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38 Cards in this Set
- Front
- Back
Musculoskeletal System:
Lec.12 - Sprains and Strains |
Musculoskeletal System:
Lec.12 - Sprains and Strains |
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Q12:
Difference between sprain and strain |
sprain - tear of ligament, usually associated with the joint (result of sudden trauma that tears a ligament in the joint capsule)
Strain - Tear of muscle fibers (force in a muscle that's already contracting) |
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Q12:
What age group does Sprains occur in? |
- Occur in all ages, but much more common in teens and young and middle aged adults
- In children the force required to sprain a muscle would likely break a bone - Older adults - bone matrix is weakened and prone to Fx |
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Q12:
In what age group are Strains most common? |
- Most common in middle aged and older adults do to decreased elasticity of collagen fibers in muscle and tendon
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Q12:
How do you evaluate a sprain or strain? |
- Hx (this is very important)
- Inspection - Bony palpation - Soft Tissue Palpation - Range of Motion - Neurologic examination -Special tests - Examination of related areas |
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Q12:
How may athletes present differently? |
- may not present with complaint of pain, but one of decreased performance
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Q12:
Different symptoms of sprain or strain? |
Sprain:
-"heard a pop" - Difficult weight bearing - Pain, edema, Ecchymosis (24-48hrs) Strain: - "snap or tearing" sensation - Pain or swelling may not be noted on the day of the injury. |
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Q12:
How do you differentiate strain from rupture? |
- Are they able to move the joint?
- If they can't this indicates rupture - a complete rupture may require surgical repair |
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Q12:
Classification of sprains: Grade 0? |
Plastic deformation of the tissue without tearing
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Q12:
Grade 1 Sprain? |
Partial tear but no instability, or opening of joint on stress maneuvers
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Q12:
Grade 2 Sprain? |
Partial tear with some instability indicated by partial opening of joint on stress maneuvers
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Q12:
Grade 3 Sprain? |
Complete tear with complete opening joint on stress
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Q12:
What other things should be tested when someone has a sprain or strain? |
-Sensation and function testing
- Deep tendon reflexes |
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Q12:
What orthopedic tests that evaluate structural integrity of the injured region? |
-Apply’s Test
-Draw(er) Tests -Hawkin’s Test -Lachman’s Test -McMurray’s Test -Near’s Test -Valgus stress test -Varus Stress test |
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Q12:
What is are some sequela sometimes seen with sprains or strains? |
- (sprain) Ligamentous laxity leading to joint instability and repeated injury
- (Strain) Prolonged muscle tightness, weakness, tenderness. - somatic dysfunction - Complex reginal pain syndrome - Compartment syndrome |
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Q12:
Complex regional Pain syndrome? |
- receptor dysfunction causing prolongation of normal postinjury process pain, autonomic dysfunction, trophic changes, functional impairment.
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Q12:
Compartment Syndrome? |
- ischemia of nerves and muscles within a fascial compartment due to increased pressure
- This is an emergency |
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Q12:
how do you treat an acute sprain? |
-NSAIDs first few days
- RICE or PRICEM (protest, rest, ice, compression, elevation, medicine / manipulation - heat may be helpful later but not following an acute injury. |
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Q12:
Treatment for Grade 1 Sprains? |
Symptomatic treatment
only. Immobilization for comfort. OMT*. (OMT after free ROM) |
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Q12:
Treatment for grade 2 Sprains? |
Immobilization to protect
injured part, but full healing expected. OMT*. |
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Q12:
Treatment for Grade 3 Sprains? |
Immobilization or
possibly repair. OMT** |
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Q12:
How do you determine when or when not to use OMT? |
- Rule out Fx, and significant intra-articular injuries clinically and / or with imaging studies.
- techniques that put stress on the injury be warry of. - |
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Q12:
what are the red flags for an orthopedic consult? |
- Grade III sprains, may need to be surgically repaired
- Severe Grade II Sprains - Complete ruptures - pain out of proportion to injury - repeat films if initially equiviccal - suspected CRPS or compartment syndrome |
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Q12:
what makes plantar flexion / inversion injuries more likely? |
- when you plantar flex the talus comes out from underneath the tibia, this makes it more prone to movement.
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Q12:
What are the compenents ot the lateral collateral ligament of the ankle? |
- Posterior talofibular ligament (complete rupture usually)
- calcaneofibular ligament* (usually 2 or 3 grade) - anterior talofibular ligament* (usually grade 1 sprain) *= most commonly injured with inversion sprains |
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Q12:
What is the most common ankle sprain |
Anterior talofibular ligament (grade 1)
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Q12:
What ligament is typically disrupted with a "high ankle sprain"? |
Anterior tibiofibular ligament
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Q12:
What are the clinical signs and symptoms of a grade 1 sprain? |
Swelling. Should be able to ambulate, usually with slight limp.
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Q12:
What are the clinical sings and symptoms of a grade 2 sprain? |
Moderate to severe swelling. Antalgic gait. Some loss of motion &/or function.
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Q12:
What are the clinical signs and symptoms of a grade 3 sprain? |
Severe swelling and ecchymosis. Sig-nificant loss of motion, function, wt bearing
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Q12:
What is the ottawa criteria? |
- a criteria used to deterime when and when not to x-ray.
Zone A = Distal fibula Zone B = medial maleolus Zone C = heal Zone D = middle of the foot bone tendetness and innability to bear weight |
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Q12:
What is a Maisoneuve Fx? |
- Fx of the distal fibula
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Q12:
what is the normal distance of the syndesmosis (being evaluated for a high ankle sprain)? |
-Should be 5mm or less
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Q12:
When is the anterior draw test positive? |
2nd and 3rd degree sprains?
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Q12:
When is the talar tilt test positive? |
3rd dagree sprains
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Q12:
when you plantar flex when does the distal fibula go? |
anterior laterally
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Q12:
what are the 4 ways in which fascia disrupts? |
-shearing force
- heat -electricity -pressure |
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Q12:
what to know? |
- know how to grade
- know OMM can help |