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43 Cards in this Set
- Front
- Back
What is a sprain?
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Injury to a ligament (bone-to-bone)
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What is a strain?
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injury to a tendon (muscle-to-bone)
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What is the ankle joint made of?
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Talus, distal tibia, distal fibula
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How many ankle injuries per year?
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1 million
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What percentage of injuries are ankle sprains?
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85%
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An ankle sprain often follows a _________________________
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Sudden stretch (secondary to inversion)
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What is the most commonly sprained ankle ligament?
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Anterior talofibular ligament
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What happens in an inversion of the ankle?
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the ankle turns in; pull lateral ligaments
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What is the second most frequently torn ligament
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the calcaneofibular ligament
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What are some clinical manifestations of a sprain?
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pain, swelling, bruising, loss of motion, loss of function; if severe the patient might say they hear a "pop" (resulting from the ligament tear
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What are some clinical manifestations of a strain?
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(injury to tendon/muscle); complete loss of use of muscle, cramping, weak, swelling, muscle spasm, heals on its own
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What are some clinical manifestations of a ruptured achilles tendon?
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hear "pop"; patient loses reflex
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What is the achilles tendon attached to?
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gastronemeous muscle
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What are the 7 steps of examination for the ankle?
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Inspect, Palpate, Range of Motion (ROM), Strength, joint above and joint below, neuro, and vascular.
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Describe what you are looking for in the following steps of examination. Inspect?
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Looking for swelling, bruising (acomyosis), bone deformity
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Palpate?
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see for infusion (fluid), pain, tenderness in objective
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ROM?
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active v. passive; move ankle joint.
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What is the difference between active and passive ROM?
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Active - patient moves joint; passive - doctor moves joint
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Strength?
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measure on a 0-5 scale; +5/5 is normal strength
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Joint above and joint below?
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Do 4 things... (?)
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Neuro?
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Sensation & Reflexes; do they have sensation in the area? deep tendon intact?
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Vascular?
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good blood supply? (check dorsalis pedis & posterior tibialis)
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What does it mean if the ankle is "frozen"?
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The ankle joint is considered "frozen" if the doc/PA can't move it past what the patients says (?)
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How can you assess sensation?
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with the "Light touch" method (using cotton balls) or with the sharp/dull test (use a swab and a stick and see if patient can tell the difference)
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What is plantar flexion?
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pointing toes down
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Dorsiflexion?
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lifting ankle up
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What is a Grade 1 sprain?
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Mild sprain; overstretching or slight tearing of ligaments with no joint instability; patient can still bear weight
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What do you do for a Grade 1 sprain?
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wrap it
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What is a Grade 2 sprain?
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moderate sprain; partial tearing of a ligament; swelling is present and patient has a difficult time bearing weight (resulting in a "limp")
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Waht is a grade 3 sprain?
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severe sprain; complete tear or rupture of a ligament; patient can't bear weight
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What are some more symptoms of a grade 3 sprain?
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patient experiences significant pain, bruising, and swelling
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What should you do for grade 2 and 3 sprains to r/o a fracture?
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order an x-ray (not good for soft tissue)
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Why should you choose an x-ray over an MRI?
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Costs less money
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What does the acronym PRICE stand for (in relation to mide-moderate sprains)?
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Protect, Rest, Ice, Compression, Elevate
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What is something else used for mild-moderate sprains?
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OTC NSAID
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When do you need to cast the patient?
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If they have a moderate-severe ankle sprain
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What is the recovery time for the following: Mild?
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1-2 weeks
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Moderate?
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3-6 weeks
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Severe?
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8-12 months
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When is physical therapy recommended?
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In treatment for moderate - severe sprains
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What are the Ottawa ankle rules in relation to specificity and sensitivity?
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sensitivity: 97.8% and specificity of 31.5
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(Ottawa Ankle Rules) When is an ankle x-ray required?
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Only if there is pain in the malleolar zone and any of the following are found:
- bone tenderness at A or B (posterior edge/tip of lateral/medial malleolus) - inability to bear weight both immediately and in the emergency department |
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(Ottawa Ankle Rules) When is a foot x-ray required?
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Only if there is pain in the midfoot zone and any of the following are found:
- bone tenderness at C or D (Base of limb metatarsal/ Navicular) |