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ABOS PART ONE > Sports > Flashcards

Sports Flashcards

1
Q

how is bundle of ACL tight in flexion tested

A

the anteromedial bundle of ACL is tested with lachman and anterior drawer test

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2
Q

how is bundle of ACL tight in extension tested

A

the posterolateral bundle of ACL tested with the pivot shift

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3
Q

motion resisted by bundle of ACL tight in flexion

A

the anteromedial bundle of ACL is primarily an anterior restraint

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4
Q

motion resisted by bundle of ACL tight in extension

A

the posterolateral bundle of ACL is primarily an rotatory restraint

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5
Q

origin of the superficial MCL

A

superficial MCL = 3.2 mm proximal and 4.8 mm posterior to the medial femoral epicondyle

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6
Q

these superficial MCL fibers are tight in the first 90* of flexion

A

the anterior fibers of the superficial MCL are tightened in the first 90* of motion

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7
Q

these superficial MCL fibers are tight in the extension

A

the posterior fibers of the superficial MCL are tight in extension

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8
Q

position of the superficial MCL relative to the hamstrings

A

the superficial MCL lies deep to the gracilis and semitendinosus

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9
Q

this portion of the MCL forms the coronary ligaments

A

the deep fibers of the MCL are intimately associated with the medial meniscus

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10
Q

femoral origin of the LCL relative to the popliteus tendon

A

posterior superior and superficial to the popliteus

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11
Q

most anterior structure inserting on the proximal fibula

A

LCL

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12
Q

description of tightness of the LCL in relation to motion

A

LCL is an anterior structure, and therefore tight in extension; loose in flexion

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13
Q

3 components of the posteromedial corner

A

multiple insertions of semimembranosus, posterior oblique ligament, and the oblique popliteal ligament

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14
Q

PLC is the primary stabilizer to

A

tibial external rotation

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15
Q

more C shaped meniscus

A

medial

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16
Q

more mobile meniscus

A

lateral

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17
Q

more stable meniscus

A

medial

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18
Q

more circular meniscus

A

lateral

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19
Q

tibial external rotation primarily restrained by

A

the PLC

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20
Q

MPFL origin

A

just anterior and distal to the adductor tubercle

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21
Q

MPFL insertion

A

jxn of the proximal and middle thirds of the patella, and onto the undersurface of VMO

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22
Q

approx tensile strength of the ACL

A

2200 N

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23
Q

this is the center of rotation in the knee joint

A

the intersection of the ACL and PCL

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24
Q

these fibers dissipate meniscal hoop stresses

A

longitudinal fibers

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25
Q

ACL deficiency: more meniscal strain in the

A

posterior horn medial meniscus

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26
Q

fall onto plantarflexed foot

A

PCL injury

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27
Q

fall onto dorsiflexed foot

A

patellar injury

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28
Q

mechanism that would make you think PLC injury

A

hyperextension, varus, and tibial external rotation

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29
Q

an ACL tibial tunnel that is too anterior

A

limits extension through roof impingement

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30
Q

an ACL tibial tunnel that is too posterior

A

PCL impingement

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31
Q

an ACL femoral tunnel that is too anterior

A

limits both flexion and extension

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32
Q

an ACL femoral tunnel that is too posterior

A

too lax in both flexion and extension

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33
Q

interference screw divergence

A

> 30* on the femur or 15* on the tibia decreases graft pullout strength

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34
Q

vertical ACL femoral tunnel

A

AP stability is fine but the rotational stability is not

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35
Q

this is the most sensitive view for revealing early OA

A

45* flexed standing PA

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36
Q

patellar tilt thresholds

A

> 15* is too lax

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37
Q

varus/valgus instability at 0 degrees

A

MCL/LCL and the PCL

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38
Q

chronic MCL radiograph

A

pellegrini lesion (MFC)

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39
Q

threshold for distal realignment in patellar maltracking

A

TT-TG distance more than 20mm

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40
Q

meniscus torn more frequently

A

medial

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41
Q

meniscus torn more frequently with acute ACL tears

A

lateral

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42
Q

primary determinant of healing potential in meniscal injuries

A

vascular supply

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43
Q

gold standard for meniscus repairs

A

inside-out vertical mattress

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44
Q

position of the peroneal nerve during a lateral meniscal repair

A

posterior to the biceps femoris

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45
Q

position of the saphenous nerve during a medial meniscal repair

A

anterior to semi-T and gracilis; posterior to inferior border of sartorius

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46
Q

meniscal cysts occur with

A

horizontal cleavage tears of the lateral meniscus

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47
Q

to be effective meniscal transplants have to be

A

within 5% of the size of the native meniscus

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48
Q

this can be used to help determine candidacy for meniscal transplant

A

three phase bone scan; would show subchondral edema if present

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49
Q

this test is most sensitive for diagnosis of an ACL injury

A

lachman

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50
Q

this test is most correlated to outcome after ACL reconstruction

A

pivot shift testing

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51
Q

low long to avoid open chain after ACLR

A

6 wks

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52
Q

this risks damage to the infrapatellar br of saphenous in ALCR

A

use of transverse incision to get the HS autograft

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53
Q

12mm difference on this is indicative of PCL injury

A

stress radiographs compared to other side

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54
Q

grade one and isolated PCL injuries

A

non-op with PT focused on the quads

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55
Q

chronic PCL deficiency

A

PFJ, medial condyle chondrosis

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56
Q

single bundle PCL tensioning

A

90*

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57
Q

average distance between screws and popliteal artery during PCLR using tibial inlay technique

A

20mm

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58
Q

why does the most common MCL injury heal better than the others

A

most common is injury to the femoral insertion and proximal injuries heal better than distal ones

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59
Q

this is associated with higher failure rates in PLCR

A

varus malalignment

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60
Q

treatment for chronic PLC injuries

A

valgus opening osteotomy

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61
Q

incidence of vascular injury after knee dislocation

A

30-50%

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62
Q

frequency of resolution with OCD lesions

A

these resolve spontaneously in nearly all juveniles, 50% of adolescents, and no adults

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63
Q

threshold for microfracture

A

up to 4cm2?

64
Q

displaced OCD, more than 3mm subchondral bone

A

ORIF

65
Q

runners on hills

A

ITBS; Ober test

66
Q

best candidate for lateral release PFS

A

extensive non-op obviously; neutral or negative tilt with 1 quadrant medial glide and 3 quadrants lateral glide

67
Q

contraindication to distal realignment for patellar maltracking

A

TT-TG less than 20mm, yes, but also proximal arthrosis of the medial patellar facet

68
Q

these tibial eminence fractures can be treated closed

A

displacement less than 3mm or elevation of less than the anterior half

69
Q

these tibial tubercle fxs need surgery

A

displaced more than 5mm, immobilize in extension 6 wks

70
Q

acute mgmt quad contusions

A

ice, overnight immobilization in 120* flexion

71
Q

RTP after hamstring strain

A

when strength is 90% of the other side

72
Q

what is sports hernia

A

groin pain from injury to adductor longus or abdominal wall, without classic hernia findings

73
Q

etiology of sports hernia

A

combination of abdominal hyperextension and thigh hyperabduction

74
Q

these can occur as the result of intense training of core muscles

A

ilioinguinal, obturator, sciatic impingements

75
Q

when to IMN THE DREADED BLACK LINE

A

after 6 months of nonop if a tibial stress fx is present it is gettin the bizness

76
Q

most specific test for stress fxs

A

MRI

77
Q

why are labral tears a common cause of mechanical hip pain

A

they provide the lubrication for the hip joint

78
Q

incidence of hip labral tears highest in this group

A

acetabular dysplasia

79
Q

two things that can cause pincer impingement

A

inadequate femoral anteversion or acetabular protrusio

80
Q

how to differentiate external and internal snapping hips

A

external (i.e. IT band snapping over the GT) does not need rotation like psoas impingement does

81
Q

anterior hip scope portal danger

A

LFCN

82
Q

anterolateral hip scope portal danger

A

SGN

83
Q

posterolateral hip scope portal danger

A

sciatic nerve especially in ER

84
Q

dorsal foot tingling worse with plantar flexion and inversion

A

SPN entrapment, where it exits the fascia 12cm proximal to fibular tip

85
Q

this move can confirm subluxing peroneal tendons

A

eversion and dorsiflexion

86
Q

two general rules about the mgmt of achilles ruptures

A

rerupture is less with surgery, complications are fewer with nonop

87
Q

thresholds for diagnosing exertional compt syndrome

A

> 20mmHg after 5 mins, or >30 after 1 min

88
Q

this test can help differentiate intermittent calf pain and foot paresthesias

A

popliteal artery syndrome can mimic compt syndrome. Having the pt actively plantarflex the foot can occlude pop art.

89
Q

ankle sprains usually, occasionally, and rarely involve which ligaments

A

usually the ATFL, sometimes the CFL, but rarely do they affect the PTFL

90
Q

what do you have to have to get surgery for your ankle sprain

A

recurrent symptomatic instability, positive tilt, positive anterior drawer either by exam or xrays

91
Q

why a high ankle sprain might get surgery

A

synostosis can occur with these and excision could be performed later

92
Q

snowboarders fx

A

lateral talar process fx.

93
Q

soft tissue cause for posterior ankle impingement

A

FHL synovitis

94
Q

lateral talar OCD mechanism

A

inversion and dorsiflexion

95
Q

medial talar OCD mechanism

A

inversion, plantarflexion, and rotation

96
Q

ankle scope portal that endangers DPN and dorsalis

A

anterocentral

97
Q

ankle scope portal that endangers SPN

A

anterolateral

98
Q

ankle scope portal that endangers saphenous vein

A

anteromedial

99
Q

what is the rotator cable

A

thickening of the coracohumeral ligament present at the avascular margin of the rotator cuff

100
Q

these two ligaments in the shoulder can be thought of as performing same action

A

SGHL and coracohumeral ligaments, as they both limit posterior translation with arm adducted, forward flexed, and internally rotated

101
Q

five phases of throwing, and two with highest torque

A

wind-up, cocking, acceleration, deceleration, and follow-through. Late cocking and decel have maximal torque generation

102
Q

active compression test

A

10* adduction, forward flexed 90*, max pronation (O’Briens?) indicates SLAP lesion

103
Q

Yerguson

A

resisted supination = biceps tendinitis

104
Q

Speed

A

resisted forward flexion = biceps tendinitis

105
Q

anteroinferior labral tear

A

bankart

106
Q

posteroinferior labral tear

A

kim (usually incomplete and concealed)

107
Q

rehab focus in MDI

A

closed chain exercises emphasized with AMBRI issues

108
Q

indication for coracoid transfer in shoulder instability

A

greater than 25% glenoid deficiency (compared to humeral head)

109
Q

MDI shoulder that fails rehab?

A

capsular shift

110
Q

chronic dislocation with more than 40% articular surface deficit

A

allograft for the young, prosthesis for the old

111
Q

lightbulb sign

A

seen on AP film of posterior GH dislocation

112
Q

jerk test

A

posterior force with arm adducted and forward flexed

113
Q

% of those over 60 with full-thickness RTC tear

A

1/4

114
Q

% of those over 70 without a full-thickness RTC tear

A

35%. Roughly a quarter don’t have a tear after 70

115
Q

% of asymptomatic tears that become symptomatic

A

50% within 3 years

116
Q

This size of PASTA lesion should be considered significant

A

7mm of exposed footprint is 50%. More than that should be considered significant

117
Q

mgmt of combined supra and infraspinatus tear

A

lat dorsi transfer to the GT

118
Q

arthroscopic evidence of chronic subscap tear

A

SGHL avulsion, represented by a comma sign

119
Q

3 requirements for RTSA

A

RTC tear arthropathy, a working deltoid, and adequate glenoid

120
Q

more complications, hemi or RTSA for RTCA

A

RTSA more complications

121
Q

functional results bt hemi or RTSA for RTCA

A

RTSA more predictable

122
Q

can occur after procedure that results in posterior capsular tightness and decreased internal rotation

A

subcoracoid impingement

123
Q

mineralization of the posterior inferior glenoid

A

bennett lesion, seen in internal impingement

124
Q

athletic etiology for internal impingement

A

external rotation and anterior translation (throwing) leads to GIRD, which causes posterosuperior shift of the humeral head and results in RTC and posterosuperior labrum impingement

125
Q

shoulder adduction and internal rotation weakness, palpable defect in a weightlifter

A

pec major rupture. Surgical repair

126
Q

adhesive capsulitis mgmt

A

supervised PT, NSAIDS, +/- injections. Cures most within 12 weeks

127
Q

when can pt with burner RTP

A

after complete resolution of symptoms

128
Q

when can pt with a second burner RTP

A

not until c-spine films can be obtained

129
Q

scapular winging

A

serratus, medial, long thoracic. most resolve spontaneously

130
Q

deltoid weakness and lateral shoulder parethesias with overhead activity

A

quadrilateral space syndrome.

131
Q

pattern of GH wear in OA vs RA

A

in RA the glenoid is worn centrally, in OA it is posterior

132
Q

transfer done for medial scapular winging

A

pec major

133
Q

transfer done for lateral scapular winging

A

levator scapulae and rhomboids (Eden-Lange). spinal accessory nerve issue, trapezius.

134
Q

maybe only radiographic sign of little leaguer shoulder

A

physeal widening

135
Q

main muscle affected in tennis elbow

A

ECRB

136
Q

why excessive resection avoided in mgmt of tennis elbow

A

puts LCL at risk

137
Q

most common nerve injury associated with repair of distal biceps tendon rupture

A

LABC. Runs parallel to the cephalic vein in the antecubital fossa

138
Q

two phases of throwing that stress the medial stabilizer of the elbow in flexion

A

the anterior band of the MUCL has high stress during late cocking and acceleration

139
Q

this has high sensitivity and specificity for injury to the MUCL of the elbow

A

moving valgus stress test

140
Q

who needs surgery for their MUCL rupture

A

only those high-level athletes that desire a return to sport

141
Q

this is usually the first ligament disrupted in an elbow dislocation

A

the LCL

142
Q

method for testing the elbow LCL

A

supinate the forearm, apply valgus and axial load. clunk at ~ 40* reduces the radiocapitellar joint (like pivot shift for the elbow)

143
Q

complaints of PLRI besides inability to do pushup or use arms to pushup from a chair

A

clicking or locking in extension

144
Q

elbow portal dangers of anteromedial

A

median nerve, MABCN

145
Q

elbow portal dangers of anterolateral

A

radial nerve, LABC

146
Q

most common nerve palsy after an elbow scope

A

ulnar nerve

147
Q

elbow stiffness associated with this structure?

A

posterior band LCL?

148
Q

this would put an athlete with concussion out for the season

A

a second episode

149
Q

when a CT head would be obtained in an athlete with a concussion

A

LOC longer than 5 mins

150
Q

exam for spondy

A

SPECT

151
Q

most common cause of amenorrhea in female athletes

A

not enough calories in diet

152
Q

female athlete triad

A

stress fxs, amenorrhea, eating disorder

153
Q

most commonly injured organ in sports

A

kidney

154
Q

length of time athlete is out after mono infection

A

3-5 wks, or when splenomegaly resolves, whichever is later

155
Q

ADI more than X on presport eval of SPECIAL athlete is indication for spinal fusion

A

> 9mm

156
Q

the pts that do worst with lat transfers

A

women, those with poor motion, subscap tears

157
Q

best pt for a lat dorsi transfer

A

Young. With irreparable RTC tear, active deltoid, active subscap, and no glenohumeral OA

ABOS PART ONE (11 decks)

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