Anterior and Medial Regions of Thigh

Question 1

hip pointer

Answer 1

• contusion of the iliac crest -usually at the anterior part
• avulsion of bony muscle attachments (really an avulsion fracture)

Question 2

contusions

Answer 2

cause bleeding from ruptured capillaries and infiltration of blood into the muscles, tendons, and other soft tissues

Question 3

charley horse

Answer 3

• cramping of an individual thigh muscle due to ischemia

- contusion and rupture of blood vessels sufficient enough to form a hematoma

Question 4

most common site of a thigh hematoma

Answer 4

quadriceps

Question 5

what does a charley horse normally follow?

Answer 5

direct trauma

Question 6

what may cause psoas abscess?

Answer 6

retroperitoneal pyogenic infection from:

• TB in vertebral column
• regional enteritis of the ileum (Crohn’s)

Question 7

referred pain w/ psoas abscess

Answer 7

hip, thigh, or knee joint

Question 8

effects of paralyzed quad muscles

Answer 8

• no leg extension against resistance

- presses against distal end of thigh during walking to prevent inadvertent flexion of knee joint

Question 9

runner’s knee

Answer 9

chondromalacia patellae - soreness/aching around patella dua to quadriceps imbalance

Question 10

what type of fracture occurs from blow to the knee or sudden contraction of quads?

Answer 10

transverse patellar fracture

• prox part pulled superiorly w/ quad tendon
• distal part remains w/ patellar ligament

Question 11

bipartite or tripartite patella?

Answer 11

when centers of ossification of patella don’t fuse to form a single bone

Question 12

how could you differentiate b/w a fracture and an ossification abnormality?

Answer 12

ossification abnormalities are almost always bilateral - get radiograph of both sides

Question 13

patellar tendon reflex

Answer 13

myotatic reflex that usually causes the Pt to extend leg

-tests the integrity of femoral nerve and L2-4 spinal cord segments

Question 14

what causes dimunition or absence of patellar tendon reflex?

Answer 14

any lesion that interrupts the innervation of the quadriceps

Question 15

what muscle an be used for transplantation to replace damaged muscles? why? what is it used to replace?

Answer 15

gracilis - weak adductor, so can get by w/o much loss of movement

• used to replace damaged hand muscles
• removed from distal attachment and repositioned to become a new external anal sphincter

Question 16

what muscles do groin pulls usually involve?

Answer 16

flexor and adductor thigh muscles

Question 17

muscle strain often seen in horseback riders

Answer 17

adductor longus

Question 18

palpation of the femoral pulse

Answer 18

midway b/w ASIS and pubic symphysis - normally a strong pulse

Question 19

how can the femoral artery be used for coronary arteriography or cardiac angiography?

Answer 19

can be cannulated just inferior to the midpoint of the inguinal ligament

Question 20

blood gas analysis

Answer 20

determination of O2 and CO2 concentrations and pressure with the pH of the blood

Question 21

cruciate anastamosis

Answer 21

four-way common meeting of medial and lateral circumflex femoral arteries w/ the inferior gluteal artery superiorly and the first perforating artery inferiorly, posterior to femur

Question 22

what type of veins do most pulmonary emboli originate from?

Answer 22

deep veins

Question 23

saphenous varix

Answer 23

localized dilation of the terminal part of the great saphenous vein - can cause edema in the femoral triangle

Question 24

how can a saphenous varix be distinguished from a psoas abscess or other groin swellings?

Answer 24

saphenous varix will also show varicose veins in other parts of lower limb

Question 25

what vein can sometimes be mistaken for the great saphenous vein in thin people?

Answer 25

femoral vein

Question 26

site of femoral hernia

Answer 26

through the femoral ring into the femoral canal - can result in strangulation and necrosis of herniated bowel due to tight borders of this space

Question 27

which sex are femoral hernias more common in and why?

Answer 27

females - wider pelves

Question 28

what artery anomaly is sometimes found in replaced obturator artery or accessory obturator artery? significance?

Answer 28

enlarged pubic branch of the inferior epigastric artery - could be involved in a strangulated femoral hernia