sport injuries Flashcards

1
Q
  • shoulder injuries:
    the 4 rotator cuff muscles are
A

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
( check structure )

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2
Q

the rotator cuff tears are injuries in —
1- origins is — :
Supraspinatus –> —
Infraspinatus–> —
Teres Minor –>—
Subscapularis –>—
2- inerstion in —
- greater tubroristy:
- lesser tuborsity:
3- innervation:
—- nerve: supraspinatus, infraspinatus
—- nerve: subscapularis
—– nerve: teres minor

A
  • shoulder
  • scapula
  • supraspinous fossa
  • infraspinous fossa
  • lateral border of scapula
  • sub scapular fossa
  • humorous
  • great: supraspinatus, infraspinatus, teres minor
  • lesser: subscapularis
  • subrascapular nerve
  • sub scapular
  • axially
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3
Q

the functions fir the rotator cuff tears are —- Supraspinatus = —
Infraspinatus = —
Teres Minor = —-
Subscapularis = —-
clinical relevance: above actions are used to elicit pain in torn rotator cuff muscles

A
  • stabilisation
  • abduction
  • external rotation
  • external rotation
  • internal rotation
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4
Q

how does the cuff tears tears:

A

1-Chronic degenerative tears: Usually older patients!
2-Chronic impingement
3-Avulsion: eg; Shoulder dislocation, falls

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5
Q

the pain in rotator cuff tears are located in — regions and usually — but can be – if the tear is traumatic , the — is a poor indicator of conservative management
- weakness causes:

A
  • deltoid region
  • insidious
  • acute
  • night pain
  • loss of rom
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6
Q

we can investigate rotator cuff tears by:
1- —–
May show calcified tendons
Cause of impingement eg: hooked acromion
2- —-
Gold Standard
3- —-
Pros: Inexpensive and readily available
Con: User dependent limited ability to identify other pathologies

A

x ray
mri
ultrasound

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7
Q

rotator cuff tears management:
1- non-operative by:
2- operative by:

A

1- Physical therapy, analgesia, steroid injections First line for most tears
- operative as:
Partial tears = Decompression: subacromial debridement
Full thickness = Rotator Cuff Repair

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8
Q

shoulder location are — articulates with the —
1- static stabilisers as:
2- dynamic stabilisers as:

A
  • humeral head articulates w glenoid
  • glenoid labrum and glenohumeral ligament
  • rotator cuff muscles and biceps brachialotis tendon ( long head )
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9
Q

the mehcniams of injury of shoulder dislocation is —
and 95% of shoulder dislocations are —

A
  • trauma as contact sport or falls n elderly
  • anterior dislocation
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10
Q

shoulder dislocation
1- symptoms:
2- signs:

A

1-
Pain
Deformity
Immobility
Feelings of instability

2-
Abducted & externally rotated arm position
Squaring of shoulder
Axillary nerve injury: Loss of sensation over regimental badge area
+- Positive rotator cuff provocative tests

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11
Q

shoulder dislocations investigation is —
management by:

A

x ray:
Incongruence of humeral head, glenoid anatomy
Humeral head anterior and medial displacement
1- non opérative for acute dislocation as closed reduction and sling
2-operative for recurrent dislocations for shoulder stabilisation ( bankart repair/latarjet )

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12
Q

anterior cruciate ligament responsible for — injury
the origin is from :
insertion :
function :

A
  • soft tissue
  • femur : lateral femoral condyle
  • tibia: anteriorly between intercondylar eminences
  • prevents anterior translation of tibia relative to the femur
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13
Q

how can you hurt ur anterior cruciate:

A

Valgus Force:
-Twisting while foot is planted firmly on the ground
-Lateral force applied to a planted leg

*Unhappy Triad = ACL, MCL, and Meniscus injury

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14
Q

symptoms and signs of anterior cruciate:
investigation by:

A

1-symptoms :
-Pain with difficulty weightbearing
-Swelling
-May report hearing a “pop”
2- signs:
Effusion
Quadriceps avoidance gait
Positive Lachman/Anterior Drawer Test
x ray : more normal
mri: gold standard

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15
Q

anterior cruciate management:

A

1- non operative:
For patients with low demand
Increased risk of meniscal/cartilage damage
2- operative = ACL reconsutrcution
-For higher demand patients
-Uses tendon graft eg; hamstring or quadriceps to reconstruct ACL

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16
Q

ankle injuries :
- modified hinge joint includes:
—- is important ligament stabilising ankle joint
N.B includes:

A

tibia fibula and talus
syndesmosis
AITFL , PITFL location

17
Q

mechanism of distal fibula fracture is —–
presentation of:

A
  • twisting ankle injury
  • pain swelling inability to weighttbear
    can be done by x ray for AP lateral and mortise view
18
Q

-ankle fibula fracture weber classification

A

-CEHCL SLIDE 28 SOSOSOOOO IMPORTANT
- we cna get:
1- isolated lateral malleolar
2- bimalleolar
3- trimalleolar

19
Q

management of distal fibula fracture:

A
  • nonoperative:
    weber A and stable mortise
  • operative = ORIF as displaced fractures and unstable mortise
20
Q

clavicle fractures:
1- mechanism of injury — and its injury in —
2- the — is pulled superiorly due to SCM
3- the — is pulled inferiorly due to the weight of the arm

A
  • direct impact to right shoulder
  • upper limb
  • medial fragment
  • lateral fragment
21
Q

investigation of clavicle fracture:

A
  • xray usually suffienct
  • ct: may be useful for preoperative planning nd medial clavicle fractures
22
Q

clavicle fractures clinical presentation:
- symptoms:
- signs:
- management:

A

1-
Pain: Acute onset
“Popping” or “Cracking” sound
2-
Tender swelling +- deformity
Check for skin tenting/open fractures
Neurovascular injury: Brachial plexus/subclavian vessels
- nonoperative:
-Majority of clavicle fractures
Sling or figure of 8 strap used
15% risk of non-union

-Who needs operative management
Open fractures/skin tenting
Vascular injuries

-Operation = Open reduction internal fixation

23
Q

scaphoid fracture is the – bone in — row
- blood supply:
1- —- : —- is the major blood supply
2- minor supply from —

A
  • largest
  • proximal carpal row
  • retrograde flow
  • radial artery : dorsal carpal branch
  • superficial palmar branch
24
Q

scaphoid mechanism of injury is typically —-
clinical presentation includes:
– pain which worse on motion and +/- swelling
- signs include :

A
  • FOOSH
  • wrist pain
  • tenderness over the anatomical snuff box
25
Q

scaphoid investigation by:
management by:

A

1-X-Ray hand
25% of fractures aren’t visible initially
X-rays should be repeated at 14-21 days if there is clinical suspicion
2-MRI/Bone Scan
Can be used to evaluate for occult fractures
3-CT
- Used to determine fracture characteristics
Non-operative = Immobilisation
Cast immobilization
Used for majority of scaphoid fractures

Operative management
Indications; Proximal pole fractures, significantly displaced/deformed fractures