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Foundational Science

Common Injuries and more

QuestionAnswer
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
Created by: PT