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ATR2010 > Remaining Exam 2 Material [CH 16 + 17] > Flashcards

Remaining Exam 2 Material [CH 16 + 17] Flashcards

1
Q

what type of joint is the knee

A

hinge joint

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2
Q

how many bones make up the knee joint

A

4
-femur
-tibia
-fibula
-patella

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3
Q

articulations of the knee joint

A

3 total
-tibiofemoral: femur + tibia
-patellofemoral: femur + patella
-proximal tibiofibular: tibia + fibula

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4
Q

menisci

A

fibrocartilage disks that lie on top of the tibial plateau

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5
Q

shape of medial menisci

A

C-shaped

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6
Q

shape of lateral menisci

A

O-shaped

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7
Q

function of menisci

A

-increase stability of the knee joint
-cushion any stresses placed on the knee

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8
Q

describe blood supply in menisci

A

-outer ring has greater blood supply than inner
-affects healing
-inner menisci cannot heal on its own

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9
Q

inner/outer menisci can heal on its own

A

outer, because more blood supply

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10
Q

anterior cruciate ligament

A

-prevents tibia from moving forward relative to the femur
-stabilizes tibia against excessive internal rotation

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11
Q

posterior cruciate ligament

A

prevents the tibia from sliding backward relative to the femur

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12
Q

ACL prevents tibia from moving forward/backward

A

forward

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13
Q

PCL prevents tibia from moving forward/backward

A

backward

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14
Q

medial collateral ligament

A

-stabilize the knee against valgus forces
-force to lateral aspect

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15
Q

lateral collateral ligament

A

-stabilize the knee against varus forces
-force to medial aspect

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16
Q

purpose of MCL

A

shock absorber against hits from the outside

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17
Q

purpose of LCL

A

shock absorber against hits from the inside

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17
Q

movement of the quadriceps

A

knee extension

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18
Q

quadriceps muscles (4)

A

-rectus femoris
-vastus medialis
-vastus intermedius
-vastus lateralis

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19
Q

hamstrings movement

A

-knee flexion
-hip extension

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20
Q

hamstrings muscles (3)

A

-biceps femoris
-semitendinosus
-semimembranosus

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21
Q

be able to label muscles ch16 ppt

A
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22
Q

accessory knee flexor muscles (5)

A

-gracilis
-sartorius
-gastrocnemius
-popliteus
-plantaris

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23
Q

external tibial rotation muscles (1)

A

biceps femoris

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24
Q

internal tibial rotation muscles (5)

A

-popliteus
-semitendinosus
-semimembranosus
-sartorius
-gracilis

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25
Q

prevention of knee injuries- physical conditioning + rehabilitation

A

-total body conditioning (strength, flexibility, cardiovascular endurance, agility, balance)
-agonist/antagonist muscles must be properly balanced because increases joint stabilization

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26
Q

should agonist/antagonist pair muscles have the same strength

A

no
ex: quadriceps to hamstring strength ratio is 3:2

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27
Q

quadriceps: hamstring strength ratio

A

3:2

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28
Q

can an AT or PT do more rehab to PREVENT injuries

A

AT because PTs work under insurance rules
-insurance companies aren’t looking for prevention programs for rehab; PTs work on people that already need rehab
-ATs have more room to do prevention programs with athletes to prevent injury

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29
Q

prevention of knee injuries- shoe type

A

-grip the playing surface when sprinting forward
-don’t stick when cutting or changing direction

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30
Q

prevention of knee injuries- shoe + cleat design

A

-greater rotational stiffness may increase injury risk
-rotational stiffness greater on synthetic grass than with natural grass

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31
Q

prevention of knee injuries- knee braces

A

-effectiveness of protective knee braces is controversial
-can restrict anterior/posterior tibial translation when combined with an appropriate rehab program

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32
Q

assessing the knee joint- history

A

-what were you doing when the knee was hurt?
-what position was your body in?
-did the knee collapse?
-did you hear a noise or feel any sensation?
-where is the pain?
-have you hurt your knee before?

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33
Q

assessing the knee joint- chronic injury history

A

-when did you first notice the condition?
-does the knee ever catch or lock?
-does your knee feel like its going to give out?
-have you changed your running shoes?

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34
Q

assessing the knee joint- palpation

A

assess bony structures for areas of tenderness, pain, or deformities

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35
Q

assessing the knee joint- observation

A

-athlete should be observed in numerous situations (walking, half-squatting, going up/down stairs, etc.)
-do the knees appear symmetrical?
-is one knee swollen?
-is muscle atrophy apparent?
-redness, discoloration, bruising?

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36
Q

knee joint palpation- which ligaments should be palpated

A

-lateral collateral ligament (LCL)
-medial collateral ligament (MCL)

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37
Q

knee joint palpation- which ligaments CANNOT be palpated

A

-ACL
-PCL

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38
Q

tenderness at the knee joint line may indicate what injury

A

meniscal injury

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39
Q

special tests for knee joint

A

-assess ligament stability
-performed by a trained professional

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40
Q

what does Lachman’s + Anterior Drawer test

A

ACL

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41
Q

cause of MCL injury

A

-medially directed force valgus from the lateral side
-lateral rotation of the tibia

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42
Q

signs of MCL injury- grade 1

A

-few ligament fibers are torn
-joint stable
-minimal swelling
-mild stiffness + tenderness
-full ROM

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43
Q

signs of MCL injury- grade 2

A

-moderate tearing of fibers
-pain at medial aspect
-general weakness/instability

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44
Q

signs of MCL injury- grade 3

A

-complete tear
-complete loss of medial stability
-mild to moderate swelling
-severe pain
-loss of ROM

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45
Q

what athletes are more prone to MCL injury

A

football offensive lineman
-because of this, all football offensive lineman wear knee braces

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46
Q

care for MCL injury

A

-POLICE
-crutches may be used if athlete is unable to walk
-conservative non-operative treatment is recommended for isolated sprains at any grade (limited immobilization, rehab program, possible use of functional hinge brace)
-return to play when knee has regained full ROM + strength

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47
Q

cause of LCL injury

A

-laterally directed varus force from the medial side
-medial rotation of the tibia

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48
Q

is MCL or LCL sprain more prevalent

A

MCL

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49
Q

signs of LCL injury

A

-pain + tenderness over the ligament
-swelling + effusion
-joint laxity with varus stress

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50
Q

LCL injury pain is greatest with which grades

A

grades 1 + 2

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51
Q

describe pain of grade 3 LCL injury

A

-pain severe initially
-subsides to dull ache

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52
Q

care for LCL injury

A

same procedures as for MCL injuries

-POLICE
-crutches may be used if athlete is unable to walk
-conservative non-operative treatment is recommended for isolated sprains at any grade (limited immobilization, rehab program, possible use of functional hinge brace)
-return to play when knee has regained full ROM + strength

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53
Q

cause of ACL injury

A

-most ACL injuries are non-contact
-deceleration, rotation, valus stress

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54
Q

most ACL injuries are contact/non-contact

A

non-contact

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55
Q

common mechanism for ACL injury

A

dynamic valgus
-valgus force
-medial tibial rotation
-hip adduction

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56
Q

ACL injury risk factors

A

-previous injury
-general predisposition
-quad dominance

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57
Q

ACL injury risk factors- previous injury

A

-biggest predictor of a future injury is history of previous injury
-full neuromuscular control was likely not regained on injured side

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58
Q

ACL injury risk factors- general predisposition

A

-anatomical structure
-biomechanics
-hormonal imbalance

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59
Q

ACL injury risk factors- quad dominance

A

-increased strength in quads compared to hamstrings
-results in landing with increased knee extension

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60
Q

signs of ACL injury

A

-audible pop
-rapid swelling at the joint line
-intense pain initially
-loss of extension

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61
Q

care for ACL injury

A

-POLICE
-surgery to repair torn ACL (bone patellar bone or hamstring graft)
-recovery generally 6-9 months

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62
Q

ACL injury swelling begins within ____ hours; peaks within ____ hours

A

-1-2 hours
-4-6 hours

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63
Q

how long is ACL injury recovery

A

recovery says it is generally 6-9 months
-it is more like 12-18 months in reality

-most people take 6 months to even get back to starting activity

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64
Q

how do you choose which ACL surgery to get

A

-choose whichever method the surgeon is better at
-both bone patellar bone + hamstring graft are equally successful

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65
Q

if you did hamstring graft…

A

you’d be weaker in the back

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66
Q

if you do bone patellar bone…

A

you will be wear in the front
-this might be better because we don’t want to make hamstrings weaker

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67
Q

cause of PCL injury

A

-falling with full weight on the anterior aspect of the bent knee (knee hyperflexed, ankle plantarflexed)
-dashboard injury car crash

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68
Q

what injury is caused by car accident

A

PCL injury

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69
Q

signs of PCL injury

A

-pop in back of knee
-tenderness in popliteal fossa
-little swelling
-laxity on posterior drawer test

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70
Q

care for PCL injury

A

-POLICE immediately
-generally non-operative treatment with rehab

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71
Q

tearing outer/inner meniscus has better chance at repairing itself

A

-outer
-tearing inner won’t repair because no blood supply

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72
Q

cause of meniscus injuries

A

-weight bearing combined with a rotational force
-tears within cartilage fail to heal due to lack of blood supply

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73
Q

medial/lateral meniscus has higher incidence of injury

A

medial

74
Q

signs of meniscus injury

A

-effusion gradually over 48-72 hours
-joint like pain; loss of motion
-intermittent locking + clicking
-feels like the knee is “giving way”

75
Q

care for meniscus injuries

A

-POLICE
-MRI to confirm diagnosis
-non-operative treatment (rehab similar to MCL sprain)
-surgical intervention

76
Q

rehab for meniscus injuries is similar to what other rehab

A

MCL sprain

77
Q

surgical interventions for meniscus injuries

A

type of surgery depends on type + location of tear
-meniscectomy
-partial meniscectomy
-microfracture
-repair

78
Q

meniscectomy

A

removal of meniscus

79
Q

cause of knee plica

A

-thickened fold of synovial membrane lining the inside of the joint capsule
-medial plica most subject to injury
-blunt force or fall on the knee with a twisting mechanism

80
Q

signs of knee plica

A

-painful feeling that the knee is locked when the patient has been sitting for a period of time
-snapping with knee flexion
-pain with stairs or squatting

81
Q

care for knee plica

A

-rest
-NSAIDs

82
Q

cause of bursitis (knee)

A

-continued falling directly on the knee or overuse
-prepatellar + deep infrapatellar bursae have the highest incidence of irritation in sports

83
Q

signs of bursitis (knee)

A

-localized swelling above the knee that is similar to a balloon
-redness + increased temperature

84
Q

care for bursitis (knee)

A

-reduce swelling
-rest
-compression wrap
-NSAIDs

85
Q

cause of loose bodies within the knee

A

-repeated trauma to the knee during sports activities

-can result from:
-OCD lesion (osteochondritis dissecans)
-fragments from menisci
-torn synovium
-torn cruciate ligament

86
Q

signs of loose bodies within the knee

A

-locking + popping
-pain, instability, + feeling the knee is going to give out

87
Q

care for loose bodies within the knee

A

surgical removal

88
Q

cause of IT band syndrome

A

-overuse condition commonly occurring in runners + cyclists
-repeated knee flexion + extension

89
Q

signs of IT band syndrome

A

-tenderness over lateral femoral condyle
-pain increases during running or cycling activities

-people tend to feel this in their knee
-therefore, people often foam roll knee which won’t help, must foam roll the actual IT band

90
Q

care for IT band syndrome

A

-stretching + reducing inflammation
-correction of foot + leg alignment

91
Q

cause of patella fx

A

-direct fall

-most result from indirect trauma:
-severe pull of the patellar tendon against the femur when knee is semi-flexed
-forcible muscle contraction may fracture the patella at its lower half

92
Q

most patella fx result from direct/indirect trauma

A

indirect

93
Q

signs of patella fx

A

-swelling
-pain + tender to palpation over patella

94
Q

cause of patella fx

A

-x-ray confirmation
-cold wrap, compression, splinting

95
Q

cause of patella subluxation/dislocation

A

-athlete plants the foot, decelerates + simultaneously cuts in an opposite direction from the weight bearing foot
-medially directed valgus force at the knee

96
Q

signs of patella subluxation/dislocation

A

-dislocate laterally
-complete loss of knee function while patella rests in abnormal position
-pain + swelling

97
Q

care for patella subluxation/dislocation

A

-knee should be immobilized
-physician should reduce patella
-x-ray to rule out fx

98
Q

cause of jumper’s knee (patellar tendinosis)

A

-repetitive running/jumping
-places extreme tension on the knee extensor muscle complex
-on rare occasions, the patellar tendon may completely fail + rupture

99
Q

can an athlete get patellar tendinosis/jumper’s knee instantly from doing something

A

NO
-takes time to develop

100
Q

signs of jumper’s knee (patellar tendinosis)

A

-vague pain + tenderness
-worsens with activity

101
Q

care for jumper’s knee (patellar tendinosis)

A

-rest, NSAIDs, ice
-brace or strap
-transverse friction massage

102
Q

transverse friction massage

A

reminds muscle to heal

103
Q

cause of Osgood-Schlatter disease

A

-common in rapidly growing immature adolescent’s knee
-repeated pull of patellar tendon at the tibial tubercle on the front of the tibia
-bony callus forms + the tubercle enlarges

104
Q

signs of Osgood-Schlatter disease

A

-swelling
-gradual degeneration
-severe pain with kneeling, jumping, + running

105
Q

care for Osgood-Schlatter disease

A

-conservative treatment
-decrease activity intensity
-protect tubercle
-isometric strengthening of quads + hamstrings

106
Q

be able to label pelvis bones see ch17 ppt

A
107
Q

thigh bone

A

femur

108
Q

pelvis bones (3)

A

-ilium
-ischium
-pubis

109
Q

hip joint name

A

femoroacetabular joint

110
Q

femoroacetabular joint (hip)

A

-articulation of femur + acetabulum
-stabilized by strong iliofemoral ligament + joint capsule

111
Q

hip flexors muscles (3)

A

-rectus femoris
-iliopsoas
-sartorius

112
Q

hip adductors muscles (5)

A

-gracilis
-pectineus
-adductor magnus, longus, + brevis

113
Q

hip extensor muscles (2)

A

-hamstrings
-glute max

114
Q

hip abductor muscles (2)

A

-glute med
-tensor fasciae latae (TFL)

115
Q

assessment of hip/groin/pelvis injuries- history

A

-do you remember a specific incident that caused your pain?
-have you ever had a probelm with the area before?
-describe the type of pain (sharp, dull, burning, aching)
-does the pain radiate down the back or front of your legs?

116
Q

assessment of hip/groin/pelvis injuries- observation

A

-postural asymmetry
-do the hips look even?
-is there any tilting of the pelvis?
-walking, bending, + sitting

117
Q

assessment of hip/groin/pelvis injuries- palpation

A

-bony palpation should include:
-iliac crest
-femur
-sacrum + coccyx

-soft tissue palpation on anterior + posterior thigh
-assessing for point tenderness or discomfort

118
Q

Thomas test is for

A

tight hip flexors

119
Q

strong muscles of thigh/hip/groin/pelvis are less/more resistant to injury

A

more resistant to injury

119
Q

prevention of thigh/hip/groin/pelvis injuries

A

-maintain strength + flexibility of muscles that act on the hip
-dynamic stretching
-strengthening exercises could include: squats, lunges, leg presses, core

120
Q

core includes what muscles

A

all the muscles that go around
-diagragm
-pelvic floor muscles

121
Q

cause of quadricep contusion

A

-traumatic blow
-compresses quad against the hard surface of the femur

122
Q

signs of quadricep contusion

A

-intense pain + weakness
-painful to touch
-athlete may limp
-loss of ROM

123
Q

care for quadricep contusion

A

-POLICE
-compression by elastic bandage with knee flexed to 120 degrees to minimize loss in ROM

124
Q

what is one of the most limiting contusions in athletics

A

quadricep contusion

125
Q

what sport is most susceptible to myositis ossificans

A

MMA
-because constant hits in th same place

126
Q

cause of myositis ossificans

A

-severe or repeated blows to the thigh
-bone formation in the quadriceps muscle
-contusion causes disruption of muscle fibers
-irritated tissue may produce tissue formations resembling cartilage

127
Q

signs of myositis ossificans

A

-pain + swelling
-history of quad contusions
-motion restriction

128
Q

care for myositis ossificans

A

-conservative treatment at first
-if loss of motion continues, bone formation may be removed after 1 year

129
Q

cause of quadriceps strain

A

sudden stretch or sudden contraction

130
Q

signs of quadriceps strain

A

-pain + discomfort
-tender to palpate
-spasm +/or loss of function

131
Q

care for quadriceps strain

A

-rest + POLICE
-neoprene sleeve for protection

132
Q

cause of hamstring muscle strain

A

-highest incidence of being strained
-quick change from knee stabilization to extension of the hip when running

133
Q

what muscle has highest incidence of being strained

A

hamstring

134
Q

signs of hamstring muscle strain

A

-can involve muscle belly or tendon attachments

135
Q

grade 1 hamstring strain

A

-muscle soreness
-point tenderness

136
Q

grade 2 hamstring strain

A

-severe pain
-loss of knee flexion

137
Q

grade 3 hamstring strain

A

-rupture
-major hemorrhage + disability

138
Q

care for hamstring muscle strain

A

-POLICE
-eccentric training exercises
-at risk for reinjury

139
Q

cause of acute femoral fx

A

-MVA or fall from a great height
-in sport, fx often occurs at the shaft

140
Q

signs of acute femoral fx

A

-deformity
-shortened thigh
-loss of thigh function
-pain, point tenderness, swelling

141
Q

care for acute femoral fx

A

-medical emergency–call 911 if femoral
-potential femoral artery damage
-risk of shock

142
Q

cause of hip sprain

A

violent twist

143
Q

signs of hip sprain

A

-athlete unable to circumduct the thigh
-hip rotation increases pain

144
Q

care for hip sprain

A

-x-ray to rule out fx
-POLICE + NSAIDs PRN
-may restrict weight bearing
-delay ROM + PRE until pain free

145
Q

cause of dislocated hip joint

A

-rarely occurs in sports, often MVA
-traumatic force from the long axis of the femur or by an athlete falling on their side

146
Q

signs of dislocated hip joint

A

-typical position- slightly flexed, adducted, internally rotated
-palpation may reveal femoral head posterior to acetabulum

147
Q

care for dislocated hip joint

A

-immediate medical attention
-immobilization + crutches

148
Q

cause of hip labral tear

A

repetitive movements such as running or pivoting of the hip causing degeneration + breakdown of the labrum

149
Q

signs of hip labral tear

A

-asymptomatic
-catching, locking, or clicking
-pain in hip/groin
-feeling of stiffness or limited ROM

150
Q

care for hip labral tear

A

-maxmimize hip ROM + hip strengthening + stability exercises
-if pain persists more than 4 weeks, surgery may be indicated

151
Q

cause of piriformis syndrome

A

sciatic nerve compressed or irritated by a tight piriformis

152
Q

signs of piriformis syndrome

A

-pain
-numbness
-tingling
-may worsen aftering sitting for a long time

153
Q

care for piriformis syndrome

A

-stretching + massage
-NSAIDs

154
Q

cause of groin strain

A

-overextension of the groin musculature
-running, jumping, or twisting with external rotation

155
Q

signs of groin strain

A

-pain
-weakness
-internal bleeding can occur

156
Q

care for groin strain

A

-POLICE first 48-72 hours
-protective spica bandage

157
Q

cause of Legg-Calve-Perthes disease (coxa plana)

A

-loss of blood to the articular surface at the head of the femur
-children ages 3-12
-affects more boys

158
Q

Legg-Calve-Perthes disease (coxa plana) age group

A

children ages 3-12

159
Q

Legg-Calve-Perthes disease (coxa plana) affects girls or boys more

A

boys

160
Q

signs of Legg-Calve-Perthes disease (coxa plana)

A

-pain in groin that is sometimes referred to the abdomen or knee
-limping
-limited hip movement + pain

161
Q

care for Legg-Calve-Perthes disease (coxa plana)

A

-bed rest
-brace to avoid direct weight bearing
-if not treated properly, can produce osteoarthritis later in life

162
Q

cause of slipped capital femoral epiphysis

A

-disorder of the epiphysis of the femur that slips from the femoral head
-occurs during periods of rapid growth in adolescent boys
-occurs more in boys than girls
-ages 10-17

163
Q

age group of slipped capital femoral epiphysis

A

10-17

164
Q

slipped capital femoral epiphysis affects boys or girls more

A

boys

165
Q

care for MINOR displacement slipped capital femoral epiphysis

A

-minor displacement: rest + non-weight bearing

166
Q

signs of slipped capital femoral epiphysis

A

-pain in groin
-hip movement limitations
-limp

167
Q

care for MAJOR displacement slipped capital femoral epiphysis

A

surgery

168
Q

cause of iliac crest contusion (hip pointer)

A

direct blow that results in extremely painful contusion to the iliac crest

169
Q

signs of iliac crest contusion (hip pointer)

A

-immediate pain
-muscle guarding
-unable to rotate the trunk or flex the thigh without pain

170
Q

care for iliac crest contusion (hip pointer)

A

-cold + compression
-x-ray to rule out fx
-utilize protective pad when returning to play

171
Q

cause of osteitis pubis

A

repetitive stress on the pubic symphysis

172
Q

signs of osteitis pubis

A

-pain in groin region
-tenderness on pubic tubercle
-pain with running

173
Q

care for osteitis pubis

A

-rest + anti-inflammatory medications
-gradual return to activity

174
Q

cause of acute fx of the pelvis

A

direct trauma

175
Q

signs of acute fx of the pelvis

A

-severe pain
-loss of function
-shock

176
Q

care for acute fx of the pelvis

A

-immediately treated + referral to physician
-manage shock

177
Q

signs of avulsion fractures

A

-ASIS pain- sartorius
-AIIS pain- rectus femoris
-ischial tuberosity- hamstrings
-swelling + point tenderness

178
Q

cause of avulsion fractures

A

forceful contraction of the muscle causing bone to pull apart attached to the tendon

179
Q

ASIS pain indicates which muscle

A

sartorius

180
Q

AIIS pain indicates which muscle

A

rectus femoris

181
Q

ischial tuberosity pain indicates which muscle

A

hamstrings

182
Q

care for avulsion fractures

A

-rest + limited activity
-gradual return to activity

ATR2010 (11 decks)

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