HK 302 exam 1 pathology

SI joint pain/ dysfunction signs and symptoms

- difficulty with sit to stand after prolonged sitting

- tenderness/tight in musculature and sacrotuberous ligament

SI joint pain management

ice, NSAIDs (anti-inflammatory drugs)

- rehabilitation for flexibility of near muscles and spinal stabilization.

total hip replacement

- cant flex past 90 degrees

- should avoid internal rotation

sports hernia

hip adductor or rectus obdominus avulsion (torn) from pubic rami

another name for sports hernia

athletic pubalgia (pubic bone)

trendelenburg gait

weakness in gluteus medius

trendenburg gait leads to

- uncompensated pattern with opposite hip drop

- compensated pattern with same side trunk lean

piriformis genetic differences

superficial to sciatic nerve

- can cause pain if tight

- 20% of people's sciatic nerve goes through piriformis muscle

piriformis syndrome

- numbness and tingling down leg

- more common in females than males

- radiating pain distally

syndrome

a group of symptoms that reflect a disease

piriformis syndrome treatment

- rehabilitation

- medication

- surgery in extreme situation

- easier to prevent than to treat

role of lateral hip rotators at knee and foot

control of internal and external rotation at the hip will impact the amount of varus and valgus stress at the knee

weak lateral rotators commonly allow

internal rotation

hamstring strain

- strain or tear to the tendons or large muscles at the back of the thigh

- ecchymosis - bleeding under skin

IT band friction syndrome

IT band crosses over lateral femoral epicondyle reatedly when the knee flexes

IT band friction syndrome pain

1-2 cm above knee and most painful at 20-30 degrees flexed where it passes over the epicondyle

IT band friction syndrome is caused by

training errors while running, lacking flexibility, abnormal foot mechanics

MCL injury

valgus knee force

- foot on ground and collapse inward

- knee rolled on

MCL injury recovery

non-surgical if injured in isolation

- miss 1-2 weeks or up to three months

MCL injury recovery time

depends on location of injury

- ends could have avulsion

middle heals faster

ACL injury

- overall rare injury - 1-2% of athletes per year

- loud pop immediate effusion

- 80% can't continue

effusion

swelling in joint

ACL injury repair

usually surgery required to reconstruct knee

- 6-12 months

ACL injury mechanism

plant twist POP

patella dislocation

- usually laterally because of femur anatomy

- young patients

patella dislocation symptoms

painful, immediate swelling

- recurrent problems

patella dislocation repair

surgical correction or activity modification

dislocation

articulating surfaces are not touching

subluxation

partly touching but not correct placement

reduce

put something back into place

medial meniscectomy

meniscus removal

- can be done with camera?

total knee replacement

no cruciate ligaments left - make space for prostheses

tibia/fibula fracture

- rare

- usually rod and pins

fracture

skin intact

comound facture

skin pierced

maisonneuve fracture

- rare

- high ankle sprain that tears syndesmosis

- fractures proximal fibula - sometimes missed in eval

maisonneuve type of fracture

spiral fracture of proximal fibula and torn syndesmosis

- fracture of medial malleolus

- talus rotates and tears tibia and fibula apart

ankle sprain avulsion fracture

(tear bone)

- peroneus brevis forced beyond resisting ankle inversion

- lateral 5th metatarsal tender

peroneals protect ankle

contract so ankle doesn't sprain

compartment syndrome

increased pressure within space of lower leg causing compression in that compartment of the neural and vascular structures

acute compartment syndrome

caused by trauma and a medical emergency

chronic compartment syndrome

exertional

lower leg compartments divided by syndesmosis and fascia

anterior, lateral, deep posterior, superficial posterior

anterior compartment

tibialis, extensor hallicus longus and extensor digitorum longus

lateral compartment

peroneus longus and brevis

deep posterior compartment

posterior tibialis, flexor digitorum longus and flecor hallical longus

- posterior tibial Artery

- tibial Nerve

way to remember deep posterior compartment

Tom, Dick, Harry, And Nick

superficial posterior compartment

gastrocnemius, soleus, and plantaris

compartment syndrome measured by

intercompartmental pressure

- resture pressure > 15 mm Hg

- 1 minute post exercise 30 mm Hg or more

- 5 minute post exercise 20 mm Hg or more

compartment syndrome treatment

surgical release

inversion ankle sprain

ankle is plantarflexed with sudden inversion

- damage lateral ankle ligaments

inversion ankle sprain treatment

usually non-operative

- could cause impingement of talus and tibia - surgery to fix

march fractures

common in 2nd and 3rd metatarsals

avulsion fracture common in which metatarsal

5th with ankle sprain

pes planus foot arch

flat foot

pes cavus foot arch

high arch