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PHTH 517 > Practical 1 Disorders > Flashcards

Practical 1 Disorders Flashcards

1
Q

lower ankle sprain grade 1

A
  • ATFL
  • slight and local edema and ecchymosis
  • FWB or PWB
  • stretched ligament
  • no instability
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2
Q

lower ankle sprain grade 2

A
  • ATFL and CFL
  • moderate and local edema and ecchymosis
  • difficult to WB without crutches
  • partial tear
  • none or slight instability
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3
Q

lower ankle sprain grade 3

A
  • ATFL, CFL, and PTFL
  • significant and diffuse edema and ecchymosis
  • impossible to WB without significant pain
  • complete tear
  • definite instability
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4
Q

high ankle sprain MOI

A
  • extreme ER or DF of the talus
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5
Q

medial ankle sprain MOI

A
  • excessive eversion an DF
  • injury to the deltoid ligament
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6
Q

posterior tibial tendon dysfunction subjective findings

A
  • Insidious onset of pain, with pain felt in one of 3 locations:
    • Distal to the medial malleolus in the area of navicular
    • Proximal to the medial malleolus
    • At the musculotendinous origin (medial shin splints), or insertion
  • Swelling on the medial aspect of the ankle
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7
Q

posterior tibial tendon dysfunction objective findings

A
  • Swelling and tenderness posterior and inferior to the med. Malleolus, along the course of the post. Tib tendon, and to its insertion into the navicular
  • Medial arch is decreased or completely flattened
  • Heel shows increased valgus
  • Pain on resisted ankle PF and inversion
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8
Q

plantar fasciitis subjective findings

A
  • Hx of pain and tenderness on the plantar medial aspect of the heel, especially during initial wt. bearing in the morning or after a prolonged period of nonweight bearing
  • Pain usually worsens with activity: jogging, climbing stairs)
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9
Q

plantar fasciitis objective findings

A
  • Localized pain on palpation along the medial edge of the fascia or at the origin on the anterior edge of the calcaneus
  • Note: firm pressure is often necessary to localize point of maximum tenderness
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10
Q

heel pain causes

A
  • obesity
  • excessive walking/ sporting activity
  • tight plantar fascia
  • flattening of the arch
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11
Q

achilles tendinitis subjective findings

A
  • Gradual onset of pain and swelling in the Achilles tendon 2 to 3 cm. proximal to the insertion of the tendon
  • Exacerbated by activity
  • Some patients will present with pain and stiffness along the Achilles tendon when rising in the morning or pain at the start of activity that improves as activity progresses
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12
Q

achilles tendonitis objective findings

A
  • Tenderness & warmth to palpation along tendon
  • Decreased active and passive DF
  • Gait may include: antalgia, premature heel off, leg may be held in ER
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13
Q

achilles tendon rupture MOI

A
  • loading on a dorsiflexed ankle with the knee extended or repeated microtrauma
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14
Q

achilles tendon rupture subjective findings

A
  • feels like being kicked in the leg or shot in the leg
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15
Q

ACL tear subjective findings

A
  • most are non contact
  • Sensation of their knee “popping” or “giving out” as the tibia subluxes anteriorly
  • Pain & Immediate dysfunction
  • Instability in the involved knee and the inability to walk without assistance
  • Immediate swelling (acute hemarthorsis)
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16
Q

ACL tear MOI

A

twisting or hyperextension of the knee

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17
Q

ACL tear objective findings

A
  • Pain
  • Positive special tests for anterior stability
  • Involvement of other knee structures (med. Meniscus, MCL)
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18
Q

ACL tear diagnostic tests

A
  • anterior drawer
  • lachman’s: most sensitive
  • pivot shift
19
Q

MCL sprain subjective findings

A
  • Immediate pain over medial knee
  • Worse with flexion/extension of knee
  • Pain may be constant or present with movement only
  • Knee feels ‘unstable’
  • Soft tissue swelling, bruising
20
Q

MCL sprain grade 1 objective findings

A
  • local tendernesson the medial femoral condyle or medial tibial plateau, with minimal swelling
  • pain but no laxity on valgus stress testing at 30 degrees knee flexion
21
Q

MCL sprain grade 2 objective findings

A
  • marked tenderness over the MCL
  • mild to moderate swelling and pain
  • laxity on valgus stress testing (The knee should be stable at full extension, with laxity only present at 30 degrees flexion
22
Q

MCL sprain grade 3 objective findings

A
  • Tenderness over the MCL
  • Severe laxity on valgus stress testing without a distinct end-feel
  • Usually laxity at full extension, indicating damage to the deeper, capsular fibers of the MCL
  • May beminimal pain on testing, due to rupture of nociceptive fibers
  • Rarely an associated medial mensicus injury, insteadlateral meniscus is more involved due to the mechanism of injury,compressing and shearing the lateral compartmentwhile opening the medial compartment
23
Q

meniscal tear MOI

A
  • patient attempts to turn, twist or change direction when weightbearing
  • can occur from contact to the lateral or medial aspect of the knee
24
Q

meniscal tear subjective findings

A
  • Reports of significant twisting injury to the knee, although older patients with degenerative tears may have a Hx of minimal or no trauma
  • Hx of popping, swelling, or clicking
  • Pain along the joint line, particularly with twisting or squatting activities
25
Q

meniscal tear objective findings

A
  • Tenderness over the medial or lateral joint line
    Some degree of effusion
  • Forced flexion and circumduction (internal and external rotation of the foot) frequently elicit pain on the side of the knee with the meniscal tear
26
Q

meniscal tear diagnostic tests

A
  • Mcmurray
  • Apley’s
  • Steinmann I Sign
27
Q

patellofemoral pain syndrome

A
  • anterior or retropatellar knee pain associated with prolonged sitting or with wt-bearing activities that load the PF joint (squatting, kneeling, running, and ascending/descending stairs)
28
Q

patellofemoral pain syndrome subjective findings

A
  • Reports of anterior knee pain with going up or down stairs or hills; instability of patella with activities
  • Usually no Hx of trauma and swelling is uncommon
  • More common in female than male patients
    They will say it feels swollen
29
Q

patellofemoral pain syndrome diagnostic testing

A
  • Clarke’s sign/patellar grind/patella tracking with compression
  • apprehension test
30
Q

patellofemoral pain syndrome objective findings

A
  • May see valgus alignment of knees, femoral anteversion (increased IR compared with ER), and abnormal tracking
  • Quadriceps weakness
  • Generalized laxity of the patellofemoral ligaments
  • Hip weakness
  • Poor eccentric quad control in weight-bearing
31
Q

hamstring strain subjective findings

A
  • distinct mechanism of injury with immediate pain during full stride running or while decelerating quickly
  • may hear a “pop”
  • posterior thigh pain, worsened with knee flexion
32
Q

hamstring strain objective findings

A
  • tenderness reported with passive stretching of the hamstrings
  • tender to palpation
  • pain with resisted knee flexion (IR/ER to isolate)
33
Q

CAM impingement provocative tests

A

FADIR
- hip flexion
- hip adduction
- hip IR

34
Q

CAM impingement

A
  • Aspherical femoral head
  • Bony prominence at anterolateral head-neck junction
  • Impinges on the rim of labrum
  • Leads to superior OA
  • Young athletic males
35
Q

pincer impingement

A
  • Over-coverage of femoral head by the acetabulum
  • Acetabulum impinges on the neck of the femur
    Lead to posterior-inferior or central OA
  • Middle aged females
36
Q

pincer impingement provocative test

A
  • hip extension
  • hip ER
37
Q

FAI symptoms

A
  • When symptoms develop, it usually indicates that there is damage to the cartilage or labrum and the disease is likely to progress. Pain experienced in the anterior groin area
  • The C sign
  • Described as dull and aching
  • Pain is worse with prolonged sitting
  • Occasional sharp catching pain with activity
  • Increase symptoms with hip flexion, adduction, and internal rotation.
  • May limp
38
Q

adductor strain diagnosis

A
  • pain with passive hip abduction
  • pain with palpation
  • weak adductor squeeze test
39
Q

hamstring strain grade 1 intervention

A

continue activities as much as possible

40
Q

hamstring strain grade 2 intervention

A

5-21 days of rehab

41
Q

hamstring strain grade 3 intervention

A

3-12 weeks of rehab

42
Q

biomechanical factors associated with hamstring strain

A

anterior pelvic tilt

43
Q

piriformis syndrome MOI

A
  • insidious onset due to compression of sciatic nerve
  • muscle tightness + long bouts of sitting
44
Q

piriformis syndrome symptoms

A
  • pain in butt or hips that can extend down the thigh
  • tingling + numbness
  • difficulty sitting for long periods
  • reduced ROM

PHTH 517 (5 decks)

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