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msk exam 2 > Clinical Boxes > Flashcards

Clinical Boxes Flashcards

1
Q

Hip pointer is another name for contusion of what bony structure?

A

contusion of iliac crest

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2
Q

What is the cause of Charley horse?

A

ischemia or contusion and rupture of blood vessles of a single muscle

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3
Q

What is the most common site of THIGH hematoma ?

A

quadriceps

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4
Q

What should ALWAYS be considered when a pt has edema in proximal part of the thigh?

A

psoas abscess (can be seen in lateral border of radiograph)

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5
Q

Psoas abscess is often overlooked as what other conditions?

A
  1. indirect/direct hernia
  2. lymphadenopathy
  3. saphenous varix
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6
Q

Softening of the patellar cartilage especially in marathon runners?

A

Chondromalacia Patellae

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7
Q

When does the patella ossify? What can result if it fails to ossify?

A
  1. 3-6 years old
  2. can result in BIPARTITE or TRIPARTITE patella

(often confused for patellar fracture)

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8
Q

Diminished patellar reflex could indicate?

A

decreased integrity of femoral nerve (L2-L4 nerve)

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9
Q

What muscle is engaged in patellar reflex

A

quadriceps

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10
Q

Between what 3 structures would you compress the femoral Artery?

A

Press POSTERIORLY on

  1. superior pubic ramus
  2. psoas major M.
  3. femoral head
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11
Q

What structure is cannulated for LEFT cardio angiography? Where is it cannulated?

A
  1. Femoral Artery

2. inferior to inguinal ligament

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12
Q

where would one feel the femoral pulse?

A

B/w the ASIS and pubic symphysis , about 3 cm below the inguinal ligament

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13
Q

What would supply the lower leg if a patient had a laceration to the femoral artery?

A

Cruciate anastomosis

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14
Q

What often results from a laceration to femoral artery?

A

and arteriovenous shunt , because the femoral VEIN is located very close to femoral ARTERY

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15
Q

Edema of the femoral triangle can be caused by dilation of what structure?

A

Great Saphenous Vein

SAPHENIX VERIX

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16
Q

What structure is used for RIGHT cardiac angiology?

A

Cannulation of femoral VEIN

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17
Q

What is important to avoid during varicose vein operations?

A

Do NOT tie the Femoral VEIN (it has no tributaries at this level except the great saphenous v.)

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18
Q

Describe the anatomical location of femoral hernias?

A

small intesting popping through the FEMORAL RING and into the FEMORAL CANAL

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19
Q

What is the cause of transverse patellar fracture? What fragments result?

A
  1. blow to the knee or sudden contraction of quadriceps

2. proximal fragment and distal fragment

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20
Q

Pt walking with forward lean and pressing on distal part of their thigh cannot perform what muscle function?

A
  1. extension of leg against resistance

(due to paralysis of quadriceps)

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21
Q

What is the cause of psoas abscess?

A

pyogenic infection in the abdomen

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22
Q

Lesion to innervation of quadriceps would result in ?

A

diminished patellar reflex

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23
Q

A groin pull involves muscles with which function?

A

staring or stretching of thigh flexors and thigh adductors

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24
Q

Where is the best site for gluteal IM injections?

A

superolateral quadrant of the buttocks

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25
Q

Pt is compensating for weakened abduction of the thigh by the gluteus medius and minimus.. what condition do they have?

What nerve is affected?

A
  1. Gluteus medius limp

2. Injury to Superior Gluteal Nerve

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26
Q

Avulsion of the ischial tuberosity could result in injury to what muscles?

A

Hamstrings

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27
Q

What condition does a pt with localized point tenderness over the greater trochanter with pain along the IT band?

A

Trochanteric bursitis

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28
Q

What muscle from the leg, along with its nerve and blood vessels can be used to replace a damaged muscle in the hand?

A

Gracilis M.

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29
Q

Avulsion fractures of the hip bone occur at which bony projection?

A

Apophyses

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30
Q

What types of activities cause avulsion fractures at the hip bone?

A

sudden acceleration and deceleration

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31
Q

Angle DECREASED between of femoral neck and the femoral shaft?

A 
Coxa VARA
(shaft of femur deformed toward midline)
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32
Q

Angle INCREASED between of femoral neck and the femoral shaft?

A

Coxa VALGA

bow- legged

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33
Q

What types of femoral fractures can result in IMPACTION (overriding bones)?

A
  1. spiral fracture
  2. transcervical fracture
  3. intertrochanteric fracture
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34
Q

Which femoral fracture can result in hemorrhage of popliteal artery?

A

Fracture of Distal or Inferior Femur

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35
Q

What is the cause of Osgood Schlatter disease?

A

disrupted epiphyseal plate of tibial tuberosity

cause inflammation or chronic pain in adoloescents

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36
Q

Dislocation of epiphysis of femoral head is caused by ?

A

increased shearing stress on epiphysis with ABduction and lateral rotation

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37
Q

What bone is common for grafting? What bony structure must be grafted along with it?

A
  1. Fibula

2. Nutrient Foramen

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38
Q

What leads to Compartment Syndrome?

A

inflammation of muscles, edema or hemorrhage due to STRONG nature of septa and deep fascia of leg forming the boundaries of the leg compartments

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39
Q

What procedure is used to relieve pressure of compartment syndrome?

A

Fasciotomy

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40
Q

How can DVT result in death?

A

large thrombus breaks free and travels to the lungs

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41
Q

Which vein is most associated with varicose veins?

A

Great saphenous V and its tributaries

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42
Q

What is the difference between normal and varicose veins?

A

varicose veins have INCOMPETENT valves

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43
Q

Venus stasis is a big cause of thrombus formation. What causes venus stasis?

A
  1. muscular inactivity
  2. external pressure on veins
  3. loose fascia
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44
Q

Which vein is best grafted for coronary bypass?

A

Saphenous vein

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45
Q

What are 3 reasons for grafting the saphenous vein?

A
  1. accessible
  2. wall is muscular more elastic than superficial veins
  3. distance between tributaries and perforating vs, is sufficient allowing to harvest more length
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46
Q

What must doctors consider when assessing abnormalities in peripheral sensory function?

A

major cutaneous nerves must be seen as anatomically different from dermatome maps

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47
Q

What procedure is done for prolong administration of blood, electrolytes or drugs?

A

Saphenous Cutdown (anterior to medial malleolus)

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48
Q

What nerve do you target for REGIONAL nerve block of lower limb?

A

Femoral nerve (L2-L4)

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49
Q

What muscle commonly compresses the Sciatic N?

A

Piriformis M.

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50
Q

Pt with (+) Trendelenburg sign would have what injury?

A

Injury to Superior Gluteal N.

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51
Q

What injuries could have (+) Trendelenburg SIgn?

A
  1. injury to superior gluteal N.
  2. hip dislocation
  3. avulsion of greater trochanter
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52
Q

Where would anesthetic block of sciatic nerve would cause paresthesia?

A

all the way to the foot

sciatic N –> tibial N—> medial and lateral plantar ns.

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53
Q

Ischial bursitis involves excessive friction between ischial bursa and what bony structure?

A

ischial tuberosity

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54
Q

This type of strain is most common in athletes who run or kick hard?

A

hamstring injury

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55
Q

What are the arteries involved in cruciate anastomosis?

A
  1. inferior gluteal A.
  2. medial femoral circumflex A
  3. lateral femoral cicumflex A
  4. 1st perforating branch of deep femoral branch
56
Q

When ligating the femoral A. the anastomosis functions to?

A

prevent NECROSIS of the femoral head

57
Q

Complete tear of hamstring with loss of motor function is ?

A

Grade 3 hamstring tear

58
Q

Hamstring tendonapathy is often associated with ?

A

avulsion of ischial tuberosity

59
Q

Mild tear of hamstring with minor swelling?

A

Grade 1 hamstring tear

60
Q

Partial hamstring tear with loss of strength ?

A

Grade 2 Hamstring Tear

61
Q

Which bony structure is susceptible to avulsion by the hamstrings?

A

ischial tuberosity

62
Q

What part of the tibia is most susceptible to COMPOUND fractures? Why?

A

Tibial shaft because of its POOR blood supply

63
Q

This type of fracture is common in pple who take long hikes before they are conditioned?

A

Transverse march (stress) fractures

64
Q

Common fracture with skiing?

A

Diagonal fracture of tibia

“ BOOT top Fracture”

65
Q

Fibular fractures are commonly associated with what other injury?

A

fx or dislocations of ankle joint

66
Q

What joint is damaged as a result of a Calcaneal Fracture?

A

Talocalneal Joint

67
Q

A hard fall on the heel can result in?

A

calcaneal fracture

68
Q

Fracture of this structure via crush injury could affect weight bearing on the foot ?

A

fracture of sesamoid bones

69
Q

What two events could result in formation of Os Trigonum? Where does it form?

A
  1. failure of secondary ossification center to fuse
  2. fracture of ossified center

behind the talus

70
Q

How do popliteal abscesses spread?

A

Tend to spread superior and inferiorly because of the toughness of the popliteal fascia

71
Q

Weakening of popliteal pulse indicates?

A

femoral artery obstruction

72
Q

How do you palpate for popliteal pulse?

A

prone position, with knee flexed

relax popliteal ossa and hamstrings

73
Q

What unique characteristics distinguish a popliteal aneurysm from other masses?

A

thrills and bruits audible via stethoscope

74
Q

What nerve is susceptible to compression by popliteal aneurysm?

A

tibial N.

75
Q

Severing the tibial N. would affect what functions?

A
  1. paralysis of plantarflexion and flexing of the toes
  2. loss of sensation in the sole of the foot

( TIbial N. supplies Posterior leg and Plantar Ns in the feet)

76
Q

infection in anterior or posterior leg spread ? In Lateral leg?

A
  1. Distally

2. Proximally into popliteal fossa via femoral N.

77
Q

Shin splints are caused by ?

A

microtrauma to TIBIALIS ANTERIOR leading to small tears in the periosteum

78
Q

What two structures contribute to the unique Everted (pronated) position of the HUMAN foot?

A
  1. fibularis longus across the sole of the foot

2. fibularis tertius at 5th metatarsal

79
Q

Most injured Nerve of the lower limb?

A

common fibular N.

b/c wraps around fibular head

80
Q

Severance of the Common fibular N. would result in what deficits?

A
  1. loss of dorsiflexion and eversion
  2. loss of sensation of anterolateral leg and dorsum of foot
  3. difficult HEEL STRIKE
81
Q

Foot drop is caused by?

A

injury to common fibular N.

82
Q

Identify the gait: individual leans to side opposite long limb

A

Waddling gait

83
Q

Identify the gait: long limb is abducted to allow toes to clear

A

Swing out gait

84
Q

Identify gait: extra flexion of the thigh to raise knee as high as necessary

A

Steppage gait

85
Q

Ski boot syndrome is caused . y ?

A

Deep fibular Nerve entrapment

cause pain in ANTERIOR compartment

86
Q

Chronic ankle sprains can cause ?

A

entrapment of superficial fibular N.

87
Q

What structure is occasionally found in the LATERAL head of the gastrocnemius M. ?

A

Fabella

88
Q

Pt recently state they picked up running after being inactive for 6 months, and pain in her heel. What may this patient have?

A

Calcaneal Tendonitis

usually occurs with sudden onset of training

89
Q

An audible snap, immediate pain over the calf and loss of plantar flexion describe what injury?

A

Rupture of Calcaneal Tendon

90
Q

Calcaneal Reflex tests which nerve roots?

A

S1 and S2

91
Q

In the absence of plantar flexion a person will ?

A

rotate the foot EXTERNALLy during the stance phase to disable passive dorsiflexion

92
Q

What is calcaneal bursitis?

A

infllammation of deep bursa in the calcaneal tendon

93
Q

severe dorsiflexion of the ankle can result in ?

A

Fractures of neck of the talus

94
Q

Cause of fracture of metatarsals?

A

heavy objects falling on foot

95
Q

Pt with abrasions and minor sepsis caused by pathogenic microorganisms will have what on physical exam?

A

enlared inguinal lymph nodes

96
Q

What muscles contibutes most to venous return of the leg?

A

triceps surae

97
Q

A distal belly medial to the calcaneal tendon present in 3% people

A

Accessory soleus

98
Q

What is important to examin in pts with occlusive peripheral arterial disease?

A

Posterior tibial pulse

99
Q

Hematoma with edema anteromedial to the lateral malleolus could indicate?

A

Contusion of Extensor Digitorum Brevis

100
Q

To numb the skin on the dorsum of the foot (except the flip flop zone), where would you administer an anesthetic block ?

A

Superficial Fibular N.

101
Q

Plantar Reflex tests which nerve roots?

A

L4. L5. S1, S2

102
Q

What does a babinski reflex indicate after the age of 4?

A

potential brain injury

103
Q

Joggers foot is a result of ?

A

Medial Plantar N compression

tingling on the medial side of the sole of the foot

104
Q

Enlargement of popliteal lymph nodes indicates?

A

infection of LATERAL side of foot

105
Q

Inguinal lymphadenopathy without popliteal lymphadenopathy sometimes indicates?

A

infection of MEDIAL side of foot

106
Q

Pes planus is caused by ?

A

inability of spring Ligament supporting talar head

107
Q

Potts Fracture - Dislocation is caused by?

A

eversion of the foot resulting in displacement of medial malleolus due to pulling on medial collateral ligament

108
Q

Most common ankle injury ?

A

inversion injury

109
Q

What ligament is involved in Lateral ankle Sprain?

A

Anterior talofibular Ligament

common in jumping activities

110
Q

What warrants a hip replacement? What is replaced?

A

OSteoarthritis of hip joint

Femoral head and neck

111
Q

What nerve can be injured with hip dislocation?

A

Sciatic N

112
Q

increased Q angle indicates?

A

Genu Valgum (knock knees)

113
Q

decreased Q angle indicates?

A

Genu Varum (bow leg)

114
Q

What direction does patella dislocate ? Why?

A

Laterally b/c of vastus medialis

115
Q

REpetitive microtrauma caused by running downhill , from friction between patella and patellar surface of femur is ?

A

Patellofemoral syndrome

116
Q

Tearing of the Medial collateral ligament (Tibial collateral ligament) results in tearing of ? (2)

A

medial meniscus or ACL

117
Q

ACL rupture would have which positive tests?

A

Lachmans

Anterior Drawer

118
Q

Pt lands on knee with flexed knee what injury is this?

A

PCL tear

119
Q

Pain with lateral rotation of tibia indicates ?

A

Lateral meniscal tear

120
Q

Pain with medial rotation of tibia indicates ?

A

medial meniscus tear

121
Q

What examination is best for debridement or removal of torn menisci?

A

Arthroscopy

122
Q

What makes up the triangular area for knee joint aspiration?

A
  1. gerdy tubercle
  2. lateral epicondyle of femur
  3. apex of patella
123
Q

Pt complains of knee pain, state he KNEELS alot at work ?

A

Prepatellar bursitis

124
Q

Friction between skin and tibial tuberosity with edema?

A

subcutaneous infrapatellar bursitis

125
Q

Edema between the patellar ligament and tibia?

A

Deep infrapatellar bursitis

126
Q

abrasion or penetrating wounds to the knee can lead to?

A

Suprapatellar Bursitis

127
Q

Herniation of gastrocnemius or semimembranous bursa into the joint capsule of the knee?

A

Popliteal cyst

128
Q

Foot deformity caused by pressure from footwear and degenerative joint disease, characterized by lateral deviation of the great toe?

A

hallux valgus

129
Q

tender and inflamed Subcutaneous bursa of the toe?

A

bunion

130
Q

inflammmation and thickened skin over PIP of toes ?

A

corns

131
Q

Mallet toe?

A

flexion at DIP

132
Q

Hammer toe?

A

extension MP

flexion PIP

133
Q

Claw toe?

A

extension MP
flexion PIP
Flexion DIP

134
Q

Trigger toe?

A

extension of MP and Flexion of IP of big toe

135
Q

Inverted, plantarflexed and adducted Foot with weightbearing mostly on the lateral side?

A

Club foot

msk exam 2 (7 decks)

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