Sprains Flashcards
What is gait?
refereed to as walking
you need how many degrees of flexion during the swing phase?
60 degrees
when maximally hyper extend you need up to how many degrees at heel off?
10 degrees
with the screw home mechanism, what happens to the tibial?
ER
if the knee doesn’t reach full extension what happens to the ankle?
it becomes hypermobile
SN; THE HIP WILL NOT COMPENSATE BC IT NEEDS TO IR WHEN KNEE ER AT THE HEEL
Descending from stairs you need how many degrees of flexion
90 degrees, but may need up to 120 degrees of flexion
Doing a sit-to-stand from a toilet or chair you need how many degrees of flexion?
105 degrees of flexion
How many degrees of flexion for cycling do you need?
120 degrees
what is the goal with a total knee arthroplasty?
120 degrees of flexion
when kneeling and going into a deep squat you need?
full flexion and arthrokinematic from 120-150 degrees of flexion
going into a squat the femoral will?
ER, posterior glide, and lateral glide
anything of the motions sound different.
Knee flexion the tibia is?
IR
knee extension the tibia is?
ER
what is a sprain?
stretching or tearing of a ligament
Stretching or tearing of a ligament may lead to what?
joint laxity and dysfunction
what is increased accessory motion and inadequate neuromuscular function
joint instability
what is functional instability?
able to offset laxity through neuromuscular function
what is mechanical instability?
unable to offset laxity and likely requires surgery
mild S&S, activity may continue, fibers are stretched but NOT torn so minimal to no change during ligamentous special test
Grade 1- 1st degree sprain
Moderate S&S, activity stops, fibers stretched and torn so increased laxity with softer late empty end feel during ligamentous test
Grade 2-2nd degree sprain
Severe S&S, Activity stops; fibers torn completely with possible avulsion, significant increased in laxity with empty end feels during ligamentous tests
Grade 3-3rd degree sprain
Ligaments and capsule
-dense connective tissue
-type 1 collagen-resist tension
-low elastin, better joint stabilization
-fibrocytes
Ligament are more multi-directional fibers than tendons
mid substance area of a ligament is
hypovascular
hyponeural
the insertional end of the ligament is?
-Hypervascular: high metabolic activity for greater healing capacity
Hyperneural: for proprioception or position sense
Extraarticular (exterior to the joint)
Blend with capsule and often heals without surgery.
Intraarticular
within the joint space
often needs surgery for repair due to dilution from synovial fluid
SN; ACL and PCL
What are the symptoms of a sprain?
Traumatic onset
swelling
likely reduce function
what are observations of a sprain?
Antalgic and asymmetrical gait
swollen joint
Sprain observations
ROM: likely impaired and painful(not all directions)
Resisted/MMT: possibly weak and painful
Combined Motions: likely inconsistent blocks
Stress tests: distraction positive, compression relief
Palpation TTP
Healing of sprains
Initial tensile strength at 3-5 weeks
Dense connective tissue by 12 weeks
10 to 12 months to normal strength postoperatively
what should be some ultimate purpose needing to be achieved following a sprain?
Tissue proliferation and integrity and stabilization.
Distinctive RX of a sprain
Policed
assistive device and external support
protecting ligament in shortened position for better long term stability.
MET primarily for sprains?
tissue proliferation and integrity and stabilization
