Blue Boxes - Bones of LE Flashcards

1
Q

The _______ ________ are discs of hyaline cartilage between the metaphysis and epiphysis of a mature long bone that permits the bone to grow longer.

A

Epiphysial Plates

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2
Q

Explain why adolescents are more vulnerable to lower limb injuries.

A

Their bones are still developing and they still have epiphysial plates. During growth spurts, bones actually grow faster than the attached muscle. The combined stress of rapid growth and physical activity on the epiphysial plates can result in irritation and injury of the plates and developing bone.

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3
Q

Fractures of the hip bone are referred to as ________ fractures. The term “hip fracture” is most commonly applied to fractures of the femoral head, neck, or trochanters.

A

Pelvic

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4
Q

What type of fractures of the hip bone can occur during sports that require sudden acceleration or deceleration (i.e., sprinting, kicking, hurdling)?

A

Avulsion fractures of hip bone

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5
Q

Avulsion fractures of the hip bone occur at ________, or bony projections that lack secondary ossification centers.

A

Apophyses

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6
Q

Avulsion fractures occur where muscles or ligaments are attached. What are the common areas for avulsion fractures of the hip?

A

ASIS
AIIS
Ischial tuberosities
Ischiopubic rami

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7
Q

When the angle of inclination between the long axis of the femoral neck and the femoral shaft is decreased, it is called…

A

Coxa vara (shaft of femur deformed toward midline)

***Knock knees – Remember this is opposite from knee. Knee is Genu Valgum

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8
Q

When the angle of inclination between the long axis of the femoral neck and the femoral shaft is increased, it is called…

A

Coxa valga (shaft of femur deformed away from midline)

***Bow-legged – Remember this is opposite from knee. Knee is Genu Varum

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9
Q

Coxa (VARA/VALGA) causes a mild shortening of the lower limb and limits passive abduction of the hip.

A

Vara

***Decreased angle between femoral neck and shaft

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10
Q

In older children and adolescents, the epiphysis of the femoral head may slip away from the femoral neck because of a weakened epiphysial plate. How is this caused?

A

Acute trauma

Repetitive microtraumas that put increased shearing stress on epiphysis

***Especially with abduction and lateral rotation of thigh

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11
Q

When there is a dislocation of the epiphysis of the femoral head, the epiphysis will slowly slip and result in a progressive _______ _______.

A

Coxa vara

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12
Q

What is the common initial symptom of a dislocated epiphysis on the femoral head? How is it diagnosed?

A

– Hip discomfort that may be referred to the knee

– Radiographic exam of the superior end of the femur

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13
Q

What part of the femur is most often fractured?

A

Femoral neck

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14
Q

The type of femoral fraction that can be sustained is often related to what?

A

Age

Sex

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15
Q

The femoral neck becomes increasingly vulnerable with age, especially in females, secondary to __________.

A

Osteoporosis

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16
Q

Transcervical (middle of neck) and intertrochanteric fractures of the proximal femur usually occur as a result of what?

A

Indirect trauma – can be from stumbling or stepping down hard, like off a curb or step

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17
Q

What happens to the limb as a result of a transcervical (middle of neck) or intertrochanteric femur fracture?

A

Impaction and muscle spasm can cause limb to shorten

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18
Q

Fractures of the Greater Trochanter and Femoral Shaft usually result from a (INDIRECT/DIRECT) trauma.

A

Direct (i.e., motor vehicle accidents and sports)

19
Q

Inferior or distal femur fractions may be complicated by separation of the condyles, resulting in misalignment of the articular surfaces of the knee joint or a hemorrhage due to what?

A

Due to the large Popliteal A. that runs directly on the posterior surface of the bone.

***This type of fracture can compromise blood supply to leg, should always be considered in knee fractures or dislocations!

20
Q

What is the most frequent site of fracture for the Tibia?

A

Middle and inferior thirds (most narrow area)

21
Q

Due to the anterior surface of the Tibia being subcuanteous, the Tibial shaft is the most common site for what type of fractures?

A

Compound fractures

***This type of fracture has bone sticking out of skin

22
Q

This type of fracture can occur in the Tibia to people who take long hikes before they are conditioned.

A

Transverse march (stress) fractures

23
Q

Frequently during skiing a fractures results from a high-speed forward fall, which angles the leg over the rigid ski boot, producing what type of fracture?

A

Boot-top fracture (transverse)

24
Q

Severe torsion during skiing may produce a _________ fracture of the tibial shaft at the junction of the middle and inferior thirds, as well as a fracture of the ________. These types of fractures are often associated with limb shortening.

A

Diagonal

Fibula

25
Q

This is the term for the disease that causes a disruption of the epiphysial plate at the tibial tuberosity, causing inflammation and chronic pain during adolescence.

A

Osgood-Schlatter disease

26
Q

In Osgood-Schlatter disease, the child’s quadriceps pull on tendons that insert at the _______ _______. This can cause pain and swelling at that spot. In some cases a small bone growth may occur to try to close the gap.

A

Tibial tuberosity

27
Q

Where does a the fibular fracture occur that is associated with fracture-dislocations of the ankle joint?

A

2-6 cm above distal end of lateral malleolus

28
Q

Fibular fractures associated with fracture-dislocations of the ankle joint are usually combined with tibial fractures during (EVERSION/INVERSION).

A

Eversion

29
Q

During excessive (EVERSION/INVERSION), the ankle ligaments tear and tilt the Talus against the Lateral Malleolus and may shear it off the Fibula.

A

Inversion

30
Q

This is a common source of bone for grating, and usually has normal function after removal.

A

Fibula

31
Q

How does a fibular bone graft survive after being taken out and placed in another area?

A

Nutrient foramen is located in the middle third of the Fibula, so it’s important to move the bone graft with this so it has a blood supply to the medullary cavity.

***When bone graft is put in place, it heals as if it were a fracture on either end

32
Q

Due to its extensive subcutaneous location, the anterior ______ is accessible for obtaining pieces of bone for grating in children.

A

Tibia

33
Q

This is a method of delivering hydration, blood, and medications directly to the medullary cavity of bone when peripheral venous access is difficult or impossible.

A

Intraosseous Infusion

34
Q

What is the most common site for Intraosseous Infusion?

A

Proximal Tibia

***Can also be done in Femur, Fibula, Humerus, and Manubrium

35
Q

When is Intraosseous Infusion primarily used?

A

Cases of traumatic shock

In children with circulatory collapse

36
Q

A hard fall onto the heel (i.e., from a ladder) may fracture the Calcaneus into several pieces. What type of fracture is this?

A

Comminuted fracture

***This fracture is often disabling because it disrupts the Subtalar (Talocalcaneal) joint.

37
Q

What is often fractured during a severe dorsiflexion of the ankle (i.e., when a person is pressing extremely hard on the brake pedal of a vehicle during a collision)?

A

Fracture of talar neck

38
Q

Fractures of ________ occur when a heavy object falls on the foot or is run over by a heavy object.

A

Metatarsals

39
Q

What is a “Dancer’s Fracture”?

A

Occurs in pointe dancers that lose balance and put their full body weight on the metatarsals, causing fractures.

40
Q

Fatigue fractures of the metatarsals are usually transverse and occur due to what?

A

Prolonged walking

41
Q

When the foot is suddenly and violently inverted, the tuberosity of the 5th metatarsal may be avulsed by the tendon of which muscle?

A

Fibularis brevis M.

42
Q

Avulsion fractures of the 5th metatarsal is common in basketball and tennis players and is usually associated with what type of injury?

A

Severe ankle sprain

43
Q

During ossification of the Talus, the secondary ossification center, which becomes the lateral tubercle of the Talus, occasionally fails to unite with the body of the Talus. This can be due to applied stress during early teens and may result in a bone (accessory ossicle) called an…

A

Os Trigonum

***Occurs in 14-25 percent of adults

44
Q

The sesamoid bones of the great toe in the tendon of the Flexor Hallucis Longus M. bear the weight of the body, especially during the latter part of the stance phase of walking. How are the sesamoid bones usually fractured?

A

From crushing injury