliac crest?

A

ITB/TFL (palpable)

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7
Q

What muscle inserts at ASIS?

A

Sartorius (palpable)

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8
Q

What muscle inserts at AIIS?

A

Rectus Femoris (not palpable)

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9
Q

What muscle inserts at greater trochanter?

A

Gluteus Medius (palpable)

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10
Q

What muscle inserts at lesser trochanter?

A

Iliopsoas (not palpable)

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11
Q

Little league shoulder (humeral head epiphysis )-how long should the athlete rest and when return to play?

A

Rest for 3 months.

RTP in 7-8 months

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12
Q

What is Sinding-Larsen-Johannson disease?

A

Patella tendon apophysitis. Superior pole-quad tendon, inferior pole-patella tendon.

Treat with rest, ice, Tylenol and Cho-Pat strap.

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13
Q

What is Iselin’s disease?

A

Apophysitis of the peroneus brevis tendon at base of 5th metatarsal.

Treat with lateral heel wedge and walking boot for severe cases.

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14
Q

What is Osteochondritis dessicans (OCD)?

A

Subchondral bone and cartilage fragment that loses its blood supply due to trauma or vascular insult.

Tend to do well in skeletally immature. Surgery if unstable or skeletally mature.

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15
Q

In OCD, what are the 4 MRI classification stages and which ones are unstable?

A

Stage 1-subchondral compression, cartilage attached, edema, signal changes
Stage 2-partially detached
Stage 3-detached fragment but still in crater
Stage 4-loose fragment in joint

3 and 4 are unstable

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16
Q

In OCD of capitellum, where is the pain?

A

Lateral elbow

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17
Q

In OCD of knee, where is it most commonly seen?

A

Medial femoral condyle (80%)

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18
Q

In OCD of ankle, where is it most commonly seen?

A

Supermedial corner of talar dome

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19
Q

What is panner’s disease and how do you treat it?

A

Avascular necrosis (osteonecrosis) of the capitellum. Seen in kids under 10. Lateral elbow pain

Treat with rest-no surgery

Good prognosis.

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20
Q

What is Kinebock’s disease and how do you treat it?

A

Avascular necrosis (osteonecrosis) of lunate.

Men 20-40

Initially treat with cast or splint. Surgery likely.

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21
Q

What is Scheuermann’s disease and how is it treated?

A

Avascular necrosis (osteonecrosis) of vertebral superior or inferior end plates.

Males with poor posture

3 adjacent vertebrae with 5 degrees of anterior wedging. Kyphosis of 45 degrees.

Treat with extension exercises and bracing. Surgery for severe deformity.

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22
Q

What is Kohler’s disease and how do you treat it?

A

Avascular necrosis (osteonecrosis) of navicular bone.

Kids 4-8

Treat with walking boot or short leg cast

23
Q

What is Freiberg’a infarction and how do you treat?

A

Avascular necrosis (osteonecrosis) of 2nd or 3rd metatarsal.

Adolescent females.

See flattening of met head

If diagnosed early- orthotic
Otherwise surgery

24
Q

What is Legg-Calve-Perthes disease and how do you treat it?

A

Avascular necrosis (osteonecrosis) of the femoral head.

Boys 4-8. Painless limp

90% unilateral.

Treat with PT, ROM, crutches and ABduction brace.

25
Q

What is Blounts disease and how do you treat it?

A

Avascular necrosis (osteonecrosis) of the medial tibial epiphysis.

Seen in adolescent obese African-American, like SCFE. You’ll see genu varus (bowleg)

You can try weight loss and bracing is usually effective in the infantile form, but they may need surgery – osteotomy

26
Q

Where does the posterior tibialis muscle tendon insert?

A

Navicular bone

27
Q

What is severs disease and how do you treat it?

A

Apophysitis of the insertion of the Achilles tendon.

They present with heel pain with activity.

Treat with calf stretching, heel cups and walking boots for severe cases.

28
Q

What is the most common sight of nosebleeds arising from?

A

Kiesselbachs plexus

29
Q

What is the estimated minimum systolic blood pressure with a palpable radial pulse?

A

80 mm Hg

30
Q

What is the treatment for a distal radioulnar joint dislocation without fracture?

A

Long arm cast for six weeks

31
Q

Where is Voshell’s bursa and how is a bursitis at this region treated?

A

It’s a bursa in between the medial collateral ligament and the tibia. It can be treated with rest anti-inflammatory medications and cross training.

It can present with knee swelling.

32
Q

Which two areas of bursitis need to be drained for possible risk of infection?

A

The olecranon and prepatellar bursa

33
Q

What is pes anserine bursitis associated with?

A

Pes planus

34
Q

What is a jersey finger and how does it present and how is it treated?

A

It’s an avulsion of the flexor digitorum profundas tendon and the athlete is unable to flex the DIP. It is treated operatively.

35
Q

Which Salter Harris fracture creates the greatest risk to joint integrity?

A

3

36
Q

Which temperature in Fahrenheit would have a wetbulb globe temperature that would warrant a black flag warning on race day?

A

> 82°F

37
Q

How long does it typically take to return from a calcaneal stress fracture?

A

4 to 6 weeks. Treatment includes activity modification including crutches with weight bearing as tolerated. Surgery is usually not required.

38
Q

What is the gold standard for diagnosis of stress fractures?

A

MRI

39
Q

What percentage of the glenoid surface would have to be affected by a fracture in order to recommend surgery?

A

Greater than 25%

40
Q

What is the recommended treatment for a tibial stress fracture?

A

Nonweightbearing for 6 to 8 weeks with physical examination and repeat imaging to follow progression of healing and surgical referral if healing not demonstrated.

41
Q

Using an MRI, what does a grade I stress fracture show?

A

Abnormal STIR

Remember: first has STIR in it

42
Q

Using an MRI, what does a grade II stress fracture show?

A

Abnormal T-2 signal

Remember: two equals two

43
Q

Using an MRI, what does a grade III stress fracture show?

A

Abnormal T-1 signal

44
Q

Using an MRI, what does a grade IV stress fracture show?

A

Fracture line on T1

45
Q

What is the mechanism of high ankle sprains?

A

Forced foot dorsiflexion with abduction and external rotation of the foot

May be associated with a Maisonneuve fracture

Take 5 to 10 weeks to heal depending on severity. Treat with a walking boot for eight weeks. Focus on tibialis posterior strengthening for medial stability.

46
Q

What is considered a well-controlled seizure disorder?

A

No seizure activity for the past month.

47
Q

When should surgery be considered for scoliosis?

A

When the curve is greater than 40 to 45° and the patient is still going to grow.

48
Q

How many degrees of loss of internal rotation is problematic?

A

Greater than 20° of side to side loss is consistent with shoulder impingement. Less than 20° is usually well-tolerated.

49
Q

Is high degree atrioventricular block an absolute contraindication to exercise or a relative contraindication?

A

Relative

50
Q

What are some possible reasons for women having more anterior cruciate ligament injuries?

A

Poor neuromuscular control, smaller notch with and smaller ACL size. There does not appear to be any correlation with hormonal issues.

51
Q

What is positive energy balance and what level is associated with amenorrhea?

A

Positive energy balance is > 45 kcal/kg/Lean body mass

Amenorrhea is associated with <30 kcal/kg/Lean body mass

52
Q

What 2 hormones are likely decreased causing hypothalamic amenorrhea?

A

Gonadotropin releasing hormone and luteinizing hormone

53
Q

Should athletes with the female Triad be allowed to participate in their sport?

A

Yes, as long as they don’t have any cardiovascular symptoms.

54
Q

What is the treatment for autonomic dysreflexia?

A

Remove the inciting noxious stimulus. Sit the athlete up. Treat the hypertension with Nitropaste or oral/IV antihypertensives

Sports Medicine (4 decks)

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