sports Flashcards
is medial or lateral meniscus tear more common
medial
is medial or lateral meniscus tear more common with ACL tear?
lateral
function of posterior oblique ligament
primary stabilizer against internal rotation and valgus from 0-30 flexion
+ dial test at 30 degrees only
isolated posterolateral corner injury
+ dial test at 30 and 90 degrees
PCL + posterolateral corner injury
MPFL attachments
origin: Schottle’s point (distal to adductor tubercle, proximal to medial epicondyle)
insertion: proximal third medial patella
origin of posterior oblique ligament
adductor tubercle
function of ACL anteromedial bundle
anterior restraint, tight in flexion
function of ACL posterolateral bundle
rotatory restraint, tight in extension
what does the Lachman and anterior drawer test evaluate?
ACL anteromedial bundle
what does pivot shift evaluate?
ACL posterolateral bundle
blood supply of ACL and PCL
branches of middle genicular artery and the fat pad
which ACL bundle originates proximal to the bifurcate ridge?
anteromedial
layer 1 of lateral knee
IT tract, biceps femoris
structures between layer 1 and 2 of lateral knee
common peroneal nerve
layer 2 of lateral knee
patellar retinaculum
superficial layer 3 of lateral knee
LCL, ALL, fabellofibular ligament
structure between deep and superficial layer 3 of lateral knee
lateral geniculate artery
deep layer 3 of lateral knee
arcuate ligament, coronary ligament, popliteus, popliteofibular ligament, capsule
layer 1 of medial knee
sartorius/sartorial fascia
structures between layers 1 and 2 of medial knee
gracilis, semitendinosus, saphenous nerve
layer 2 of medial knee
MPFL, POL, superficial MCL, semimembranosus
layer 3 of medial knee
capsule, deep MCL, coronary ligament
what’s the most anterior structure inserting on the fibular head?
LCL
what structure is the primary stabilizer of external tibial rotation?
posterolateral corner
main components of posterolateral corner
LCL, popliteus, popliteofibular ligament
what does the popliteus do?
internally rotates the tibia
where is the popliteal artery relative to the PCL
lateral and posterior
what ACL graft has the greatest tensile strength
quadrupled hamstring
how do you calculate insall-salvati ratio?
length of patellar tendon over length of patella
what happens in the pivot shift test
lateral tibia is subluxed in full extension (+valgus/internal rotation), IT band reduces tibia at 20-30 degrees of flexion causing a palpable clunk
gold standard meniscus repair
inside-out with vertical mattress
where are Bakers cysts usually located?
between semimembranosus and medial head of gastroc
most sensitive test for ACL
Lachmans
result of vertical tunnel in ACL
decreased rotational stability
result of anterior femoral tunnel in ACL
limited flexion
ACL innervation
posterior articular nerve (branch of tibial nerve)
acute management of quads contusion
cold compression and overnight immobilization in 120 degrees flexion
risk with hip scope anterolateral portal
superior gluteal nerve
risks with hip scope anterior portal
LFCN, ascending branch of lateral femoral circumflex artery, femoral neurovascular bundle
risks with hip scope DALA portal (direct anterolateral)
ascending branch of lateral femoral circumflex artery
risks with hip scope posterolateral portal
sciatic nerve
most common location of os acromiale
junction of meso and meta acromion
main vascular supply to humeral head
posterior humeral circumflex artery
contents of rotator interval
coracohumeral ligament, SGHL, biceps tendon, glenohumeral capsule
borders of rotator interval
lateral coracoid base, supraspinatus, subscap, transverse humeral ligament
inheritance of hypertrophic cardiomyopathy
autosomal dominant with variable pentrance
shoulder scope posterior portal risks
axillary nerve, suprascapular nerve and artery
shoulder scope anterior portal risks
cephalic vein, axillary nerve and artery
shoulder scope superior portal risks
suprascapular nerve and artery
what is a bankart lesion
anteroinferior labral tear
what nerve is at risk in a pec major transfer
musculocutaneous
histology of adhesive capsulitis
dense matrix of type III collagen containing fibroblast and myofibroblasts
lateral scapular winging
spinal accessory nerve/trapezius
medial scapular winging
long thoracic nerve/serratus anterior
function of posterior horn of medial meniscus
secondary stabilizer to anterior tibial translation
nerve at risk with BTB harvest
infrapatellar branch of saphenous nerve
which PCL technique has a biomechanical advantage?
tibial inlay, decrease in killer turn and graft attenuation (compared to trans-tibial)
which compartments develop arthritis in chronic PCL tears?
medial and patellofemoral
most common site of injury for MCL
femoral origin
most common complication of mensical transplantation
meniscal allograft tear
what forms to heal an articular cartilage injury
fibrocartilage (type 1)
benefits of OATS vs microfracture
can be used with subchondral bone loss, results in type II hyaline cartilage (vs type I fibrocartilage), RTP 4-6 months (vs 6-9 months)
when does ROM begin after SLAP repair?
7-10 days, passive and active assist
which nerve is at risk with subpec biceps tenodesis?
musculocutaneous
pitcher with pain in late cocking phase and loss of velocity/lack of command
internal impingement
surgical indications for partial rotator cuff tear
articular-sided >50% thickness/6mm, bursal-sided >25% thickness/3mm
what is the primary restraint to valgus stress in normal elbow ROM
anterior bundle of UCL
secondary restraint to valgus stress in normal elbow ROM
radial head
primary restraint to valgus stress with elbow in maximal flexion
posterior bundle of UCL
insertion of anterior bundle of UCL
sublime tubercle of medial coronoid process
insertion of LUCL
supinator crest
primary restraint to varus and external rotation stress through elbow ROM
LUCL
muscle involved in lateral epicondylitis
ECRB origin
histology of lateral epicondylitis
angiofibroblastic hyperplasia
muscle involved in medial epicondylitis
flexor pronator mass origin
is LCL-deficient elbow more stable in pronation or supination
pronation
which direction does the radial head subluxate in a lateral pivot shift?
posterior
what throwing phases place highest stress on UCL?
late cocking, acceleration
nerve at risk in anteromedial elbow portal
medial antebrachial cutaneus and median nerves
nerve at risk in elbow proximal anteromedial portal
medial antebrachial cutaneous nerve
nerve at risk in elbow anterolateral portals
lateral antebrachial cutaneous and radial nerves
nerve at risk in elbow posterolateral portal
posterior antebrachial cutaneous
what position do you splint in for isolated LUCL rupture?
pronation
what position do you splint in for elbow MCL rupture with intact LUCL?
supination
most likely initiating location of rotator cuff tear
15 mm posterior to biceps tendon near supra/infra junction
muscle involved in lateral epicondylitis
ECRB
pivot shift for PLRI
radial head dislocates posteriorly in extension and reduces in flexion
top 2 most common cause of sudden death in athletes
1 = HOCM, 2 = CAD
when can you RTP with herpes lesions
no new lesions for 72 hours/meds for 5 days
RTP with impetigo
no crusting
anterior tibial tunnel in ACL
notch impingement
posterior tibial tunnel in ACL
PCL impingement
where does popliteus originate relative to LCL
POP is DAD - popliteus is deep, anterior, and distal to LCL on femur
rate of OA following knee dislocation
25% at 10 years
TTTG to consider TTO
> 20
