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rheumatology > sports medicine > Flashcards

sports medicine Flashcards

1
Q

spine tackler’s spine

what are the three anatomic features?

A

Anatomic features
Loss of cervical lordosis
Cervical stenosis
Arthritic changes

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2
Q

stinger symptoms? (4)

A

Stinging/burning or electric shock sensation
Arm numbness or weakness
Sensation of warmth
C-5 most common

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3
Q

c-spine fracture dislocation.

mechanism?

most common levels?

A

Mechanism
Axial load most common

Most common levels
C5-6 most common
C4-5, C6-7 next

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4
Q

Lower Thoracic Spine Compression Fracture

mechanism?

A

Mechanism
Axial load
Fall

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5
Q

Lumbar Spine: Stress Fracture of Pars

which two symptoms?

A

Symptoms
Pain LB
Rare neuro sx

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6
Q

which condition?

which two symptoms

A

ruptured lumbar disk

Symptoms
Pain down leg
Neuro sx

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7
Q

what are 5 shoulder injuries?

A

Rotator cuff
Instability
Labral tears
AC separations
Clavicle fractures

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8
Q

what are four elbow injuries?

A

OCD capitellum
Elbow dislocation
Biceps tendon rupture
UCL injuries

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9
Q

what are four wrist/hand injuries?

A

Waist fracture
Scaphoid fracture
Metacarpal fracture
PIP dislocations
Jersey finger
Mallet finger

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10
Q

rotator cuff: what does the empty can test teset?

A

Empty can test (supraspinatus)

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11
Q

rotator cuff: what does the external rotation tesst?

A

External rotation
Stress test
Lag sign
Pseudoparalysis

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12
Q

what are two posterior shoulder instability injuries?

A

Posterior Bankart lesion

PHAGL lesion

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13
Q

tests used in physical exam of SLAP tear? (3)

A

O’Brien

speed

jobe

tests have high sensitivity; low specificifty

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14
Q

acromioclavicular joint separation.

which types are treated with surgery? which types are non-operative

A

type I-III = non operative

type IV-VI: tx w/surgery

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15
Q

osteochondritis dissecans of capitellum.

note the loose body.

what is the etiology?

which age group affected most?

which gender?

A

Unclear
Articular forces during throwing
Compressive loads
Excessive axial loading (gymnasts, weight lifters)
Primarily 10-15 years of age
85% males

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16
Q

osteochondritis dissecans of capitellum.

what are three symptoms of the condiiton?

what does the loose body lead to?

A

Dull, poorly localized elbow pain
Aggravated with use, relieved with rest
Loose body —->catching, locking of elbow

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17
Q

how to do you tx OCD capitellum?

non operative?

operative?

A

Nonoperative
Activity limitation, RICE(rest, ice,compression, elevation)
Physical therapy

Operative

Arthroscopic excision of loose body
Arthroscopic abrasion chondroplasty/drilling
Fixation of loose body
Osteochondral grafts
Radial head excision

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18
Q

elbow dislocation

A
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19
Q

is a proximal bicpes tendon rupture serious? what does the muscle look like?

A

not serious; you get the pop eye muscle:

mostly cosmetic. the corachobrachialis and brachialis continue to support flexion so decreased range of motion loss; often after biceps tendonitis.

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20
Q

distal bicepts tendon rupture. What is affected? what are the two funcitonal defecits?

A

functinonal defecits: elbow flexion and forearm rotation

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21
Q

all the following describe which type of injury?

Pain, tenderness inner side of elbow, especially when throwing
Swelling and bruising at inner elbow
Inability throw at full speed, loss of control
Elbow stiffness
Numbness/tingling in ring and little fingers
Clumsiness/weakness of hand grip

A

ulnar collateral ligament injuries

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22
Q

what is the main component of the UCL?

A

anterior bundle

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23
Q

how do you treat a UCL injury?

A

Tommy John procedure (ulnar collateral ligament is replaced by another ligament from the body)

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24
Q

what is the CC for a scaphoid structure?

A

wrist pain; will look normal on X-ray, but will present w/pain and swelling of wrist in anatomical snuffbox. you want to immoblize these patients and have them come back for xray in 1-2 weeks

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25
Q

t/f. the scapohid is a dificult bone to heal; you want to immoblize pts for 8-12 weeks.

A

true

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26
Q

a fourth metacarpal fructure is also known as a _______

A

boxer’s fracture

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27
Q

PIP joint dislocation. how would to tx this?

A

increase deformity and pop it back in.

28
Q

a fourth metarcarpal fracture is also known as a ______

A

boxer’s fracture

29
Q

what results from evulsion of the flexor digitorum profundus insertion—> inability to flex the DIP+ pain in the tendon

A

jersey finger ( felxor tendon injury)

30
Q

the mallet finger is what type of injury?

A

extensor tendon injury

31
Q

what are three hip/pelvis injuries?

A

avulsion fractures

labral tears

quadriceps/hamstring tears

32
Q

what are 5 knee/leg injuries?

A

meniscal injury

ligament injury

patellar instability

quadriceps/patellar tendon ruptures

OCD

33
Q

what are 4 foot/ankle injuries/

A

sprains

5th metatarsal fractures

lisfranc injuries

turf toe

achilles tendon rupture

34
Q
A

common sites for pelvic avulsion fractures.

avulsion = injury in which body part is forcibly detached from its normal point of insertion

35
Q

what causes pelvic avulsion fractures?

who is at risk?

presentation?

what are the three most common sites?

A

Strong muscular contraction during sports activities
Skeletally immature patients
Pain and popping sensation at site of fracture
Most common sites: ASIS, AIIS, IT(ischial tuberosity)

36
Q

what are the surgical and non surgical tx for pelvic avulsion fractures?

A

Nonoperative: rest, activity limitation, rehab
Operative: reattachment of tendon

37
Q

what are three symptoms of a labral tear?

A

Symptoms
Groin pain
Clicking/snapping of hip
Limited motion of hip joint

38
Q

what are the three femoroacetabular impingment injuries?

A

Cam lesion (mass at neck of femur)

pincer lesion ( osteophytic bud on os coxae adjacent to acetabulum)

combined lesion (premature arthritis of hip)

39
Q

what is the most common quadriceps/hamstring injury

what would you give to rich ppl with injury?

A

superficial rectus

platelet rich plasma

40
Q

what are the 5 types of menical injuries

A

longitudinal; bucket handle; flap; transverse; torn horn

41
Q

what are the three tx options for meniscal injury?

A

nonoperative

repair

remove

42
Q

what are the four main kneee ligaments?

A

anterior cruciate

posterior cruciate

medial collateral

lateral collateral

43
Q

etiology of ACL inury

what accounts for 70% of inury?

what is another mech of inury?

80% of ACL injury are _____ related

A

Noncontact deceleration, jumping, or cutting action (70%)
Other mechanism includes external forces applied to knee (MCL)
80% sports related

44
Q

ACL injury.

how to pts describe knee?

what do they hear/feel?

how to the patients present?

do they get hemarthrosis?

A

Patients often describe knee being hyperextended
70% hear / feel pop
Knee seems to pop out of joint and then reduce
Fall to ground, walking difficult
Knee swells within few hours - hemarthrosis

45
Q

ACL injury:

which gender is more prone to ACL injury?

what are some extrinsic causes of ACL injury? intrinsic(4) ?

A

Female gender 2-4 X increased incidence in basketball, soccer, rugby, and volleyball

Extrinsic causes – body movement, muscle strength

Intrinsic causes – joint laxity, hormonal influences, limb alignment, notch dimensions, ligament size

46
Q

know: what is the most sensitive test for ACL injury? how do you perform it?

what is the pivot shift?

A
  • *_Lachman test most sensitive (95%): _**
    1. Increased excursion relative to opposite knee
    2. Lack of firm end point
  1. basically hoold femur still and anteriorly accelerate tibia.

Pivot shift
Relaxed patient
Intact MCL
Reproduces pathologic motion

47
Q

what is the most accurate test for an ACL injury?

how should this test be perfomed in order to catch the entire ACL in one frame?

what does it identify?

which bone bruises are classic for this injury?

A

MRI 95%-100% accurate
Non-orthogonal plane – knee external rotated 15°
Usually catches entire ACL in one frame
Identify associated meniscal/chondral injuries, collateral ligaments
Bone bruises – LFC(lateral femoral condyle) (mid 1/3), LTP(posteolateral part of tibial plateau) (post 1/3)

48
Q

how do you tx ACL injuries? waht does this depend on?

A

Nonoperative: low demand pts w/less laxity

operative: higher demand, active pts (reduces incidences of chonral and meniscal injury)

49
Q

Is a PCL injury more or less common than an ACL inury?

what is the mechanism of a PCL injury?

what is a sign of PCL injury?

how do you tx PCL?

A

Much less common than ACL injury

**Mechanism: **
Direct blow to the tibia (dashboard injury)
Fall on flexed knee
Hyperextension
sign: Posterior sag

  • *Treatment**
  • *Nonoperative:** PRICE(protection, rest, ice, compression,elevation) immobilization, rehab
  • *Operative:** arthroscopic reconstruction
50
Q

is MCL or LCL injured more often?

what are LCL injuries associated with?

what is the mechanism of injury?

A
  • *MCL injured more often than LCL**
  • *LCL usually associated with other injuries**
  • *Mech**: Direct (MCL) or outwards (LCL)
  • *Mech:** Noncontact: pivoting, awkward landing, sliding into base
51
Q

how do you tx MCL injuries?

A

Treatment – usually non-operative unless associated with other ligament injuries

52
Q

multi-ligament knee dislocations:

High velocity: what causes?

low velocity: cause?

ultra-low velocity: cause?

A

**High-velocity: **MVA, Falls > 5 feet

**Low-velocity: **Sports, Falls < 5 feet

**Ultra-low velocity: **ADL, obese

Multiple ligament repair/reconstruction procedures

53
Q

which nerve is most prone to damage in knee dislocation?

wihch artery?

what happens if there is an 8 hour delay in revascularization?

A

Peroneal nerve injury in ~26% (1%-40%); half result in permanent neurologic deficit

Popliteal artery injury in ~24%
86% amputation rate for revascularization > 8 hours

54
Q

timing of knee dislocation surgery?

A

Immediate (within 10-14 days) (try to get tissues b4 they reorganize; anatomy more easily recognized)

if you chose delayed surgehry, you will need to reconstruct ligaments

55
Q

patellar instabilty

what is it?

what does it present with?

how do you tx?

A

Patellar dislocation
Patellar apprehension sign

**tx: **Nonoperative treatment

**Operative treatment
 Fulkerson osteotomy(patella stabilization)
 MPFL(medial patellofemoral) reconstruction**
56
Q
A
57
Q

most common ages for quadriceps/patellar tendon injury

A

20s - achilles tendon

30s - patella tendon

40s - quad tendon tear

58
Q

what are three causes of osteochondral injuries of the knee?

what are 5 symptoms of osteochondral injuries of the knee?

A

cause: vascular, traumatic, genetic
symptoms: pain, joint popping/locking, joint weakness, decreased ROM, swelling and tenderness

59
Q

what are three tx option sfor osteochondritis dessicans of the knee?

A

microfracture, fixation of fragment, and OATS(transfer plug of bone to injured site)

60
Q

ankle sprains: what is the most common injury?

what type of injury is known as a high ankle sprain?

A 
Lateral ligament (inversion) injury most common --\> most heal with rest and immobilization 
 Syndesmosis (high ankle) sprain--\> long time to heal; may need surgery
61
Q

what are the nonoperative tx of ankle strains?

operative?

A

Nonperative treatment
Boot, corset, physical therapy

Operative treatment
Lateral ligament reconstruction
Fixation of syndesmosis

62
Q

what are the three 5th metatarsal fractures?

A

Jones fracture - at the metaphyseal/diaphyseal juction(hard to tx–> often fixed with screw)

pseudo -Jones fracture - roll ankle/invert foot –>evulsion type fracture where peroneus brevis attaches

stress fracture

63
Q

what are lisfranc injuries?

A

mid-foot injuries located at the tarsal-metarsal joints. mid-fooot injuries due to axial load. very subtle changes at base of foot.

64
Q

describe mech of turf toe?

A

hyperdorsiflex big toe and tear plantar plate. this injury takes player out for several weeks

65
Q

what is described below?

Pop or snap, followed by sharp pain
Swelling near heel
Inability to stand on toes
Inability to push off with injured leg
Peak age 30-40 years

A

achilles tendon tear

66
Q

what is the thompson test used for?

A

to dx diagnose achilles tendon tear:

  1. squeeze gastroc and if foot plantarflexes –> achilles tendon intact; if nothing happens –> achilles tendon tearted
67
Q

how do you tx achilles tendon tear?

A

open repair

percutaneous repair

rheumatology (5 decks)

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