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Huang's Orthopaedic Surgery > Sports > Flashcards

Sports Flashcards

1
Q

What are the signs/symptoms of concussion?

A 
Head injury with the following:
headache
diplopia
tinnitus
amnesia
loss of consciousness
nausea
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2
Q

For how long should a player with a symptomatic concussion be held out of play for?

A

At least 24 hours, even if they have normal advanced imaging

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3
Q

What bundle of ACL does pivot shift test?

A

Posteromedial (bc it is tight in extension) - think posterior is tight in extension

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4
Q

What bundles of ACL does drawer and lachman’s test?

A

anteromedial bundle of ACL

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5
Q

What are the 2 bundles of ACL?

A

Anteromedial

Posterolateral

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6
Q

What length of graft do you want for ACL recon?

A

7cm

2cm in tibia, 2cm in femur, 3cm in between

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7
Q

What are the advantages of bone-patellar-bone grafts?

A

Faster healing
No need to take hamstrings
Can take however much patellar tendon as you want (thickness)

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8
Q

What are the disadvantages of bone-patellar-bone graft?

A

Risk of Anterior knee pain
Risk of patellar fracture
Risk of patellar tendon rupture

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9
Q

What ligaments connect PCL to LCL?

A

Humphrey’s (anterior)

Wrisberg (posterior)

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10
Q

What width of graft should you get from bone-patellar-bone?

A

11mm

in hamstrings, you get what you get in diameter

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11
Q

What will too vertical a tunnel in ACL reconstruction cause?

A

Rotatory instability & positive pivot shift

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12
Q

What is your femoral tunnel placement?

A

1-2mm rim of bone between tunnel and posterior condyle of femur

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13
Q

What are some rules of revision ACL reconstruction?

A

Use high strength grafts (BTB, hamstring)
Use 2 modality fixation (suspensory & interference screw)
Don’t use another BTB

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14
Q

With PCL injury, what angle of flexion do patients reports the most instability?

A

90 degrees (same as dial test)

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15
Q

What bundle of the PCL is tight in flexion?

A

Anterolateral (PAL)

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16
Q

What are the bundles of the PCL?

A

anterolateral

posteromedial

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17
Q

What kind of rehab should be done for ACL injuries?

A

Closed chain quadriceps strengthening

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18
Q

What are the management options for isolated PCL injury?

A

Non-op

If grade 3 (>10mm), quad strengthening with extension bracing

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19
Q

In PCL injuries, how do you reduce posterior sag?

A

Increase tibial slope (N=3deg)

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20
Q

Where do most degenerative meniscal tears occur?

A

Posterolateral horn of the medial meniscus

21
Q

Double PCL sign?

A

Bucket handle tear of meniscus

22
Q

Treatment of asymptomatic discoid meniscus?

23
Q

What is the functional deficit following distal biceps tendon rupture?

A

40-50% loss of supination strenth
30% loss of elbow flexion strength
15% loss of grip strength

24
Q

What are the two approaches to distal biceps tendon repair?

A

One incision

Two incision

25
What is the most common complication of distal biceps tendon repair, regardless of technique?
Lateral antebrachial cutaneous nerve injury
26
What is the main advantage of two incision approach to distal biceps repair?
Less risk to the radial nerve
27
What ligament connects the two menisci?
Transverse (intermeniscal) ligament
28
What ligaments attach the menisci to the periphery?
Coronary ligaments
29
Define Isometric
Constant muscle length and tension that is proportional to external load - Causes muscle hypertrophy - Pushing against stationary object
30
Define Isotonic
Constant force through ROM | - Bicep curls
31
Define Open Chain
Exercise where distal segment is not fixed
32
Define Closed Chain
Exercise where distal segment is fixed
33
Isokinetic
Muscle contracts at a constant velocity | Requires Cybex
34
Concentric
Muscle fibers shorten
35
Eccentric
Force remains constant as muscle fibers lengthen
36
Plyometric
Rapid Concentric-eccentric shortening Good for sports that require power Box jumps
37
Type IIA/B fast twitch muscle
Anaerobic: - IIA: Anaerobic & aerobic - IIB: Anaerobic
38
Type I slow twitch muscle
Aerobic
39
What bundles of ACL/PCL are right in flexion?
Both of the anterior bundles - PCL: anterolateral (PAL) - ACL: anteromedial
40
Grading of ACL tear (Lachman's test)
``` Grade 1-3, A & B A: Firm endpoint B: no endpoint IA/B: 0-5mm translation IIA/B: 5-10mm translation IIIA/B: >10mm translation ```
41
What are the different classification systems for cartilage damage?
ICRS: International Cartilage Repair Society Outerbridge Lysholm Noyes
42
Describe ICRS Grading:
International Cartilage Repair Society for cartilage damage 0: Normal 1: Nearly normal: Soft indentations or superficial fissures/cracks 2: Abnormal: lesions 50% cartilage depth 4: Severely abnormal: through subchondral bone
43
Describe Outerbridge grading:
``` Cartilage damage grading 0: normal I: cartilage softening or swelling II: Partial thickness damage (fissures etc) that does NOT reach subchondral bone and 1.5cm IV: Exposed subchondral bone ```
44
Where can the suprascapular nerve get impinged?
``` Supraglenoid notch (by supraglenoid ligament) Spinoglenoid notch (by spinoglenoid ligament) ```
45
What will suprascapular impingement at the suprascapular notch cause?
Weakness in BOTH supraspinatus & infraspinatus
46
What will suprascpular impingement at the spinoglenoid notch cause?
Weakness in infraspinatus only | - Branch to supraspinatus has already taken off
47
What are the types of meniscal tears?
``` Vertical/longitudinal Bucket handle Radial Horizontal Oblique/Flap/Parrot beak Complex ```
48
What are good prognostic factors for meniscal repair?
Peripheral (red zone) - AKA lower rim width, the distance between edge of tear and edge of meniscus Vertical/longitudinal tear 1-4cm in length Acute tear repaired in combination with ACL tear

Huang's Orthopaedic Surgery (15 decks)

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