Term
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Definition
acceleration->decel resulting in flex->ext
findings are non-radiating non-focal pain, spasm of paraspinal muscles and trap, occipital headaches
these findings hold for CERVICAL SPRAINS in general |
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Term
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Definition
a degenerative disc disease
usually involves bone spurs, protrusions, herniated material. these are more extensive than simple sprains |
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Term
| difference between a myelopathy and a radiculopathy? |
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Definition
a myelopathy will effects the spinal CORD probably resulting in bilateral pathologies. a radiculopathy will impact a single root
if there are long tract signs or bowel and bladder sysfunctions, think myelopathy or cervical stenosis |
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Term
| most common back radiculopathies? |
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Definition
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Term
| the impact of where a disc is herniating |
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Definition
| if it is herniating completely laterally, then it is possible that it may only affect the superior root, if it is semi-laterally, it affects the bottom, if it is medial, it is very serious and affects many inferior roots (cauda equina syndrome) |
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Term
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Definition
| a narrowing of the vertebral formina possible due to herniation or several other causes. the important thing is that it compresses the spinal column |
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Term
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Definition
compression of the cord due to massive central lumbar disc herniation below L2
possibly due to fracture, epidural abscessor herniation |
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Term
| what is the only bony connection which that connects the upper limbs to the rest of the axial skeleton? |
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Definition
| the shoulder girlde by way of the clavicle |
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Term
| describe the onset of rotator cuff disease/impingement syndrome |
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Definition
an impingement begins on the undersurface of the acrominon
the bursa in that area or the intratendonous surface develops edema or hemorrhage (reversible), followed by tendonitis or fibrosis, followed by AC spurs and cuff tears
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Term
| description of calcific tendonitis |
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Definition
may be secondary to teissue hypoxia
very very painful in reabsorptive phase
it looks like chalf or toothpaste or chemical inflammation when substance leaks into the bursa |
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Term
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Definition
seen in occult fractures with little radiographic evidence or in inflammatory processes
there is a light dome of fat around a bone and it is the fat from within the marrow cavity escaping and causing pain |
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Term
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Definition
usually occur with fall on an outstretched arm (foosh); can also occur as a flexion type when one falls on elbow
injuries are often associated with radial, medin, and ulnar nerve injuries, and injuries of the brachial artery |
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Term
| what is a concern of fractures in the forearm that is connected to the fascia surrounding the anterior and posterior? |
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Definition
| compartment syndrome can occur |
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Term
| dequervain's stenosing tenosynovitis |
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Definition
1st dorsal compartment contains abductor pollicis longus and extensor pollicis brevis
extensive friction and irritiation causes problem here, dx'd by finkelsteins |
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Term
| what is a "felon" of the hand |
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Definition
| a closed compartment infection at the pulp of the fingertip |
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Term
what is a paronychia of the hand
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Definition
| an abscess at the end of the finger tip (nail plate) caused by trauma and bacterial inoculum into the soft tissue |
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Term
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Definition
| a cut into the MP joint during a fight which may allow strep viridans or staph aureus into the bursa and cause a systemic infection |
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Term
| how do you arrive at a mallet finger? |
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Definition
disruption of the extensor digitorum insertion followed by flexion of the DIP
the late deformity is known as swan neck |
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Term
| how does a trigger finger work? |
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Definition
a nodule is on the flexor tendon on one side of the A1 pully (tendon sheath)
when it is flexed, it gets pulled through to the other side of the sheath. when it tried to relax, the nodule is now stuck on the other side of the sheath |
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Term
| what is the muscle ability index? |
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Definition
5 - normal with full resistance
4 - complete range against gravity and SOME resistance
3 - complete range against gravity but NOT against resistance
2 - complete range with gravity eliminated
1 - contractibility but NO joint motion
0 - nothing |
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Term
| most common dislocation of the hip? |
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Definition
| posterior dislocations, often from MVAs and dashboard injuries |
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Term
| why are intracapsular fractures of the femur more dangerous? |
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Definition
| blood supply is much less intracapsularly. it is increased extra, the extra has great healing potential for this reason |
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Term
| why are knee dislocations so dangerous? |
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Definition
| because of vascular compromise of the popliteal artery |
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Term
| what is the ankle mortise? |
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Definition
| the fitting of the talus into the groove formed by the tibia and fibula. gapping in the mortise suggests that there may be some interosseous membrane tear. |
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Term
| mechanism of most common ankle fracture? |
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Definition
| external rotation of planted foot, sprains are often incurred with plantar flexion and internal rotation |
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Term
| closed chain movement is? |
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Definition
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Term
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Definition
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Term
| what is the screw home mechanism? |
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Definition
| the internal rotation of the femur on the tibia as the knee goes into extension. the popliteus muscle is what initiates the internal rotation. therefore, when seated, our tibia goes externally when we extend |
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Term
| significant complication seen in lower extremity fractures involving veins? |
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Definition
thromboembolitic disease; can lead to chronic venous insufficiency and to fatal or non-fatal pulmonary emboli
pts develop DVT without mechanical or pharmacologic prophylaxis |
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Term
| acute hematogenous osteomyelitis |
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Definition
begins in metaphysis area, likely because there is a lot of arteriole to venule wrapping around and bad stuff collects (like bacteria); this bad stuff can go through the articular surface, not the growth plate (which is usually a natural barrier to the spread of infection)
usually staph aureus
Hx
A high index of suspicion
Often a history of recent or concurrent infection
Unexpected bone pain
Fever
Swelling and refusal to move or stand on limb
Warmth and tenderness
Swelling of adjacent joint? |
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Term
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Definition
Can develop from osteomyelitis either transepiphyseal or via intra-articular metaphysis (hip, shoulder, elbow, ankle)
Purulent exudate (pus) is chondrolytic therefore surgical drainage is emergent
Treatment beyond 5 days leads to irreversible changes; pus under pressure and compromised blood flow can lead to joint cartilage, epiphyseal bone or growth plate damage |
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Term
| most common cause of acute hip pain in children? |
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Definition
transient (toxic) synovitis
unilateral
needs to be ruled out first to see if the afflicted pt actually has septic arthritis |
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Term
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Definition
congenital hip dysplasia
-dislocation of the hip, mostly female, often due to breech position birth |
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Term
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Definition
| adduction causing poster dislocation |
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Term
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Definition
| abduction, positive with click |
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Term
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Definition
| pt supine with knees up, absence of a nice horizontal line means that one femur is not in its correct place |
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Term
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Definition
Non-inflammatory deformity of the femoral head due to vascular insult leads to osteonecrosis of proximal femoral epiphysis
Usually in boys 4-8 yrs old with mild delayed development
Boy : girl 5:1
In the bony epiphysis,
(1)necrosis of the marrow space and trabecular bone, (2)compression fracture of the trabeculae, (3)fibrovascular granulation tissue invasion and (4)osteoclastic resorption of the necrotic bone |
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Term
| Slipped Capital Femoral Epiphysis (SCFE) |
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Definition
Salter I fracture of proximal femoral physis
Widened growth plate in zone of hypertrophy
This may widen to represent 80% of total growth plate
Histologically, abnormal cartilage maturation, endochondral ossification, and perichondral ring instability occur. This leads to less organization of the normal cartilaginous columnar architecture. Slippage occurs through this weakened area.
LOSS OF HIP INTERNAL ROTATION and FLEXION
happens through zone of HYPERTROPHY |
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Term
| what is the ultimate cause of an overuse injury? |
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Definition
the volume of an activity exceed what the body can manage to repair. Couple be few strenuous actions over someone's ability, or a 1000 small activities that add up to an excess of MICROTRAUMA
the body naturally goes through adaptive changes when exposed to stressors, but injury occurs when the insult outpaces adaptive ability |
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Term
| reactive change progression for overuse injuries (from first to last step) |
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Definition
Early inflammatory phase
Clearing of necrotic tissue
Granulation tissue
Maturation
Scar formation
Secondary calcification
Possible rupture (ligament, tendon, etc.) |
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Term
overuse injury site:
muscle-tendon junction |
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Definition
a force-generating mechanism
shock absorbing mechanism
important things to consider:
range of motion, force-velocity relationship, type of contraction, fiber type |
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Term
overuse injury site:
tendon-bone junction |
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Definition
a site of stress conc.
area of compressive force
tendons and ligaments are not very vascular so they do not heal easily if compromised |
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Term
overuse injury site:
tenosynovitis and bursitis |
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Definition
VULNERABLE AREAS:
SHOULDER (Subacromial)
HIP (Greater trochanter)
KNEE (Pre-patellar, suprapatellar, anserine)
ELBOW (Olecranon)
any confined space like the tendon sheaths of the fingers
mononuclear inflammatory cells will accumulate at site |
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Term
overuse injury site:
muscle overload |
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Definition
gylcogen depletion in runner's muscles; the concept of hard day and easy day alteration was born from this
overdevelopment of internal rotators in swimmers (should always equally exercise agonists and antagonists for a healthy workout) |
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Term
| most common compartments injured by compartment syndrome due to trauma? |
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Definition
| anterior forearm and anterior leg (dorsiflexors) |
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Term
| intrinsic factors leading to overuse injuries |
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Definition
MALALIGNMENT
LIMB LENGTH DISCREPANCY
MUSCULAR IMBALANCE
MUSCULAR INSUFFICIENCY
JOINT INFLEXIBILITY |
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Term
| extrinsic factors leading to overuse injuries |
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Definition
TRAINING ERRORS
SURFACES
ENVIRONMENTAL CONDITIONS
FOOTWEAR AND EQUIPMENT |
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Term
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Definition
| the sciatic nerve is often compressed between the piriformis and the gemellus. counterstrain can actually help a great deal in relieving this pain |
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