Questions Flashcards
List the 3 types of discoid meniscus
- I-block shaped and covers > 80% of the lateral plateau; stable
- II-covers less than 80% of tibial plateau
- III-unstable and is usually an enlarge posterior horn of the lateral meniscus that is unstable and snaps into the intercondylar notch
what is the most involved level for burners/stinger injuries?
C5/6
what phase of the throwing cycle does internal impingement occur? what is impinging?
- late cocking
- posterior labrum and humerus
what is the main difference when comparing medial opening and lateral closing wedge HTO’s?
opening wedge would take slope away and be a better option in a patient with previous ACL/PLC injury
what ligament of the shoulder is the primary restraint to inferior translation?
coracohumeral ligament
what is the most effective test to screen for hypertrophic cardiomyopathy in a young athlete that has family history of sudden death?
echocardiogram
The origin of the LCL is ___ and ___ to popliteus
- posterior and proximal
name to rehabilitation restrictions s/p SLAP repair?
- passive ER with the arm at 90 deg abduction
2. active/resisted biceps exercises
what is the most common direction for a proximal tib-fib dislocation? what is the initial treatment? what are the symptoms?
- anterolateral
- closed reduction with posterior force on the fibular head and flexion of the knee to relaxis the LCL
- intermittent pain and occasional numbness from the affects to the CPN
When is the axillary nerve injured during a laterjet procedure and what is the treatmetn?
- glenoid exposure or graft insertion
- it is usually traction and treatment with observation
what is the transfer for lateral winging involving SAN? what is the transfer for medial winging involving the LTN?
- levator scapulae and rhomboid major/minor laterally
- pectoralis to the inferior border of the scapula
what is the main difference in the affect on the kinematics of the knee with medial closing wedge vs lateral opening wedge osteotomies? what type of deficient knee would this be helpful? what type of knee would this not be helpful?
- opening wedge adds on average 3 degrees of slope
- PCL as the increased slope helps with rollback
- ACL as this increased slope would increase the anterior shear
Chronic exertional compartment syndrome (CECS): what are the levels for resting, 1 min, and 5 min post exercise?
- > 15 mm Hg, > 30 mm Hg, > 20 mm Hg
what is the risk of doing a SLAP repair in a patient > 40 years of age?
stiffness
how is MRSA spread on sporting teams most commonly?
skin lesions such as turf burns
what is the best predictor of outcomes after arthroscopic partial menisectomy?
outerbridge cartilage score; so basically the presence and extent of degenerative changes
what is the common presentation of partial biceps rupture?
- increased signal on MRI at the insertion site; normal hook test; pain with resisted supination
what is the classic location of a juvenile OCD of the knee?
-posterolateral aspect of the medial femoral condyle
what are the 3 ossification centers of the acromion? between what 2 do you most commonly see failure to fuse and possible stress fractures?
- pre, meso, meta
- meso and meta
where do osteophytes develop in the elbow of overhead athletes and throws? what is the risk with resection?
- posterior and medial
- valgus instability
what is the first ligament affected with high ankle sprain injuries such as ER moment on an extremity of a slalom skier?
AITFL
what condyle does spontaneous osteonecrosis affect? what age?
- weightbearing portion of the MFC
- women > 60
where does most of your elbow flexion strength come from? how much supination strength is lost with distal biceps rupture? how about flexion?
- brachialis
- 40%
- 10%
is the sternocostal or the clavicular head more commonly ruptured with pectoralis major tears?
sternocostal
in comparison to young shoulder dislocations, older aged patients with shoulder dislocations are more or less likely to dislocate again?
less likely
what is the preferred technique for UCL recon? are outcomes better or worse with ulnar nerve transposition?
- docking with splitting flexor pronator mass
- worse
what must be obtained prior to excising a tib-fib synostosis?
bone scan with no uptake to prove that it is done ossifying so that it doesn’t recur
which type of HTO, closing lateral vs open medial, would you discuss proximal tib-fib disruption as a complication?
- closing
can you do a revision labral repair after thermal capsulorrhapy has been done?
no; literature supports revision in most other cases except this and glenoid bone loss > 20%
how does the hamstring harvest incision and tendon stripper cause a neurologic change?
- saphenous nerve; they would have AM knee pain and decreased AL sensation as the infrapatellar branch off of the saphenous nerve is injured
what is the purpose of getting a cardiovascular evaluation for Marfan’s patients?
aortic dilation/dissection that can cause sudden cardiac death
what is the sulcus sign of the shoulder?
- represents inferior subluxation of the humeral head and typical presents with instability cases
what is the most common complication of both medial opening and lateral closing wedge high tibial osteotomies?
patella baja
what is a buford complex? what happens if you repair it? what is the footprint of the SS tendon?
- absent anterior inferior labrum with cordlike MGHL
- if you repair it you will get stiffness at 45 deg abduction for ER
- 12-14 mm medial to lateral
go over ALPSA and GLAD lesions of the shoulder
- anterior labral periosteal sleeve avulsions; consider open procedures and remplissage for humeral defects
- glenoid labral articular defect-often times incorporate the labrum into it +/- microfracture
small and medium RCT single and double row repair ___ but with larger ___ is preferred
- have similar outcomes
- double row
what is the most common cause of late failure of meniscal allograft transplantation?
- graft tear
what is the standard of care for HSV outbreak on the skin for NCAA athletic events?
- no new lesions for 72 hours; scabbed over; no systematic lesions
what is the gene with CA MRSA? when can you return to play?
- PVL SCC
- 72 hours after treatment and 48 hours after no new lesions
what is the Slocum knee test?
knee at 90 degrees doing an anterior drawer test; you ER the leg and if the anterior translation is the same this is indicative of a PM corner injury; also can IR this and test for ALL injury
what type of gait is associated with ACL tear?
- quad avoidance gait
what are the numbers for exertional compartment syndrome at rest, 1 min and 5 min? which compartment is most common?
- 15, 20, 30
- anterior
for the D zone test in athletes, what does this help you with in treatment of MRSA?
- if positive, then it won’t be sensitive to clindamycin and you should switch to doxycycline
what is the cutoff for graft size for which there is significantly higher rerupture rate if it is under this?
- 8 mm
what is the cutoff for graft size for which there is significantly higher rerupture rate if it is under this?
- 8 mm
what type of MCL tear of the knee heals most reliably: proximal, midsubstance, or distal?
- proximal
what is the most common structure that blocks reduction of a tibial eminence fracture?
- anterior horn of the medial meniscus
2. intermeniscal ligament
