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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?

A

Leave it

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
Q

What is the most common complication of distal biceps tendon repair, regardless of technique?

A

Lateral antebrachial cutaneous nerve injury

26
Q

What is the main advantage of two incision approach to distal biceps repair?

A

Less risk to the radial nerve

27
Q

What ligament connects the two menisci?

A

Transverse (intermeniscal) ligament

28
Q

What ligaments attach the menisci to the periphery?

A

Coronary ligaments

29
Q

Define Isometric

A

Constant muscle length and tension that is proportional to external load

  • Causes muscle hypertrophy
  • Pushing against stationary object
30
Q

Define Isotonic

A

Constant force through ROM

- Bicep curls

31
Q

Define Open Chain

A

Exercise where distal segment is not fixed

32
Q

Define Closed Chain

A

Exercise where distal segment is fixed

33
Q

Isokinetic

A

Muscle contracts at a constant velocity

Requires Cybex

34
Q

Concentric

A

Muscle fibers shorten

35
Q

Eccentric

A

Force remains constant as muscle fibers lengthen

36
Q

Plyometric

A

Rapid Concentric-eccentric shortening
Good for sports that require power
Box jumps

37
Q

Type IIA/B fast twitch muscle

A

Anaerobic:

  • IIA: Anaerobic & aerobic
  • IIB: Anaerobic
38
Q

Type I slow twitch muscle

A

Aerobic

39
Q

What bundles of ACL/PCL are right in flexion?

A

Both of the anterior bundles

  • PCL: anterolateral (PAL)
  • ACL: anteromedial
40
Q

Grading of ACL tear (Lachman’s test)

A 
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
Q

What are the different classification systems for cartilage damage?

A

ICRS: International Cartilage Repair Society
Outerbridge
Lysholm
Noyes

42
Q

Describe ICRS Grading:

A

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
Q

Describe Outerbridge grading:

A 
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
Q

Where can the suprascapular nerve get impinged?

A 
Supraglenoid notch (by supraglenoid ligament)
Spinoglenoid notch (by spinoglenoid ligament)
45
Q

What will suprascapular impingement at the suprascapular notch cause?

A

Weakness in BOTH supraspinatus & infraspinatus

46
Q

What will suprascpular impingement at the spinoglenoid notch cause?

A

Weakness in infraspinatus only

- Branch to supraspinatus has already taken off

47
Q

What are the types of meniscal tears?

A 
Vertical/longitudinal
Bucket handle
Radial
Horizontal
Oblique/Flap/Parrot beak
Complex
48
Q

What are good prognostic factors for meniscal repair?

A

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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