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Ortho > Sports Medicine > Flashcards

Sports Medicine Flashcards

1
Q

Define Sports Medicine

A

Treatment & prevention of injuries related to sports activities

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2
Q

Non-Orthopedic Conditions Seen by Sports Medicine Providers

A 
ID: dermatology
DM
Exercise induced issues
Concussions
Pre-participation assessment
Female triad
Psychology: athlete, parent, coach
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3
Q

Female Triad

A

Eating disorders
Amenorrhea
Osteoporosis

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4
Q

Shoulder Injuries

A

Rotator cuff disease
Degeneration
Instability
Biceps & SLAP tears

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5
Q

Elbow Injuries

A

Medial pain issues

Lateral pain issues

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6
Q

Knee Injuries

A 
ACL
PCL
MCL
LCL
Meniscus
Articular cartilage
Anterior knee pain
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7
Q

Foot & Ankle Injuries

A

Sprains

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8
Q

Risk Factors for Rotator Cuff Injuries

A

Trauma

Repetitive overuse

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9
Q

What tendons are more difficult to repair due to a degenerative tendon?

A

Rotator cuff

Achilles

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10
Q

Non-Operative Treatment of Sports Injuries

A 
Reduce inflammation
Activity shutdown
NSAIDs
Sub-acromial injection
Modalities
PT: ROM & strength
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11
Q

Surgical Options for Rotator Cuff Tears

A

Open repair
Mini-open repair
Arthroscopic repair

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12
Q

Post-Op Course for Rotator Cuff Tears

A 
Sling: 6 weeks
Rehab: 3 months
Golf: 4-5 months
Tennis: 6 months
Swimming: 7-8 months
Full recovery: 1 year
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13
Q

What muscle performs the first 30 degrees of abduction of the arm?

A

Supraspinatus

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14
Q

How does a reverse prosthesis work?

A

Switches abduction force from the supraspinatus to the deltoid

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15
Q

Treatment of Early or Moderate Shoulder Arthritis

A 
Activity modification
NSAIDs
Steroid injections
PT??
Arthroscopy??
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16
Q

Treatment of Severe Shoulder Arthritis

A

Shoulder replacement

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17
Q

Results of Total Shoulder Replacement if a Good Rotator Cuff

A

3% failure
Predictable pain relief
Excellent function

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18
Q

Treatment of First Shoulder Dislocation

A

Reduction: x-ray
Immediate: external rotation brace
Surgical

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19
Q

Pro’s of Open Instability Treatment

A

Higher success rate
Better in ligamentously laxity
Glenoid reconstruction possible

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20
Q

Con’s of Op Instability Treatment

A

Risk of over tightening

Painful post-op

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21
Q

Reasons for Outlet Impingement of the Shoulder

A

Acromion shape/slope
AC joint enlargement
Cuff & biceps problems

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22
Q

Important History for Biceps Disease

A 
Age
Occupation
Injury
Activities
Handedness (R/L)
Chief complaint
Pain: location, duration
Weakness
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23
Q

Biceps Disease Physical Exam Tests

A 
Speed's
Yergason's
Hawkin's
Neer's
Belly press
Lift-off test
Bear hug
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24
Q

Diagnostic Imaging for Biceps Disease

A

MRI: biceps

US

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25
Q

Non-Operative Management of Biceps Disease

A

Rest
NSAIDs
PT: rotator cuff strengthening
Injections

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26
Q

Surgical (Tenotomy or Tenodesis) Indications for Biceps Disease

A

Subluxation or dislocation of biceps
>25% tear
Significant inflammation, atrophy, hypertrophy
Irreparable rotator cuff tear

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27
Q

Tenotomy vs. Tenodesis

A

Tenotomy: elderly, easier rehab, revision
Tenodesis: less than 50, cosmetic/strength

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28
Q

Important History for SLAP Tears

A 
Age
Occupation
Injury
Activities
Handedness (R/L)
Chief complaint: instability, pain (location, duration), weakness, mechanical symptoms
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29
Q

SLAP Tear Tests

A

O’brien’s test

Crank test

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30
Q

Non-Operative Management of SLAP Lesions

A

Rest
NSAIDs
PT x 3 months
Throwing program

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31
Q

Indications for SLAP Repairs

A 
Young patient (less than 40)
Mechanical symptoms
Associated instability, internal impingement, acute rotator cuff tear
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32
Q

Contraindications for SLAP Repairs

A

Elderly: tenotomy
Frozen shoulder
Anatomic variant
Chronic rotator cuff tear

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33
Q

Conditions with Medial Elbow Pain

A 
Medial epicondylitis
Ulnar neuropathy
Flexor pronator strain
Zpronator syndrome
Medial ulnar collateral ligament
Olecrenon stress fracture
34
Q

Conditions with Lateral Elbow Pain

A

Lateral epicondylitis
Radial tunnel syndrome
Lateral ulnar collateral ligament
Capitellar OCD

35
Q

Reason for Lateral Epicondylitis

A

Overuse injury involving eccentric overload at origin of common extensor tendons
Repetitive pronation/supination with elbow extended

36
Q

Presentation of Lateral Epicondylitis

A

Pain with resisted wrist extension, gripping

37
Q

Treatment of Lateral Epicondylitis

A 
Ice
NSAIDs
Rest
Ultrasound
Larger racket grip
38
Q

Lateral Epicondylitis & Injections

A

Some benefit

No indication for PRP

39
Q

Medial Collateral Ligament Complex

A

Anterior bundle
Posterior bundle
Transverse portion

40
Q

Treatment for Medial Collateral Ligament Tear

A

Rest
Ice
NSAIDs
Throwing program x 3 months

41
Q

Parts of a Throwing Program

A

Short toss
Long toss
Mound

42
Q

Reasons for an ACL Injury

A 
Sudden deceleration
Twist
Pivot
Cut
Clipping/pile-up
Backward fall skiing
43
Q

Surgery for ACL Injuries

A

Reconstruction

Due to synovial environment

44
Q

Reconstruction Tendon Options for an ACL Repair

A

Patella tendon
Hamstring tendon
Quadriceps tendon
Allograft tendon

45
Q

Conditions with Anterior Knee Pain

A

Patello-femoral pain
Quadricep or patellar tendon pain
Osgood Schlatters’ disease

46
Q

Treatment for Anterior Knee Pain

A

Rehab
Brace
Surgery

47
Q

Age Groups for Osgood Schlatter’s Disease

A

Boys: 12-15
Girls: 8-12

48
Q

Presentation of Osgood Schlatter’s Disease

A

Pain at anterior aspect
Worse with kneeling
Tender over enlarged tubercle
Worse with resisted extension

49
Q

Treatment of Osgood Schlatter’s Disease

A 
NSAIDs
Rest
Ice
Activity modification
Quad/Hamstring strengthening
Cast: severe
50
Q

Lateral Ankle Ligament Complex

A

Anterior talofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament

51
Q

Medial ligament injuries result from what?

A

Ankle external rotation

Ankle eversion

52
Q

Positions in the Ankle that Provide Little Bony Stability

A

Plantar flexion

Inversion

53
Q

Predictable Pattern of Ankle Ligament Tears

A

Anterior tibiofibular ligament
calcaneofibular ligament
Posterior tibiofibular ligament

54
Q

Risk Factors for Inversion Injuries

A

Tight Achilles tendon
Varus hindfoot
Limited subtalar motion

55
Q

Testing for Ankle Instability

A

Anterior drawar test

Talar tilt test

56
Q

Describe Talar Tilt Test

A

Ankle in neutral to place stress on CFL
Apply varus stress
Must block subtalar motion

57
Q

Diagnostic Tests for Lateral Ankle Injuries

A 
X-rays: palpable pain on bony areas
MRI: chronic pain
Radiographic stress test
Radiographic anterior drawer: >4 mm abnormal
Radiographic talar tilt: >6 mm abnormal
58
Q

Treatment of Grade I and II Ankle Sprains

A

Early weight bearing & ROM show less pain, less atrophy, & earlier return to activities

59
Q

Treatment of Grade III Ankle Sprains

A

Controversial
Early mobilization
Cast immobilization
Primary surgery

60
Q

When may reconstruction be indicated with chronic ankle instability?

A

Failure of rehab program of proprioception, muscle strengthening & Achilles stretching

61
Q

Ankle Sprains are a Combination of

A

Mechanical instability

Functional instability

62
Q

What does mechanical instability include?

A

Ankle mobility

63
Q

What does functional instability include?

A

Feeling of ankle giving way

64
Q

Mechanism of Injury for Syndesmotic Injuries (High Ankle Sprains)

A

External rotation

Dorsiflexion

65
Q

3 Ligaments that Unite the Distal Tibia-Fibula

A

Anterior tibiofibular
Posterior tibiofibular
Interosseous

66
Q

Diagnosing Syndesmotic Injuries

A

Tender over anterior syndesmosis
Tenderness at proximal fibula
Compression squeeze test
External rotation test

67
Q

Compression Squeeze Test for Syndesmotic Injuries

A

Squeeze at mid-calf

Will cause pain at anterior syndesmosis

68
Q

Treatment of Syndesmotic Injuries

A

Boot or walking cast 2-4 weeks
Rehab
Widening noted: surgery

69
Q

Recovery for Surgical Repair of Syndesmotic Injuries

A

Non-weight bearing cast: 4 weeks
Weight bearing immobilization: 4 weeks
Screw removal: 10-12 weeks

70
Q

Sequelae of Persistently Painful Sprained Ankles

A 
Vague pain
Feeling of giving way
Problems walking on uneven surfaces
Swelling
Stiffness
Locking
71
Q

Define Stress Fracture

A

Fatigue induce fracture of the bone caused by repeated stress over time

72
Q

Most Common Bones for Stress Fractures

A

Tibia
Metatarsals
Navicular
Femoral

73
Q

Etiology of Stress Fractures

A

Osteoblasts overwhelmed
Bone & muscles serve as shock absorbers to stress
Muscles fatigue- bone may be taxed
Female triad

74
Q

Presentation of Stress Fractures

A

Pain with weight bearing that increases with exercise or activity
Resides with rest
Localized tenderness
Generalized swelling

75
Q

Diagnosis of Stress Fractures

A

X-rays: may take 10-14 days
MRI
Bone scan

76
Q

Treatment of Stress Fractures

A

Rest
Unloading of stress area: boot, crutches
Gradual return to activities
Don’t respond: surgery

77
Q

Prevention of Stress Fractures

A 
Gradual ramp up of loading activities
Strengthening of muscles
Replace shoes every 300-500 miles
Increase calcium & vitamin D
Address female triad
78
Q

Treatment of Tibial Stress Fractures

A

Activity restriction
Protected weight bearing
IM nail: rare

79
Q

Diagnosis of Femoral Neck Stress Fracture

A

MRI

80
Q

What type of femoral neck stress fracture requires surgical treatment?

A

Tension side

Superior-lateral

81
Q

Other Overuse Injuries

A 
Little league elbow
Rotator cuff tendinitis
Greater trochanteric bursitis
IT band tendinitis
Hamstring tendonitis

Ortho (22 decks)

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