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KT 1.4 > PTA 1.4 > Flashcards

PTA 1.4 Flashcards

1
Q

more commonly injured meniscus and why?

A

medial, because it has ligaments attached to it

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2
Q

function of meniscus

A

joint stability, distribution of loads, shock absorption

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3
Q

if an injury does occur, where would it be better for it to occur? (location on meniscus) and which meniscus

A

on the outter part of the lateral meniscus, as its better vascularised

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4
Q

which meniscus is more commonly injured in young people?

A

lateral

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5
Q

which treatment is used for lateral meniscus tear in young people?

A

meniscal repair /meniscopexy

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6
Q

which injury of the meniscus occurs more often in older people? which treatment is used?

A

medial meniscus tear. meniscectomy (meniscal removal)

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7
Q

are lesions always symptomatic?

A

can also be asymptomatic

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8
Q

how does ana ctue trauma most often occur( which movements of the knee happen)?

A

flexion + rotation

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9
Q

how do you treat chronic tears of the knee?

A

NSAIDs, PT

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10
Q

name 3 types of tears

A

longitudinal (bucket handle), radial (parrot beak), horizontal (flap tear)

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11
Q

BMI, age and gender wise who is more likely to get a meniscus injury?

A

high BMI, older, men

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12
Q

do track and field athletes have a high risk for meniscus injury?

A

no

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13
Q

which tool/measurement instrument to use to screen if Xray is needed

A

Ottawa ankle rules

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14
Q

explain ottawa knee rules

A

age >55, tenderness at head of fibula, at patella, inability to flex 90degr knee, inability to bear weight

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15
Q

signs and symptoms of a meniscal tear?

A

pain along joint line, delayed onset of swelling (12-24hr), locking of the knee, knee weakness

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16
Q

whats special about swelling after a meniscal tear?

A

delayed onset, 12-24hrs

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17
Q

describe the CPRS lowery

A

history of knee locking; joint line tenderness; + mcmurrays sign; + thessalys sign; pain with hyperext of knee; pain with max passive knee flexion

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18
Q

how many tests in CPR lowery should be positive to have at least 90% chance of meniscal tear?

A

3/5

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19
Q

does CPR lowery have high specificity or sensitivity

A

specificity - rule in meniscal tear

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20
Q

whats the thessalys test

A

patient a bit bent in the knees, pt rotates them sideways. pain provocation during rotations

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21
Q

if meniscal injury is medially located, what type of treatment do you do? why

A

meniscectomy /meniscal removal. less blood supply

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22
Q

is recovery time faster meniscectomy or meniscopexy

A

meniscectomy

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23
Q

recovery time of meniscectomy and meniscopexy?

A

Meniscectomy: 6-12wks; meniscopexy: 12-24 months

max 3mo vs 2 years

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24
Q

after which treatment is RTS more likely

A

meniscopexy, 96%

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25
Q

name the most important negative prognostic factor

A

posterior part of meniscus removed

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26
Q

after which meniscal op can you not do 90degree flexion for 4-6 wks?

A

meniscectomy

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27
Q

criteria to go from phase 1 to phase 2 after meniscetomy

A

normal gait; no swelling, full knee ROM

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28
Q

which test is most sensitive and specific to diagnose meniscal injury?

A

thessalys

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29
Q

how long are inflammation, prolif, early remodel and late remodelling phase?

A

infl: 0-3days; prolif 4-11; early remodel: 11-21; late remodel 3-6weeks

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30
Q

during proliferation phase of acute ankle sprain, whats the treatment and criteria?

A

put weight on foot. exercises like forward lean into a lunge, world arounds, stand on heels (toes off), stand on toes, heel raises

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31
Q

during early remodeling phase of acute ankle sprain, whats the treatment?

A

lunges on tippy toes, balance exercises: on bosu ball (heel to toe movement, rock back and forth), standing ABD

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32
Q

during late remodelling phase of acute ankle sprain, whats the treatment

A

jump from bosu ball to bosu ball, sport specific eg side lunge and serve volleyball ball, rope jumps

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33
Q

which test tests for tibia-fibula syndesmosis rupture?

A

syndesmosis squeeze test

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34
Q

whats the anterior drawer test testing for?

A

tibial anterior translation (>6mm) and pain, checks for ACL tears

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35
Q

which test tests for ACL rupture?

A

anterior drawer test

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36
Q

whats the talar tilt test?

A

moving foot from PTF, neutral and DFL into inversion and testing talar ligament integrity (lateral ankle sprain)

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37
Q

which test do you use to check anterior ankle impingement?

A

forced dorsiflexion test

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38
Q

name syndesmosis injury tests

A
  1. fibular translation test; 2. external rotation test
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39
Q

name ankle ligament injury tests

A

anterior drawer test, talar tilt test (inversion stresst test), squeeze test

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40
Q

whats is APAS

A

acute primary anterior shoulder dislocation

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41
Q

where does a dislocation in shoulder most often occur

A

anterior part

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42
Q

explain what happens during a shoulder trauma regarding anatomical structures

A

humerus slides away from the glenoid socket in some direction

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43
Q

which gender dislocates their shoulder more often?

A

males

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44
Q

the cause of shoulder dislocation

A

sports with high risk to traumas (men) and falls in elderly (women)

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45
Q

which aged population has a high recurrence rate of APAS/shoulder trauma?

A

people of <20 years of age

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46
Q

whats a huge risk factor for a recurrence of APAS

A

a previous trauma in the shoulder. and also returning to a high risk sport.

47
Q

what are the 2 mechanisms of APAS? explain each

A

direct (force goes through shoulder dislocating it) and indirect trauma (when shoulder is in certain position e.g. abd and horizontal ext rot, and force of the arm will dislocate it as a result)

48
Q

name symptoms/signs of APAS

A

acute pain, complete loss of function, movement painful, visible dislocation, patient will support the arm

49
Q

name the 4 different steps of examination for APAS

A

inspection of shoulder, palpation, basic examination (impossible-pain), special tests

50
Q

are you able to perform basic examination of the shoulder with APAS?

A

no, impossible due to pain

51
Q

name the 2 different structural lesions with APAS

A

Bankart (avulsion/detachment of anterior and inferior labrum) and Hill Sachs (compression fracture of posterior part humeral head)

52
Q

whats bankart lesions?

A

Bankart (avulsion/detachment of anterior and inferior labrum)

53
Q

whats Hill sachs lesions?

A

Hill Sachs (compression fracture of posterior part humeral head)

54
Q

which examination diagnoses bankart vs hill sachs?

A

MRI -bankart; CT for hill sachs

55
Q

which 2 types of ‘lesions’ can you have after APAS

A

structural/bony (hills and bankart) and soft tissue (muscles, rotator cuff tear)

56
Q

would you perform surgery for someone who has an asymptomatic RC tear (soft tissue lesions after APAS)?

A

if they can live with it they might not need surgery!!

57
Q

what structure predominantly stabilize the shoulder?

A

muscles (as there are not many ligaments in the shoulder)

58
Q

whats instability in the shoulder? inability to..

A

inability to center humeral head in the glenoid

59
Q

describe difference between instability and hyperlaxity

A

hyperlaxity (hypermobility= normal, they can control it, increased ROM but able to center humeral head); instability (pathology= not able to center humeral head within glenoid)

60
Q

name symptoms of instability

A

feeling of instability/apprehension; decreased strength; pain; shoulder fatigue

61
Q

4 different techniques to reposition the shoulder

A

hippocrates, kocher, stimson, milch

62
Q

after reposition of shoulder, shoulder’s in inflammation phase. what should you do with the shoulder? (reduces pain)

A

immobilize for a short time with the use of a sling

63
Q

is rehab needed for patients with APAS + normal course?

A

no

64
Q

who is more likely to receive a surgery after APAS: an athlete who will return to high risk sport or an elderly woman?

A

an elderly woman due to less risk for reoccurence

65
Q

what happens to the chances of APAS reoccurence with surgery?

A

decrease drastically

66
Q

what should APAS rehab focus on ? (which structure)

A

shoulder muscles (and their strength)

67
Q

name the 5 P’s aka categories/muscles of APAS rehab

A
  1. preparators 2. pivoters 3. protectors 4. positioners 4. propellers (mneunomic: prepare the pivoters to protect the position and propel)
68
Q

what are the preparators? (1)

A

muscles of lower extremities and trunk that prepare sports performance

69
Q

APAS REHAB: which muscles do you train first, which last?

A

first ones away from shoulder (lower extremities and trunk), then progressively get closer to the shoulder

70
Q

what are pivoters, name them (2 from 5P’s) - APAS REHAB

A

all muscles that move the scapula: trapezius, rhomboids, pectoralis minor, levator scapula, serratus anterior

71
Q

what are protectors (3 from 5P’s) - APAS REHAB

A

local muscles that centralize the humeral head:

  • subscapularis
  • infraspinatus
  • teres minor
  • biceps caput longum
  • (supraspinatus).
72
Q

if you train protectors, what parameter are you training?

A

stability

73
Q

what are positioners (4 from 5P’s) - APAS REHAB

A

muscles positioning the humerus in space

  • deltoids
  • supraspinatus
74
Q

what are propellors (5 from 5Ps) - APAS REHAB

A

muscles that propel force, big cross section -> movement. muscles of huge interest to athletes.

  • pectoralis major
  • latissimus dorsi
  • triceps brachii
75
Q

where does ultrasound fit in the ICF model?

A

body functions & structures (impairments)

76
Q

name some advantages of ultrasound

A

high resolution soft tissue imaging, can see image in real-time, enables rapid contralateral (healthy) limb examination for comparison.

77
Q

for what is cold therapy used and why

A

for achilles tendinitis, for neovascularisation (new blood vessels)

78
Q

of the 4 stages of analgesia induced y cryotherapy, what do you feel between 0-3minutes?

A

cold sensation

79
Q

of the 4 stages of analgesia induced y cryotherapy, what do you feel between 2-7minutes?

A

burning or aching

80
Q

of the 4 stages of analgesia induced y cryotherapy, what do you feel between 5-12minutes?

A

local numbness or analgesia

81
Q

of the 4 stages of analgesia induced y cryotherapy, what do you feel between 12-15minutes?

A

deep tissue vasodilation

82
Q

how cold should the icepack be and what should you use between the pack and skin?

A

-18degrees; a towel

83
Q

explain what makes up MCI in cervical case

A
  1. muscle properties (eg fiber composition type; muscle atrophy, fatty infiltration)
  2. control strategies (decreased activation of deep neck flexors; prolonged muscle activity)
  3. pain
84
Q

what are outcomes of MCI cervical

A

less strength, more fatigue, limited endurance, reorganization of muscle coordination

85
Q

first, there is changes in muscle fibers. then fatty infiltration and then atrophy of deep neck flexors. what happens to the fiber composition of these?

A

type 1 turn into type 2b fibers which are not meant for endurance. they are fast twitch, tire quickly, low aerobic metabolism, little mitochondria, lots of power, not efficient.

86
Q

whats the problem with deep neck flexors changing from type 1 to type 2b?

A

not meant for holding posture, tire quickly

87
Q

3 main subsystems of spine (MCI topic)

A

passive subsystem: spinal column
active subsystem: spinal muscles
control subsystem: neural

88
Q

what type of changes can occur with MCI cervical spine, regarding 3 subsystems?

A

spine: changes in cervical posture
spine muscles; atrophy, hypertension, reduced reaction time
neural system: proprioception changes

89
Q

name and function of local stabilisers of the cervical spine?

A

anterior: longus capitis, longus colli
posterior: m multifidus, m spinalis, m semispinalis, rectus capitis posterior, obliquues capitis

function: segmental stability

90
Q

describe what happens with dysfunction of local stabilisers in cervical spine

A

loss of neutral vertebral position
loss of segmental motor control
atrophy of local stabilisers, fatty infiltration, changes in muscle fiber type

91
Q

name global stabilizers of the neck

A

sternocleidomastoid, trapezius descendens, levator scapula, longissimus, scalenii, hyoids, splenius

92
Q

which type of muscles (global or local stabilisers) are the prime movers, function in ROM ?

A

global stabilisers

93
Q

result of dysfunction of global stabilisers?

A

poor eccentric control; disability of concentric contraction, poor isometric endurance and strength, increased muscle tension

94
Q

specific red flags for cervical spine

A

trouble swallowing, headaches, vomiting,

95
Q

signs and symptoms of neck pain

A

Intolerance to long term static postures

Tiredness, inability to keep head up

Better with external support

Continuous need for self manipulation

Sensation of instability, shaking or loss of head control (places arms under chin for support)

Pain worse at the end of the day

Episodes of acute neck pain complaints

Neck makes clicking sound

Heavy feeling of the head

96
Q

whats CCFT and what are norm outcomes/values?

A

cranio cervical flexion test
norm values: Men 39sec
W 29sec

97
Q

how do you treat neck pain grade 1 and 2 with normal course

A

Treatment profile A; inform and advise, advise on work related risk factors (sedentary work,

98
Q

whats recommended as most important therapy for neck treatment profile B and C

A

stability exercises

99
Q

whats spondylolisthesis

A

forward slipping of a vertebrae

100
Q

whats sponylolysis

A

stress fracture of an intervertebral disc

101
Q

spondylolisthesis and spondylolysis: which leads to which?

A

first spondylolysis, then spondylolisthesis

102
Q

how does panjabi describe MCI in lumbar spine

A

loss of spine’s ability to maintain its pattern of displacement under normal physiological loads

103
Q

with MCI lumbar spine, can you see that there is radiophacically something wrong with the spine? (abnormalities)

A

no

104
Q

describe. local muscles

A

type1 , red, aerobic, attached directly to lumbar verterbae

examples: multifidus, transverse abdominis

105
Q

describe global muscles

A

not directly attached to the lumbar spine
type 2 fibers, white
function: initiation of movementy
examples: quadratus lumbrom, erecto spinae

106
Q

gowers sign is a sign of what?

A

LSI

107
Q

explain why with prone instability test there is less pain when legs are raised up

A

back extensors counteract the instability

108
Q

name local muscles in lumbar spine

A

Transversus abdominis

Multifidus

Internal oblique

Psoas major

Lumbar ilicostalis lumborum

Diaphragm

109
Q

explain the draw-in maneuver: with the stabiliser

A

activation of tranvs. abd.
pump stabiliser to 70mmHg
ask patient to lie prone on it and lower it by 6-10mmHg and hold for 10 seconds.

110
Q

whats is form closure

A

stability created via shape of sacrum fitting within ilium

111
Q

whats force closure

A

SIJ gains further stability from input forces around sacrum through ligaments, tendons and muscles

112
Q

name clinical symptoms of groin injury

A

dysfunction, swelling, sensation impairments, muscle insufficency (abd and add ratio); hypermobility

113
Q

what increases the risk of low back injuries? (oftenn seen in soccer players with groin problems(

A

delayed onset of transverseu abdominis; delayed trunk muscle reflex response

KT 1.4 (8 decks)

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