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Foundational Science
Common Injuries and more
| Question | Answer |
|---|---|
| Fx of clavicle typically occurs? | 2/3 medial and 1/3 laterally |
| An SC jt injury typically occurs after? | AC jt and clavicle |
| What structures are injured with a shoulder separation? | AC jt ligs making it unable which causes pain and dysfunction to shoulder complex |
| What is crutch pasly? | Compression of radial N due to improper use of crutches |
| If suprascapular N is injured from impingement, what impinges it and what results from it? | Transverse scapular lig impinges it causing pain and decr ABD and ER of shoulder. |
| What can result from postural dysfunction? | Impingement of the brachial plexus under the clavicle or pec minor. |
| What are 4 N. that can be injured from a fall causing fx of the humerus? | Radial, Median, Ulnar, and musculocutaneous |
| Injury or laceration to the Brachial Art. can result in? | Volkmans ischemic contracture causing shortening of the flexor muscles. |
| What is the fx of the radius called that is commonly due to a FOOSH? | Colles' fx |
| What compress the median N resutling in CTS? | flexor retinaculum |
| What carpal bone is most frequently fx bone which can result in? | Scaphiod resulting in avascular necrosis |
| Fx of the radiocarpal can cause? | functional problems at the wrist |
| Anterior dislocation of which carpal bone can compress the median N? | Lunate can ant. dislocate compressing N against Flex retinaculum. |
| What fx can cause damage to the radial art in the cubital fossa? | Supracondylar fx of elbow |
| What mm hollows the palm to perform cupping action? If weak or damage can result in? | opponens digit minimi, if damaged unable to drink water from a glass or hold cylindrical objects |
| Median N damage affects what in the wrist and hand? | flexion of the digits on the radial side of the and PRECISION GRIP |
| Radial Ndamage affects what in the wrist and hand | ability to maintain the functional wrist position and to release an object. |
| Ulnar N damagedamage affects what in the wrist and hand | affects flexion of the ulnar digits and POWER GRIP |
| Why are women more susceptible to femur neck fracture and men? | menopause=osteoporosis |
| If femur neck is Fx what art can it disrupt? Which causes? | Obturator Art. resulting in aseptic necrosis |
| Besides the piriformis what other mm can irriitate and compress the sciatic N? | Hamstrings |
| Which art in the LE is vulnerable to injury due to superficial position? | Femoral Art. |
| What is the condition called that affects the underside of the patella from cumulative trauma from repetitive stresses and can be damaged with abnormal alignment of tibia and femur? | patellofemoral syndrome |
| What way are the tibia and femur rotated when placed in the "locking" position? | During open chain ex the lateral rotation of the tibia or closed chain ex medial rotation of femur |
| What lig is generally injured when there is damage to the superior part of tibia when struck with flexion of knee? | PCL- car accident when knee is flexed and hits the dashboard |
| When is the ACL typically torn? | when tibia is driven anteriorly on femur or femur is driven posteriorly on tibia. OR the knee jt is hyperextended with internal rotation of tibia. |
| During CC ex what can cause lateral displacement of patella? | weak VMO, tight ITB or lateral retinaculum: which all can lead to PFS. |
| A severe knee injury can disrupt which art? | popliteal art due to is close proximity to the knee jt |
| Spiral fx of tibia can occur from? | severe torsion of tibia such as in skiing accident |
| Due to tibias poor vasular supply how long can undisplaced fx possible take to heal? | 6 months |
| Violent inversion of the foot may result in? | Avulsion of the tuberosity on the fifth MT bone which is where peroneus brevis inserts at |
| What consists with a trimalleolar fx? | both malleoli and inferior tibia |
| During DF at the talocrural jt what occurs with talus relating to stability and mobility | DF the talus slides posteriorly on tibia wedging into the convex surface and adding jt stability and decr jt stability..... opposite with PF |
| What does a pronated subtalar jt allow in gait? what occurs when supinated? | pronation of ST jt allows the foot to conform to irregular surfaces compared to supination it acts as a rigid lever that allows for propulsion. |
| What way does the tibia rotate with ST jt pronation and supination? | pronation=IR and Supination=ER of tibia |
| In OC movements that mm causes PF and inversion? | post tibialis |
| What is the main function of post tibialis, FDL, and FHL in CC such as midstance in gait? | they control the forward motion of the tibia on the ankle during midstance of gait |
| What mm supports transverse and longitudinal arches and stabilizes first MT during push off? | peroneus longus |
| What 3 mm contract eccentrically to control PF as foot goes from heel strike to flat foot? | ant. tibialis, EDL, EHL |
| What is essential to palpate to R/O intermittent claudication? | dorsalis pedis |
| How can a burst fx occur on the vertebral body? | excessive compression |
| wedge fx of spine results from? | forced flexion of the thoracic or lumbar spine |
| What can cause a teardrop fx of the spine what part of the vertebra do they occur? | compression of the anterior aspect of the vert body |
| How does a facet injury occur? What else is affected? | quick flexion and rotation movement can cause impingment, along with the related spinal N are affected. This can cause pain along the related dermatomes and/or myotomes |
| which mm are commonly strained in back with flexion and rotation movements? | erector spinae |
| What 3 actions does the piriformis affect on the following: 1. when hip is extended and in non WB, 2.when hip is flexed at 90 deg it, 3. in WB the mm resists? | 1. when hip is extended and in non WB piriformis IR. 2.when hip is flexed at 90 deg it abducts the hip 3. in WB the mm resists hip IR |
| What mm injury can have diskogenic radicular sx? | piriformis |
| If absent carotid pulse may indicate? | cardiac arrest |
| If TMJ is not closing properly the disc may displace which way? | anteriorly |
| what causes the TMJ dislocates anteriorly? | yawning or taking a bit or contraction of the lateral pterygiod mm |
| Siatic N list the following: spinal cord segments? MM innervation, sensory innervation and loss of function with which mm | L4-S3 it innervates hams and adductor mag, the sensory is post/lat of calf, ankle and heel. If injured loss of knee flexion, weak hip add, and loss of all mm below the knee |
| Femoral N list the following: spinal cord segments? MM innervation, sensory innervation and loss of function with which mm | spinal cord seg: L2-4, muscle innervation: sartorius, quads, and pectinus. Sensory middle ant thigh and medial thigh prox to knee. If injured loss of hip flexion and knee ext |
| Tibial N list the following: spinal cord segments? MM innervation, sensory innervation and loss of function with which mm | Spinal cord seg: L4-S3, MM inn: GS, plantaris, popliteus and post tibialis. Sensory: post/lat calf and ankle. Loss of PF and Supination |
| Superficial peroneal N list the following: spinal cord segments? MM innervation, sensory innervation and loss of function with which mm | Spinal cord: L5-S2, MM inn: peroneus lonus and brevis, sensory: ant/lat distal lower leg/ankle and dorsum of foot. Loss of Eversion |
| Deep peroneal N list the following: spinal cord segements? MM innervation, sensory innervation and loss of function with which mm | Spinal seg: L4-S2, MM inn: tibialis antm EHL, EDL, peroneus tertius, 1st/2nd interossei, EDB, EHB. If injured: loss of DF and weakness of intrinsic mm of foot |
| If platelet count is too low or pt is on anticoagulant therapy what may appear? | Ecchymosis |
| What is indolent? | a long-standing painless wound that is very slow healing and has characteristics of VENOUS insufficiency ulcer. |
| WHat is induration? | hardening of the skin around an ulcer occurs with PRESSURE SORES or VENOUS ULCERS |
| AIDS what are some opportunistic infections? | pneumocystis carinii, secondary CA, salmonella, neuropathies, meningitis |
| What can cause HIV to progress into full AIDS? | T cells less than 250 and high viral load |
| Cellulitis-differential dx characteristics? | skin over area is hot, red, edematous and resembling the skin of an orange. |
| Cellulitis Rx? | Antibiotics, elevation and cool wet dressing applied |
| What is a superfical inflammation of the skin characterized by vesicles(when acute) redness, edema, oozing, crusting, scaling, usually itchy? | Dermatistis |
| DVT-differential dx characteristics? | skin appears cyanotic, warm, cool, or normal temp. Pain, tenderness or swelling, POSITIVE venogram. postive Homens(has poor sensitivity don't rely on this test alone) |
| DVT-Rx? | bed rest, hospitalization, foot of bed ELEVATED 6 INCHES and anticoagulant |
| Hemophilia What is it? | Bleeding disorder has to do with clotting factor deficiency |
| Hemophilia complications with other systems? Rx? | hemarthoses, jt contractures, muscle weakness, decr aerobic-fitness, postural scoliosis and gait deviations. Rx: blood infusions. meds for pain, rest ice elevation during acute. Subacute and chronic: exercise and conditioning |
| Hepatitis-differential dx characteristics? | elevated lab values of hepatic transaminases, bilirubin and enlarged liver with tenderness, fever and jaundice |
| Herpes Zoster what is it and characteristics | Acute CNS viral infection involving dorsal root ganglia. Characteristics: vesicular erupton and neurolgic pain in the cutaneous areas that are supplied by sensory nerves along the dermatomes and myotomes |
| Herpes Zoster Rx: | if given early corticosteriods may relieve the pain and prevent or reduce post-herpetic pain in severe cases. |
| Intermittent Claudication what is it? Differential dx? | Sx of arterial insuff resutls in ischemia to ex muscle. DD: Peripherial pulses weak or absent with bruits heard via stethoscope. Limb elevation will result in pallor and the depend position will cause rubor. BP measurements are decr. |
| Intermittent Claudication Rx? How is progress measured? | walking program can help improve collateral circulation and should be done 5-6x/wk for short durations(upto 20mins)to control pain level. Progress is measuref by using arterial BP readings, doppler US over a course of time. |
| Lyme Disease Differential Dx? | "bulls eye" round rash and flu-like sx. Later can develop into arthritis (usually knees), neurolgical disorders such as neuritis, ataxia, or meningitis and cardiac abnormalities |
| Psoriasis-what is it? Diff Dx? | A chronic skin disease with erythematous plaques cover with slivery scale. common on the scalp, knees, elbos and genitalia. DD: precipitating factors such as trauma, infection, pregnancy, cold weather, smoking, anxiety, and stress. |
| Psoriasis blood test? Rx? | Blood tests: Rheumatoid factor neg, and x-ray positive. Rx long wave UV light. Combo of UV light with oral photosenisitizing drug such as psoralen |
| Scleroderma what is it? | a chronic diffuse connective tissue causing fibrosis of skin, joints, blood vessels, and internal organs. Accompanied by Raynaud's phenomenon |
| Scleroderma DD? Rx? | Symmetrical induration of distal extremeties and face. Skin is taut, firm, edematous and firmly bound to subcutaneous layer. Rx:supportive therapy such as meds. If contractures occur treated through stretching |
| Pt with vascular or cardiac disease should refrain from which type of exercises/contractions? Which causes? | isometric due to the sharp rise in blood pressure and workload on heart. Valsalva should be avoided also! |
| Which type of ex/contraction causes incr soreness? | eccentric contractions |
| What occurs with the cardio/pulm sys with aerobic ex? | Cardiac: resting & submax HR decr, SBP/DBP decr at rest and during submax ex, CO & SV are incr. Pulm: TV incr, vent rate decr during submax ex and O2 extraction from blood is incr. |
| What temp should rehab water be? | 91-93 degrees |
| Cardio/pulm responses to water immersion at rest and ex | SV & CO incr, HR remains the same or slightly lower |
| Hydrostatic pressure on chest results in? | incr resistance to chest expansion, IRV and FVC are reduced.....PROBLEM for pt with reduced lung capacity or breathing issues |
| When should THR be established during aquatic therapy? | In the pool due to lower HR during deep water ex compared to land |
| Erythrocyte sedimentation rate: which type of drugs can alter this? What dx is ESR increased? | Anticoagulant. RA this is incr |
| Creatine when is it incr? | kidney disease |
| Albumin indicative of what disorder is abnormal? how can it relate to marathon runners? When are these levels decr? | indicative of renal disorder. Runners: proteinuria. Albumin is decr with burn injuries. |
| WHen is gamma globulin incr? | pt with MS |
| Hematocrit if low pt may have a prob with? | aerobic ex. |
| anticholinergic drugs are used for? list 3? S/E? Toxicity signs? | Parkinson's decr tremor and mm spasms. benstropine(cogentin), oxybutynin (ditropan) and artane are three types. S/E: dry skin, no sweating, palpations, mental status change. Toxicity: pt may describe self as "hot, dry, mad" |
| Cardiac meds: list general S/E | angina, arrhythmia, orthostatic hypotension. Beta blockers are often culprit |
| Pulm meds gen S/E? | resp depression (opiates), brochospasms (beta blockers) pulm infiltrates from CA chemotherapy. |
| What OTC painkiller can cause tinnitus or decr hearing? | Aspirin |
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