AMSSM Sports Medicine CAQ Study Guide | Complete Review, Practice Questions &
Certification Exam Prep
What are two major types of femoral neck stress fractures?
Which carries a higher rate of complications?
Management for this more complicated Fx? - ANS ✔✔Tension side (lateral)
Compression side (medial)
Tension side: Risks
- Unstable Fx, risks of displacement
- AVN of femoral head
- Need for hip replacement
Tension side: Management:
- Non-weight bearing immediately
- Orthopedic referral
Compression-sided femoral neck stress fracture: When to consider surgery? - ANS ✔✔Fracture
comprising > 50% of femoral neck
What concept of thermoregulation occurs during cold water immersion? - ANS ✔✔Conduction:
Heat transferred from a warm surface to cold surface
What is is the concept of convection?
Example? - ANS ✔✔When the body exchanges heat with the surrounding air
,Ex. Fans / wind cooling body
What is the concept of radiation re: thermoregulation?
Example? - ANS ✔✔Heat is absorbed or reflected without contact
Ex. Wearing lighter colored clothing to reflect heat
The sleeper stretch addresses which specific part of the shoulder?
How is this performed?
In which athletes is this most useful? - ANS ✔✔Posterior capsule
Technique:
- Side-lying position with a roll under axilla
- Opposite extremity forces flexed elbow in a downward direction, internally rotating the
shoulder and stretching posterior capsule
Overhead-throwing athletes
Which types of athletes/maneuvers are at greatest risk of developing lumbosacral pars
interarticularis stress fractures (spondylolyis)? - ANS ✔✔- Recurrent lumbar extension
- Increased lumbar lordosis
- Poor abdominal strength and control
- Skeletal immaturity
,- Male gender
Spondylolisthesis grading re: displacement - ANS ✔✔- Grade 1: 0% - 25%
- Grade 2: 25% - 50%
- Grade 3: 50% - 75%
- Grade 4: 75% - 100%
- Grade 5: Complete displacement
When is surgical intervention indicated in spondylolistheses? - ANS ✔✔- Persistent symptoms in
grade 1-2
- Symptomatic grade 3
- All grade 4-5
Lumbosacral pars interarticularis stress fractures (spondylolyis): Imaging modalities if negative
plain films? - ANS ✔✔1. Bone scan with SPECT
- Differentiate between acute and chronic lesions
2. CT scan (thin cuts through area of concern)
- Second study for staging
Limit on intentional weight loss? - ANS ✔✔No more than 1.5% body weight / week
What are diagnostic findings of complex regional pain syndrome on triple phase bone scan? -
ANS ✔✔- Phase 1/2: Hypoperfusion
- Phase 3: Increased uptake / Juxta-articular accentuation
, What are the two types of complex regional pain syndrome? - ANS ✔✔- Type 1: No injury to a
specific nerve
- Type 2: Evidence of injury to a specific nerve
What are some contributing factors that cause patellofemoral pain syndrome? - ANS ✔✔- Hip
abductor weakness (gluteus medius)
- Quadriceps/VMO weakness / tightness
UCL injuries and MRI statistics? - ANS ✔✔MRI 100% specificity
Risk of injury to what nerve in supracondylar Fx?
Complications from this? - ANS ✔✔Median nerve
Masks compartment syndrome
Valgus extension overload - Radiographic findings? - ANS ✔✔Small irregular loose bodies in
posterior elbow
Valgus extension overload - Sx? - ANS ✔✔- Posteromedial elbow pain
- Worse during DECELERATION and FOLLOW THROUGH phases of throwing
How does valgus extension overload differ from ulnar collateral ligament injury? - ANS ✔✔VEO:
- Posteromedial elbow pain in terminal extension during DECELERATION and FOLLOW THROUGH
phases
Ulnar collateral ligament injury:
Certification Exam Prep
What are two major types of femoral neck stress fractures?
Which carries a higher rate of complications?
Management for this more complicated Fx? - ANS ✔✔Tension side (lateral)
Compression side (medial)
Tension side: Risks
- Unstable Fx, risks of displacement
- AVN of femoral head
- Need for hip replacement
Tension side: Management:
- Non-weight bearing immediately
- Orthopedic referral
Compression-sided femoral neck stress fracture: When to consider surgery? - ANS ✔✔Fracture
comprising > 50% of femoral neck
What concept of thermoregulation occurs during cold water immersion? - ANS ✔✔Conduction:
Heat transferred from a warm surface to cold surface
What is is the concept of convection?
Example? - ANS ✔✔When the body exchanges heat with the surrounding air
,Ex. Fans / wind cooling body
What is the concept of radiation re: thermoregulation?
Example? - ANS ✔✔Heat is absorbed or reflected without contact
Ex. Wearing lighter colored clothing to reflect heat
The sleeper stretch addresses which specific part of the shoulder?
How is this performed?
In which athletes is this most useful? - ANS ✔✔Posterior capsule
Technique:
- Side-lying position with a roll under axilla
- Opposite extremity forces flexed elbow in a downward direction, internally rotating the
shoulder and stretching posterior capsule
Overhead-throwing athletes
Which types of athletes/maneuvers are at greatest risk of developing lumbosacral pars
interarticularis stress fractures (spondylolyis)? - ANS ✔✔- Recurrent lumbar extension
- Increased lumbar lordosis
- Poor abdominal strength and control
- Skeletal immaturity
,- Male gender
Spondylolisthesis grading re: displacement - ANS ✔✔- Grade 1: 0% - 25%
- Grade 2: 25% - 50%
- Grade 3: 50% - 75%
- Grade 4: 75% - 100%
- Grade 5: Complete displacement
When is surgical intervention indicated in spondylolistheses? - ANS ✔✔- Persistent symptoms in
grade 1-2
- Symptomatic grade 3
- All grade 4-5
Lumbosacral pars interarticularis stress fractures (spondylolyis): Imaging modalities if negative
plain films? - ANS ✔✔1. Bone scan with SPECT
- Differentiate between acute and chronic lesions
2. CT scan (thin cuts through area of concern)
- Second study for staging
Limit on intentional weight loss? - ANS ✔✔No more than 1.5% body weight / week
What are diagnostic findings of complex regional pain syndrome on triple phase bone scan? -
ANS ✔✔- Phase 1/2: Hypoperfusion
- Phase 3: Increased uptake / Juxta-articular accentuation
, What are the two types of complex regional pain syndrome? - ANS ✔✔- Type 1: No injury to a
specific nerve
- Type 2: Evidence of injury to a specific nerve
What are some contributing factors that cause patellofemoral pain syndrome? - ANS ✔✔- Hip
abductor weakness (gluteus medius)
- Quadriceps/VMO weakness / tightness
UCL injuries and MRI statistics? - ANS ✔✔MRI 100% specificity
Risk of injury to what nerve in supracondylar Fx?
Complications from this? - ANS ✔✔Median nerve
Masks compartment syndrome
Valgus extension overload - Radiographic findings? - ANS ✔✔Small irregular loose bodies in
posterior elbow
Valgus extension overload - Sx? - ANS ✔✔- Posteromedial elbow pain
- Worse during DECELERATION and FOLLOW THROUGH phases of throwing
How does valgus extension overload differ from ulnar collateral ligament injury? - ANS ✔✔VEO:
- Posteromedial elbow pain in terminal extension during DECELERATION and FOLLOW THROUGH
phases
Ulnar collateral ligament injury: