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Specialty Medicine > Soft Tissue Injuries > Flashcards

Soft Tissue Injuries Flashcards

1
Q

What is a strain?

A

Muscle injury resulting in partial or full thickness tear

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2
Q

What is a sprain?

A

Ligamentous injury resulting in a partial or full thickness tear

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3
Q

What is the most common part of the body that is sprained?

A

Ankle

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4
Q

True or false: strains can occur anywhere along the muscle, including tendon insertions

A

True

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5
Q

What is tendinitis? How long does it last for? Treatment?

A

Acute inflammation of tendon, usually from overuse

  • usually resolves in 2-3 days
  • RICE and PT
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6
Q

What is tendinopathy?

A

Chronic inflammation of a tendon that can last for several months

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7
Q

What is the treatment for tendinopathy?

A

NSAIDs do not work–PT, PRP

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8
Q

True or false: shoulder injuries are common

A

True

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9
Q

What indicates that laxity is an issue?

A

If there is pain associated with it

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10
Q

what are the three major extrinsic factors in shoulder joint pain?

A

Intensity
Duration
Frequency

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11
Q

what is the major intrinsic factor in shoulder pain?

A

Skeletal immaturity

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12
Q

Where do the long and short heads of the bicep tendon attach to?

A

Long head = supraglenoid tubercle

Short head = Coracoid process

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13
Q

Which head of the biceps is usually affected?

A

Long head

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14
Q

What causes the pain with biceps tendonitis?

A

tendon becomes inflamed in the bicipital groove

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15
Q

What is Yergason’s test?

A

Supinate arm against resistance to check for bicipital tendonitis

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16
Q

What is Speed’s test?

A

tests for bicipital tendonitis or superior labral tears

-hold hand fully out and supinated. Pain in the bicipital groove

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17
Q

How reliable is pain in locating the pathology of shoulder pain?

A

Poor

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18
Q

What are the two muscles that are likely injured with lateral shoulder pain?

A

Supraspinatus

Infraspinatus

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19
Q

What is the muscle that is likely injured with anterior shoulder pain?

A

Subscapularis

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20
Q

What are the history bits that are common to shoulder muscle tears?

A

Pain when rolling onto that side at night

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21
Q

What is the full can test, and what does it assess for?

A

Supraspinatus

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22
Q

What is the correct way to test the supraspinatus with empty can test?

A

arms in 45 degree abduction

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23
Q

What is the bear hug test, and what does it assess for?

A
  • Examiner tries to pull the patient’s hand from the shoulder contralateral shoulder
  • Positive test = weakness of the subscapularis
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24
Q

What is the external rotation test, and what does it assess for?

A

elbow at side and flexed to 90. Resisted external rotation weakness = Infraspinatus / teres minor

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25
Q

What is Patte’s test, and what does it assess for?

A

hornblower’s sign

-external rotation against resistance weakness/pain = infraspinatus / teres minor issue

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26
Q

What are the two tests for subacromial bursitis?

A

Neer’s test

Hawkin’s test

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27
Q

What is the treatment for subacromial bursitis?

A

PT
NSAIDs
Ice

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28
Q

What are the primary and secondary causes of subacromial bursitis?

A
  • Primary - overuse

- Secondary - shoulder instability in young athletes

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29
Q

What is the usual cause of olecranon bursitis?

A

Trauma to the olecranon

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30
Q

What are the s/sx of olecranon bursitis?

A

boggy, non-tender mass over the olecranon

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31
Q

What is the treatment for olecranon bursitis?

A
  • RICE
  • Steroid injection
  • Surgery
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32
Q

What is the cause of lateral epicondylitis?

A

Insidious onset from repetitive supination

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33
Q

What are the s/sx of lateral epicondylitis?

A

Pain and decreased grip strength with resisted supination

-TTP (tenderness to palpation) near lateral epicondylitis

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34
Q

What is the treatment for lateral epicondylitis?

A
  • RICE
  • PT
  • Steroid injections
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35
Q

What is the test for lateral epicondylitis?

A
  • Resistance against supination pain

- Extension against resistance

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36
Q

What is the OMM nonsense for lateral epicondylitis?

A

Anterior/posterior radial head SDs

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37
Q

What are the s/sx of medial epicondylitis?

A
  • TTP over flexor masses

- Pain with resisted pronation

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38
Q

What is mallet finger?

A

Object striking the finger, creating a forceful flexion of extended DIP, and tearing the extensor digitorum tendon

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39
Q

What are the exam findings of mallet finger?

A
  • TTP over the dorsal aspect of the DIP

- No active extension at the DIP

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40
Q

What is the treatment for mallet finger?

A

Splint the DIP continuously for 6 weeks

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41
Q

When is referral for mallet finger indicated?

A
  • If avulsion of more than 30%

- If passive extension is not achieved.

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42
Q

what are the three views that should be obtained with any orthopedic complain?

A

AP
Lateral
Oblique

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43
Q

What is jersey finger?

A

Forced extension of the DIP during active flexion tears the flexor digitorum profundus

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44
Q

What are the exam findings of Jersey finger?

A
  • TTP

- Inability to flex the DIP joint

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45
Q

What is the treatment for Jersey finger?

A

Splint and refer to ortho

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46
Q

What is the central slip extensor tendon injury?

A

PIP joint is forcibly flexed while actively extended, causing central slip rupture and a resulting boutonniere’s deformity

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47
Q

What are the exam findings with central slip extensor tendon injuries?

A
  • TTP at dorsal PIP

- Inability to actively extend

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48
Q

What is the treatment for central slip extensor tendon injuries?

A

Splint PIP joint in full extension for 6 weeks

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49
Q

What are the two indications for referral to ortho with slip tendon injuries?

A
  • Avulsion of more than 30% of joint

- Full passive extension is not achieved

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50
Q

What is a “jammed” finger?

A

Forced ulnar or radial deviation of a finger causing partial or complete collateral ligament tears

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51
Q

What joint is usually affected with jammed fingers?

52
Q

What are the exam findings of Jammed fingers?

A

TTP at the collateral ligaments

53
Q

What is the treatment for jammed fingers?

A

Stabilize joint and buddy tape weeks

54
Q

When is referral indicated for jammed fingers?

A

Unstable joint or child with injury

55
Q

What is the best way to assess for a jammed finger (rupture collateral ligament)? Why?

A

Flexion of 30 degrees to remove the stabilization effect of the MCP joint

56
Q

What is the correct way to buddy tape fingers?

A

do not leave 5th finger exposed

57
Q

What is a volar plate injury?

A

Forced hyperextension of the (usually at the PIP joint) causes a rupture of the volar plate

58
Q

What are the exam findings of volar plate injuries?

A

TTP at the volar aspect of the involved joint

59
Q

What are the two tests that should be done with volar plate injuries?

A
  • Full flexion and extension

- Collateral ligament stability

60
Q

What is the treatment for volar plate injuries?

A

Splint 30 degrees of flexion and progressively increase extension for 2-4 weeks

61
Q

When is referral indicated for volar plate injury?

A

Avulsion or unstable joint

62
Q

What is skier’s thumb?

A

Disruption of the ulnar collateral ligament by forced abduction of the MCP joint (partial/complete tears, with/without avulsion)

63
Q

What are the exam findings of skier’s thumb? How do you isolate the ulnar collateral ligament?

A
  • TTP over the UCL at MCP joint

- Stress to full flexion to isolate ligament

64
Q

What is the treatment for Skier’s thumb?

A

Splinting for 6 weeks

65
Q

When should Skier’s thumb be referred to ortho? (3)

A
  • Fracture or avulsion fracture
  • More than 35 degree of joint opening
  • No clear end point
66
Q

What is a Stener’s lesion?

A

Complication from Skier’s thumb, where the proximal end of the UCL becomes trapped outside of the adduct aponeurosis
-Presents with joint instability and tender mass

67
Q

What is the treatment for a Stener’s lesion?

68
Q

Who usually gets trochanteric bursitis?

A
  • Runners
  • Over pronators
  • ballerinas and figure skaters
69
Q

What are the s/sx of trochanteric bursitis?

A

Pain over the lateral hip, with TTP over the greater trochanter

70
Q

What is the treatment for trochanteric bursitis?

A
  • RICE
  • NSAIDs
  • Gentle hip stretching
  • Steroid injections
71
Q

What in particular should be stretched with trochanteric bursitis?

72
Q

What are the attachments of the IT band?

A

Gerdy’s tubercle and lateral femoral condyle

73
Q

What is snapping hip?

A

acute trochanteric bursitis associated with pain over or just posterior to the trochanter that presents as a snap that appears every time they snap their hip

74
Q

Who usually gets a snapping hip?

A

Athletes who repetitively flex and extend their hip

75
Q

What is the treatment for a snapping hip?

A
  • Topical anti-inflammatory
  • IT band rehab
  • Injection of trochanteric bursae
76
Q

what is an internal snapping hip?

A
  • Iliopsoas tendon rubbing over the iliopectineal ligament eminence of the pelvic brim
  • Presents as a deep anterior snapping sensation with hip flexion
77
Q

What is the treatment for an internal snapping hip?

A
  • Stretching
  • PT
  • bursa injections
78
Q

What is iliotibial band friction syndrome?

A

Inflammation of the IT band due to overuse, that classically presents with TTP along the lateral femoral condyle

79
Q

What is the treatment for iliotibial band friction syndrome?

A
  • Stretching
  • Massage
  • Foam rollers
80
Q

What is the thomas test for iliotibial band friction syndrome?

A

Flex hip and see if contralateral leg externally rotates–indicates a tight iliopsoas

81
Q

What is the largest and most complicated joint in the body? What type of joint is it?

A

Knee

Ginglymus

82
Q

What does the stability of the knee depend on?

A
  • Strength and support of muscle and tendons

- Ligaments connecting the femur and the tibia

83
Q

what is the motion of the knee?

A

Screw–external/lateral rotation of the tibia on the femur

84
Q

What is the purpose of the screw motion of the knee?

A

Medial femoral condyle is longer than the lateral femoral condyle

85
Q

Which is stronger: the ACL or the PCL?

86
Q

What is the role of the patellar ligament, relative to the quads?

A

Holds the quad forward

87
Q

Which knee meniscus is C shaped? Which is O shaped?

A 
C = Medial
O = lateral
88
Q

Which meniscus of the knee is attached to its overlying collateral ligament?

A

Medial to the MCL

89
Q

Why is the lateral meniscus of the knee less frequently injured than the medial?

A

Fibular head protection

Not attached to the LCL

90
Q

What usually causes ACL injuries?

A

Valgus stress with acute hyperextension

91
Q

What are the components of the unhappy triad?

A

Injury to the MCL, ACL, and the medial meniscus

92
Q

What is the treatment for the unhappy triad?

93
Q

How is the PCL commonly injured?

A

Acute hyperflexion–“dashboard knee”

94
Q

What are grades I - III of PCL tears?

A

I = mild laxity
II = moderate laxity
III complete tear

95
Q

What is the treatment for PCL tears?

96
Q

What is the treatment for meniscal tears?

A

Depends on severity of the symptoms–pain control and rehab vs surgery

97
Q

What is patellofemoral syndrome?

A

Patellar tracking syndrome of chondromalacia–abnormal tracking through the trochlear groove d/t degeneration in the articular cartilage

98
Q

what is the treatment for patellofemoral syndrome?

A

PT
OT
Patellar taping or band

99
Q

What is Hoffa’s syndrome?

A

fat pad in the deep infrapatellar space leads to anterior knee pain that is worse with taping

100
Q

What is osteochondritis dissecans?

A

Fragmentation of the articular cartilage that may eventually progress to necrosis

101
Q

What is the treatment for osteochondritis dissecans?

A

If immature skeleton = avoid running and jumping for 8 months

Mature = skeleton

102
Q

What is osgood-Schlatter’s syndrome (“apophysitis”)?

A
  • Overuse injury with avulsion of the patellar tendon leading to pain
  • Usually seen in adolescents
103
Q

What is the treatment for osgood-schlatter’s syndrome?

A

RICE
Isometric stretches
PRP

104
Q

What is patellar tendonitis? Treatment?

A
  • “Jumper knee”
  • Overuse injury that is a risk for OS
  • RICE
105
Q

What is a baker’s cyst?

A

Posterior popliteal cyst that is a complication of chronic inflammation of the knee

106
Q

What is the treatment for a Baker’s cyst?

A

RICE
NSAIDs
Aspiration if necessary

107
Q

What is housemaid’s knee?

A

Prepatellar bursitis from kneeling for long periods

108
Q

What is Clergyman’s knee?

A

Superficial infrapatellar bursitis that is commonly seen in roofers

109
Q

What is deep infrapatellar bursitis?

A

Inflammation between the patellar ligament and the tibia

110
Q

What is the risk of injection and/or aspiration of bursa?

A

All connected so increased risk of infection spreading

111
Q

What ways does the fibular head move?

A

Anterolateral and posteromedial

112
Q

What is the treatment for fibular head abnormalities?

A

Anti-inflammatories

113
Q

What nerve may be associated with fibular head abnormalities?

A

Peroneal nerve

114
Q

What is tibial torsion? How is it treated?

A

External or internal torsion of the tibia that usually occurs in children. Usually treated with ME

115
Q

What is the ligament that is on the medial side of the ankle?

A

Deltoid ligament

116
Q

What are the ligaments that are on the lateral side of the ankle, from anterior to posterior (3)?

A
  • Anterior tibiotalar
  • Calcaneofibular ligament
  • Posterior talofibular ligament
117
Q

Should you evaluate the gait with an ankle injury?

118
Q

What is Morton’s toe?

A

Long second toe

119
Q

What is the functional test for arch assessment?

A

Forward squat test–keep heels on the ground

-If arches roll inward = pronation

120
Q

Which ligament is being assessed for with the anterior drawer test?

A

Anterior talofibular ligament

121
Q

Which ligament is being assessed for with the talar tilt test? What does a positive test indicate?

A
  • Calcaneofibular ligament

- Increased motion and/or lack of endpoint

122
Q

Which ligament is being assessed with the reverse talar tilt?

A

Deltoid ligament

123
Q

What is the external rotation test of the ankle, and what does it assess for?

A

Forceful external rotation of the foot

-If affected side opens more than 15 degrees compared to other, then indicates a high ankle sprain

124
Q

Where on the leg is the squeeze test performed?

125
Q

What are the components of the ottawa ankle rules?

A

TTP over:

  • Lateral malleolus
  • Medial malleolus
  • base of the 5th metatarsal
  • navicular

or inability to bear weight

126
Q

What is the swing test?

A

Keep plantar aspect of the foot parallel to the ground while passively flexing the knee
-Positive test is when RROM is felt

Specialty Medicine (36 decks)

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