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41 Cards in this Set
- Front
- Back
Sprain or strain: which involves stretching of ligamentous tissue? Musculotendinous tissue?
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sprain; strain
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Complete tear of a muscle or tendon is called what?
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rupture
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Sprains are most common in what age group? Strains?
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1. teens, young, and middle-aged adults
2. middle-aged and elderly |
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In children, force necessary for sprain would cause what to happen?
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fracture at the physis
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What steps need to be taken to evaluate a sprain or strain?
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History
Inspection Bony palpation Soft Tissue palpation Range of motion Neurologic examination Special tests Examination of related areas |
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Athletes don't usually come into clinic unless what is affected?
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sports performance
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Athletes that play when injured with a sprain/strain develop what?
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ligamentous laxity
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Which would more likely produce ecchymosis: sprain or strain
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sprain (24-48 hours later); a strain might be located too deeply to visualize
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"I heard a pop" is associated with sprain or strain?
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sprain
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Bony tenderness should lead you to suspect what?
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fracture
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The greater the degree of laxity may indicate what?
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greater degree of injury
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How can you differentiate between a rupture and a strain?
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rupture-can't move; strain-can move
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What grade is this sprain: partial tear but no instability, or opening of joint on stress maneuvers?
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grade I
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What grade is this sprain: partial tear with some instability indicated by partial opening of joint on stress maneuvers?
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grade II
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What grade is this sprain: complete tear with complete opening joint on stress?
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grade III
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DTR's are important in what strains?
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cervical and lumbar strains to rule out nerve root encroachment
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What are possible sequelae for sprains and strains?
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1. sprain- ligamentous laxity leading to joint instability and repeated injury.
2. strain- prolonged muscle tightness, weakness, tenderness |
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What is ischemia of nerves and muscles within a fascial compartment due to increased pressure called?
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compartment syndrome
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What is receptor dysfunction causing prolongation of normal post-injury process pain, autonomic dysfunction, trophic changes, and functional impairment called?
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complex regional pain syndrome
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Should heat be applied immediately following a sprain or strain?
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no
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What is the treatment for sprains and strains?
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(P)RICE(M):
Protection (immobilize) Rest Ice-controls inflammation Compression Elevation Medicine/Manipulation |
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Immobilization should occur in grade I sprains for what reason? Grade II?
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1. comfort
2. protection |
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Grade III sprains may require what in addition to immobilization?
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surgical repair
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What OMT can be administered safely in all sprains?
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MR
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What must be ruled out in order to administer OMT to a sprain?
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fractures and significant intra-articular injuries
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What are the benefits of providing OMT for sprains?
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reduces chances for compartment syndrome by enhancing lymphatic drainage
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When should you seek orthopedic consult in sprains and strains?
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1. grade III sprains
2. severe grade II sprains 3. complete ruptures 4. pain out of proportion to injury 5. suspected CRPS or compartment syndrome |
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What are the differential diagnoses for sprains and strains?
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fracture or soft tissue contusion
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Which is more stable: dorsiflexion of plantarflexion?
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dorsiflexion: the mortise fits snugly against the talus
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Which occurs more often, inversion or eversion ankle injuries?
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inversion
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Which ligaments are the most commonly injured ligaments in inversion sprains?
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anterior talofibular and calcaneofibular ligaments
(hint: ATF-always tears first) |
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In addition to the anterior talofibular and calcaneofibular ligaments, what ligament can also be injured in a "high ankle injury"?
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anterior tibiofibular ligament
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Which grade of ankle sprain shows the following: swelling, can ambulate with slight limp?
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grade I
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Which grade of ankle sprain show the following: moderate to severe swelling, antalgic gait, some loss of motion &/or function?
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grade II
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Which grade of ankle sprain shows the following: severe swelling and ecchymosis, sig-nificant loss of motion, function, and ability to bear weight?
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grade III
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Ankle x-ray series is indicated if patient has malleolar pain and any of the following:
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bony tenderness in latera/medial malleolus or inability to bear weight
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Foot x-ray series is indicated if patient has midfoot pain and any of the following:
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bony tenderness at base of 5th metatarsal, navicular bone, or inability to bear weight
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If above the mortise, this is likely what kind of ankle sprain?
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high ankle sprain
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Which test is positive in grade II and III sprains? Grade III only?
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anterior drawer's; talar tilt
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Inversion ankle sprains may also show what somatic dysfunctions?
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anterior lateral malleolus and anterior talus with plantarflexion; ankle foot myofascial restriction;
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What OMT is indicated in the following SD's: anterior lateral malleolus with plantarlexion, anterior talus with plantarflexion, and ankle foot myofascial restriction?
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1. ME
2. ME/HVLA 3. MR |