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ID:36792099
大小:2.66 MB
页数:60页
时间:2019-05-10
《Knee 膝关节运动损伤》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、MS3SportsMedicineWorkshopFamilyMedicineClerkshipKneeProblemsMS3FamilyMedicineAnatomyReviewFemurMedial&lateralCondylesEpicondylesTrochleargrooveIntercondylarnotchPatellaSuperiorpole(base)Inferiorpole(apex)Medial&lateralfacetsTibiaMedial&lateralCondylesGerdy’stuberclePesanserineareaTibialtuberos
2、ityTibialplateauTibialspinesFibulaHeadNeckAnatomy–MajorLigaments&TendonsQuadricepstendonPatellartendonMedial&lateralpatellarretinaculuaMCLLCLAnatomy–MeniscioftheKneeMedialmeniscusLateralmeniscusMeniscalligamentsFunctionsofthemenisciMeniscalzonesWhite-whiteRed-whiteRed-redKneeExamOverviewInspec
3、tionPalpationRangeofMotionStrengthNeurovascularSpecialTestsCase1–MedialRightKneePain16yoHSsoccerplayer,previouslyhealthyTackledfromrightsidewhilerunningImmediateonsetofmedialjtlinepainDelayedonsetlocalmedialedema,stiffnessAbletobearweightKeyQuestionsintheHistoryMechanismofInjury?AcuteorChronic
4、?Locationandlevelofpain?Abletowalk?MechanicalSymptoms?(Locking,popping,catching?)Associatedinstability?Swelling?Previousinjuriesorsurgeries?Case1-ExamInspection:MildmedialkneeedemaPalpation:+ttpmedialkneeROM:can’tbend>80dStrength:mildlydecreasedNeurovascular:normalSpecialtests:NegLachman,Anter
5、iorDrawer,McMurray,varusstress+mildincreasedgaponvalgusstress(comparedtoleft)withgoodendpointSpecialTests-ACLInjuryLachmanTestSpecialTests-PCLInjuryPosteriorDrawerTestSagSignQuad-ActiveTestVarus/ValgusstressforLCLandMCLInjuryFeaturesthatshouldpromptanxrayafteracutekneeinjuryinclude:Unabletobe
6、arweightCan’tflex>90dPatellaTTPFibularheadTTPAge<18or>55Alloftheabove5OttawaKneeRulesi.e.WhentoorderakneexrayafteracuteinjuryAge>55or<18UnabletowalkTTPonPATELLATTPonFIBULARHEADUnabletoflex90degCase1-ImagingNormal!Case1–DifferentialDiagnosisMoreLikelyLessLikelyMeniscalTearLigamentousInjuryWhich
7、ligament?ACLPCLMCLLCLMuscleStrainFracturePatellofemoralPainPlicaMCLSprainDiagnosis?WhatgradeofsprainislikelypresentoftheMCL?Grade1:nolaxity,buthurtsGrade2:mildlaxity,stillintactGrade3:completetearGrade4:hurtslike*^%*MCLSprainTreatment?R
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