Sports Flashcards
ACL origin.
Posteromedial aspect of lateral femoral condyle.
ACL length.
30mm
ACL diameter.
11mm
Bundles of ACL are named based on this.
Relationship at tibial insertion.
Two bundles of ACL
Anteromedial, posterolateral.
Anteromedial ACL bundle tight in this position.
Flexion.
Posterolateral bundle of ACL tight in this position.
Extension.
The anteromedial bundle of ACL resists this motion.
Anterior translation of tibia.
The posterolateral bundle of ACL resists this motion.
Rotation.
Lachman test evaluates this bundle of ACL.
Anteromedial
Pivot shit test evaluates this bundle of ACL
Posterolateral
Collagen composition of ACL.
90% Type I, 10% type III
Blood supply to ACL.
Middle geniculate artery.
PCL origin.
Anterolateral medial femoral condyle.
PCL length.
38 mm
PCL diameter.
13 mm
PCL bundles.
Anterolateral, posteromedial
Anterolateral PCL bundle tight in.
Flexion.
Posteromedial PCL bundle tight in.
Extension.
This meniscofemoral ligament is anterior to PCL.
Humphrey.
This meniscofemoral ligament is posterior to PCL
Wrisberg.
Origination of the superficial MCL.
3mm proximal and 5mm posterior to medial femoral epicondyle.
LCL origin relative to the insertion of popliteus tendon.
Posterior and superior.
Most anterior structure inserting on proximal fibula.
LCL
The LCL is tight in ____ and lax in ____.
Tight in extension, lax in flexion
Primary stabilizer of tibial external rotation.
Posterolateral corner.
Structures in layer I of medial knee.
Sartorius and fascia.
Structures in layer II of medial knee.
Superficial MCL, posterior oblique ligament, semimembranosus.
Structures in layer III of medial knee.
Deep MCL, capsule.
Structures in layer I of lateral knee.
IT band, biceps femoris, fascia.
Structures in layer II of lateral knee.
Patellar retinaculum, patellofemoral ligament.
Structures in layer III of lateral knee.
Arcuate ligament, fabellofibular ligament, capsule, LCL.
Order of insertion of structures on the proximal fibula anterior to posterior.
LCL, popliteofibular ligament, biceps femoris.
Components of the posterolateral corner (7).
- Biceps femoris
- IT band
- Popliteus
- Popliteofibular ligament
- Lateral capsule
- Arcuate ligament
- Fabellofibular ligament
Meniscus is primarily composed of this type of collagen.
Type I.
Medial or lateral meniscus more mobile?
Lateral
Greater AP dimension, medial or lateral condyle of femur?
Lateral
Origin of the MPFL in relation to the adductor tubercle.
Anterior and distal.
Knee ligament with greatest tensile strength.
MCL
Major knee ligament with least tensile strength.
LCL
Radiographic view most sensitive for early osteoarthritis.
Weight bearing 45 degree flexed posteroanterior view.
Most common arthroscopic complication.
Iatrogenic articular cartilage damage.
What is more common, medial or lateral mesniscus tear?
Medial.
Primary determinant of healing potential to meniscus.
Vascular supply.
Gold standard for meniscal repair.
Inside-out technique with vertical mattress sutures.
What nerve is at risk during medial meniscus repair.
Saphenous.
What nerve is at risk during lateral meniscus repair.
Peroneal.
Position of the saphenous nerve relative to semitendinosis, gracilis, and sartorius.
Anterior to semiT and gracilis. Posterior to inf border of sartorius.
Position of the peroneal nerve relative to biceps femoris.
Posterior to biceps femoris.
Meniscal cysts usually involve the medial or lateral meniscus?
Lateral.
These occur in conjunction with horizontal cleavage tear of lateral meniscus.
Meniscal cyst.
Popliteal (Baker) cysts usually form here.
Between semimembranosus and medial head of gastroc.
Crucial for mensical transplantation success.
Graft size accurate to within 5% of native.
In situ force of ACL is highest at ____ flexion.
30 deg.
Most sensitive physical exam maneuver for acute ACL injury.
Lachman.
Early post-op ACL reconstruction rehab consists of these two protocols.
- Closed chain exercises
2. Compressive loading
Open chain extension after ACL reconstruction should be avoided for this long.
6 weeks
Placement of femoral tunnel too anteriorly during ACL reconstruction causes this limitation post-op.
Limited flexion.
Most common complications of ACL reconstruction.
Aberrant tunnel placement.
Vertical ACL graft results in this.
Rotational instability.
This increases risk of damaging infrapatellar branch of saphenous during ACL recon.
Horizontal incision at hamstring autograft harvest site.
Fall onto ground with plantar-flexed or dorsi-flexed foot puts at risk for PCL rupture?
Plantar-flexed foot
Non-op rehab for PCL rupture involves this.
Strengthening of knee extensors.
Grade III posterior drawer is indicative of this.
Combined PCL injury with posterolateral corner or ACL.
Distance from fixation screws to popliteal artery in tibial inlay technique for PCL recon.
20 mm
Most common site of MCL rupture.
At femoral insertion.
MCL rupture at this location has less healing potential than other site.
Distal injuries less healing potential.
Prophylactic bracing helpful for these athletes to prevent MCL rupture.
Interior linemen.
Pelligrini-Stieda sign.
Chronic MCL injury.
This knee alignment is associated with higher rates of PCL reconstruction failure.
Varus.
Chronic PLC injury treatment.
Valgus opening wedge osteotomy, reduce posterior slope.
Most common site of osteochondritis dessicans.
Lateral aspect of medial femoral condyle.
Fibrocartilage is primarily this type of collagen
Type I.
More common in patients greater than 40 years, quad or patellar tendon rupture?
Quadriceps.
Articular cartilage on this patellar facet is most commonly injured after a patellar dislocation.
Medial.
Contraindication to tibial tubercle anterior-medialization.
Medial patellar facet arthrosis.
Anterior hip arthroscopy portal puts this nerve at risk.
LFCN
Anterolateral hip arthroscopy portal puts this nerve at risk.
Superior gluteal nerve.
Posterolateral hip arthroscopy portal puts this nerve at risk.
Sciatic.
First branch of lateral plantar nerve.
Baxter nerve.
Point where the FDL and FHL cross.
Knot of henry.
Diagnosis of exertional compartment syndrome.
Higher than 30 mmHg 1 minute after exercise, Higher than 20 mmHg 5 minutes after exercise, absolute value higher than 15 mmHg during rest.
Most commonly involved ligament for ankle sprains.
Anterior talofibular.
Diagnosis of “high” ankle sprain.
Pain in anterior syndesmosis in response to external rotation stress.
Treatment of persistently symptomatic os acromiale.
ORIF
Most common failure of fusion of the os acromiale.
Between mesoacromion and metaacromion.
Contents of the rotator interval (4).
- Coracohumeral ligament
- Superior glenohumeral ligament
- Biceps tendon
- Glenohumeral capsule
Borders of the rotator interval.
- Medial – lateral coracoid base
- Superior – anterior edge of supraspinatus
- Interior – superior border of subscapularis
Primary restraint to excessive anterior and posterior translation of the sternoclavicular joint.
Posterior capsule.
The rotator cable is a thickening of this ligament.
Coracohumeral ligament.
Bony changes that may be found in chronic throwing athletes.
Increased humeral head retroversion and glenoid retroversion.
5 phases of throwing.
- Wind-up
- Cocking
- Acceleration
- Deceleration
- Follow-through
Maxial torque is generated during these phases (2).
- Late cocking
2. Deceleration (just after ball released)
Loss of this in overhead throwing athletes.
Glenohumeral internal rotation.
Lesion most commonly found after traumatic shoulder instability.
Anteroinferior labral tear (bankart lesion).
HAGL involves avulsion of this ligament.
Inferior glenohumeral ligament.
Most important risk factor for recurrent shoulder instability.
Age at first dislocation.
These type of exercises for multidirectional shoulder instability (2).
- Scapular stabilization
2. Closed kinetic chain
Indication for coracoid transfer procedure.
Shoulder instability with glenoid deficiency greater than 25%.
Indication for capsular shift.
Failed extensive rehab for MDI.
Rotator interval closure results in this.
Decreased external rotation.
Incomplete and concealed avulsion of the posteroinferior labrum.
Kim lesion.
Prevalence of full thickness rotator cuff tear in the greater than 60 year old population.
28%
Prevalence of full thickness rotator cuff tear in the greater than 70 year old population.
65%
PASTA.
Partial articular supraspinatus tendon avulsion.
When to repair PASTA.
Greater than 50% of tendon insertion (> 7mm) avulsed from footprint.
Comma sign represents this.
Avulsed SGHL.
Empty bicipital groove and transverse humeral ligament tear on MR indicates this is likely.
Subscapularis tear.
Abnormal distance between humerus and coracoid process.
7 mm
Internal impingement between these structures.
Posterosuperior labrum and rotator cuff.
Sleeper stretch.
For GIRD. Posterior and posteroinferior capsular stretching.
SLAP tear in patient greater than 40 years.
Biceps tenodesis.
Nerve injury with medial scapular winging.
Long thoracic nerve
Muscle dysfunction causing medial scapular winging.
Serratus anterior.
Cysts within the _____ notch affect only the infrapspinatu.
Spinoglenoid notch.
With quadrilateral space syndrome, weakness or atrophy of these muscles may be present.
- Teres minor
2. Deltoid
Injury to this nerve for lateral scapular winging.
Spinal accessory.
Wear pattern for glenohumeral osteoarthritis.
Posterior glenoid.
Wear pattern for glenohumeral rheumatoid arthritis.
Central glenoid.
9-10 year old pitch count per game
50 per game
11-12 year old pitch count per game
75 per game
13-14 year old pitch count per game
75 per game
Lateral epicondylitis pathoanatomy.
Microtear at the origin of the ECRB.
Activity modification for lateral epicondylitis (4).
- slower playing surface
- more flexible raquet
- lower string tension
- larger gip
Excessive resection during surgery for lateral epicondylitis may cause this.
Instability due to LCL attachment.
Greatest load to failure of the distal biceps tendon repair techniques.
Endobutton.
Most common complication of single-incision distal biceps repair.
Neuropraxia of lateral antebrachial cutaneous nerve.
Reconstruction of elbow ulnar collateral ligament with these tendon options (2).
- Palmaris longus
2. Hamstring
Reconstruction of elbow medial ulnar collateral ligament in this manner.
Figure-of-eight
Posterolateral rotatory instability.
Lateral ulnar collateral ligament injury.
Little leaguer’s elbow.
Stress fracture of medial epicondyle of elbow.
Most common finger for FDP avulsion.
Ring finger.
Sagittal band rupture in professionals versus amateurs.
Pros – index and long finger
Amateurs – ring and small finger
Radiographic hallmarks of sapholunate ligament injury (3).
- Increased SL interval (>3mm)
- Cortical ring sign
- Increased SL angle on lateral (> 70 deg)
Pavlov ratio (vertebral body to canal ratio) consistent with cervicla stenosis.
less than 0.8
Most common cause of sudden death in young athletes.
Hypertrophic cardiomyopathy.
Cardiac contusion from direct blow to the chest.
Commotio cordis.
These type of murmurs are consistent with hypertrophic cardiomyopathy.
Increase in intensity with valsalva.
Second leading cause of death in football players.
Heat stroke.