| 6 types of closed fractures | 1. Greenstick: complete breaks in bone, "bending", normally in kids
2. Comminuted: compressive force, 3 or more fragments
3. Transverse: sheer force, straight line
4. Linear: compressive force, bone splits along the length
5. Oblique: torsion, through the bone, one end received sudden twisting and the other end is stable
6. Spiral: wrap around the bone, s shaped separation, plating and rotating |
| Osteoblasts | Bone forming cells |
| Osteclasts | cells that absolve or remove osseous tissue |
| Casting time | long bones: 6 weeks
small bones: 3-4 weeks |
| Dislocation vs Subluxation | Dislocation: bone is forced out of alignment and stays out
Subluxation: bone is forced out of alignment but goes back into place |
| Ligaments | Bone to bone |
| Tendons | Muscle to bone |
| Sprain | Injury to ligament or joint capsule that connects bone to bone |
| Grades of Sprain/Strain | 1: stretching and separation of ligamentous fivers, minimal instability and swelling, moderate pain
2: Some tearing and separation of the ligament fibers, moderate instability, moderate to severe pain
3: total tearing of ligaments, high instability, severe swelling and pain, may need surgery to reconstruct |
| Myositis Ossifiicans | calcium deposits that result from repeated trauma |
| Hematoma | Collection of blood in the tissues outside the blood vessels |
| Strain | Stretch, tear, or rip in the muscle or its tendon |
| Muscle Cramps | Involuntary muscle contraction |
| Muscle Guarding | Muscle contraction in response to pain |
| Muscle soreness | Pain caused by overexertion in exercise (DOMS) |
| Trigger point | Area of tenderness in a tight band of muslce |
| Neuritis | Chronic nerve irritation |
| Crepitus | Crackling feel or sound |
| Signs of Inflammation | Pain
Warmth
Swelling
Loss of function
Redness |
| Tendinosis | Failed healing of tendon |
| Tendinitis | Inflammation of a tendon |
| Tenosynovitis | Inflammation of a tendon and its synovial sheath |
| Bursae | Pieces of synovial membrane that contain a small amount of fluid |
| Osteoarthritis | Wearing down of hyaline cartilage |
| Phases of the healing process | 1. Inflammatory response phase (stop, drain, and clean up the water) 2-4 days
2. Fibroblastic repair phase (patch up the area) 4-6 days
3. Maturation-remodeling phase (clean it up so it can function properly) 3 weeks-3 years |
| Bones of foot | Total: 26 bones- 7 Tarsals- 5 metatarsals- 14 phalangeal |
| Arches of foot | Medial longitudinal
Lateral longitudinal
Metatarsal
Transverse |
| Foot adduction and supination muscles (5) | Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Tibialis anterior
Extensor hallucis longus |
| Foot abduction and pronations (4) | Fibularis longus
Fibularis brevis
Fibularis tertius
Extensor digitorum longus |
| Toe Flexion (7) | Flexor digitorum brevis
Flexor digitorum longus
Flexor hallucis brevis
Flexor hallucis longus
Flexor digiti minimi brevis
Quadratus plantae
Lumbricals |
| Toe extension (3) | Extensor digitorum brevis
Extensor digitorum longus
Extensor hallucis longus |
| Toe abduction (3) | Abductor hallucis
Dorsal interrosi
Abductor digiti minimi |
| Toe adduction (2) | Adduction hallucis
Plantar interossi |
| Retrocalcaneal bursitis (Pump bump) | irritation on back of heal (where adidas pro shoes rub) |
| Plantar fasciitis | Many MOI so it's hard to figure out the cause, takes time to heal |
| Jones fracture | 5th metatarsal, normally from plant and twist or consequence of stress fracture |
| Pes planes vs Pes cavus | Pes planes: low arch (plains are flat)
Pes cavus: high arch (caves are round) |
| Hallux valgus deformity (Bunions) | Growth/calcification on side of big toe |
| Bunnionette | Growth/calcification on side of pinky toe |
| Mortons Neuroma | Mass in plantar nerves. Commonly between third and fourth metatarsal heads |
| Turf Toe | Hyperextension of big toe or sprain of metatarsal phalangeal joint |
| Blisters | Caused because of friction. If it's going to pop on its own its better to intentionally pop it in sterile conditions. If it's not going to pop on its own its better to leave it alone. |
| Corns | Normally between fourth and fifth toe. Kinda like a blister, thick, white, macerated skin with black dot in the center. |
| Care for ingrown toenail | 1. soak in hot water for 20 min 2-3xday
2. when nail is soft use forceps to put cotton under the edge of the nail
Tip: cut a "v" in middle of toenail |
| Care for Subungal hematoma (blood under the toenail) | 1. apply ice pack and elevate foot
2. drill small hole into the nail bed |
| Ankle joint is composed of.... | Tibia
Fibula
Talus |
| Anatomy of ankle | . |
| Ankle Dorsiflexion | extensor digitorum longus
extensor hallucis longus
tibialis anterior (primary dorsiflexor) |
| Ankle plantar flexion | soleus
gastrocnemius |
| Ankle inversion | Components of deep posterior compartment
- tibialis posterior
- flexor digitorum longus
- flexor hallucis longus |
| Ankle eversion | Components of lateral compartment
- fibularis longus
- fibularis brevis
- tibialis anterior |
| Bump test | Gentle blow applied upwards on the bottom of the heel. + test: pain, path: fx |
| Anterior drawer test (ankle) | Grab lower tibia in one hand and the calcaneus in the other. looking for how much it moves compared to other ankle.
+ test: laxity
Path: ATF (anterior talofibular)/CF (calcaneofibular) |
| Talar tilt | move to inversion
+ test: laxity
Path: caneofibular and possible anterior/posterior talofibualr ligaments. |
| Ankle joint anatomy | . |
| Ankle sprain | Stretching/tearing of ligaments. Lateral side is more common |
| Thompson test | squeeze the calf muscle
+ test: if foot doesn't moves
path: Achilles tendon rupture |
| MTSS - Medial tibial stress syndrome (shin splints) | anterior lower-leg pain |
| Compartment syndromes | increased pressure in one of the four compartments
1. acute: practice POLIE (no compression) can be considered a medical emergency
2. acute exertional: increase in pressure within a closed fascial space.
3. chronic: commonly while running or jumping. |
| Knee anatomy | . |
| ACL | Prevent excessive anterior translation of the tibia in relation to the femur |
| PCL | Prevent excessive posterior translation of the tibia in relation to the femur |
| MCL | Stabilize against side to side forces (valgus forces) |
| LCL | Stabilize against side to side forces (varus forces) |
| Meniscus | shock absolutions and stabilization |
| Valgus/varus stress test | + test: laxity
Path: MCL/LCL
athlete lies supine with leg extended. valgus/varus stress with knee fully extended and at 30 degrees of flexion. |
| Lachman's Test | + test: laxity
path: ACL |
| Anterior/Posterior drawer test (knee) | + test: laxity
path: ACL/PCL |
| Apley's Compression test | + test: pain
path: Meniscus |
| Knee Plica | thickened fold of synovial membrane lining the inside of the joint capsule
symptoms may be similar to torn meniscus |
| Illiotibial band friction syndrome (Runners knee) | overuse condition. Irritation over lateral femoral condyle or at the bands incertion on lateral side of knee. |
| Patellar Tendinopathy (jumpers knee) | jumping, landing, kicking, or running may place tension on the knee extensor muscle complex. May begin inflammatory process leading to tendon degeneration or tendinosis. |
| Chondromalacia patella | Softening and deterioration of the articular cartilage on the posterior surface of the patella |
| Osgood-Schlatter Disease | Repeated pull of the patellar tendon at the tibial tubercle on the from to the tibia. May result in enlarged tibial tubercle. |
| Hip Anatomy (soft tissue) | . |
| Hip Anatomy (bones) | . |
| Hip flexion (4) | Rectus femoris
Sartorius
Iilacus
Psoas |
| Hip extension (5) | Hamstrings
Bicep femoris
Semimembranosus
Semitendinosis
Gluteus maximus |
| Hip abduction (2) | Gluteus medius
Tensor fasciae latae |
| Hip adduction (5) | Gracilis
Pectineius
Adductor magnus
Adductor longus
Adductor brevis |
| Hip medial rotation (1) | Gluteus minimus |
| Hip lateral rotation (6) | Piriformis
Superior gemellus
Inferior gemellus
Obturator internus
Obturator externus
Quadratus femoris |
| Thomas test | + test: straight leg comes off the table, path: tight hips flexors |
| Straight leg raise test | + test: leg can't be flexed 90, path: hip extensors |
| Mytositis Ossificans | sever blow or repeated blows to thigh, can cause ectopic bone formation within the muscle. |
| Avascular Necrosis | tissue death caused by lack of circulation. Can occur from dislocated hip. |
| Hip labral tear | most often result form repetitive movements such as running or piloting of the hip that causes degeneration and breakdown of labrum. Can cause catching, locking, or clicking sensations in hip joint. |
| Piriformis syndrome | tight piriformis can be confused for sciatica |
| Sciatica | due to herniated lumbar disc pressing on the sciatic nerve as it exits the lumbar spine. May cause irritation, numb, shooting pain down back of the leg. |
| Osteitis Pubis | chronic inflammatory condition by the pull of muscles in pubic symphysis area |
| Hip pointer | bruise and hematoma near the pelvic rim |
| 4 compartments of the leg | anterior, lateral, deep posterior, superficial posterior |
| Knee flexion (8) | biceps femoris
semitendinosis
semiembrinosis
gracilis
sartorius
gastrocnemius
plataris
popliteus |
| knee extension (4) | vastus medialis
vastus lateralis
vastus intermedius
rectus femoris |
| external tibial rotation (1) | biceps femoris |
| internal tibial rotation (5) | popliteus
semitendinosis
semimembrinosis
sartorius
gracilis |
