Lower Extremity Path

Question 1

How does a hip dislocation present?

Answer 1

shortened and internally rotated leg following a high energy MOI

Question 2

What is a major complication of hip dislocation?

Answer 2

avascular necrosis

Question 3

What is the major blood supply to the femoral head?

Answer 3

medial femoral circumflex from the profunda artery

Question 4

How does a hip fracture present?

Answer 4

shortened and externally rotated leg after a fall

Question 5

Which hip fracture has more difficulty healing?

Answer 5

femoral neck fracture

Question 6

What are two important side effects of bisphosphonate?

Answer 6

AVN of the jaw

proximal femoral stress fractures

Question 7

Where is articular hip pain felt? (arthritis)

Answer 7

anterior and groin

Question 8

Where is trochanteric pain felt?

Answer 8

lateral

Question 9

How does trochanteric bursitis present?

Answer 9

lateral hip pain
tenderness over greater trochanter
pain with activity
normal ROM

Question 10

What is a common cause of femoral nerve deficit?

Answer 10

cardiac cath

Question 11

What is a physical exam finding for hip abductor weakness?

Answer 11

Trendelenburg sign/gait:
pelvic sag away from injury
swaying over injury

Question 12

What is the most commonly injured quad muscle?

Answer 12

rectus femoris

Question 13

What bursa commonly get inflamed in the knee? (2)

Answer 13

prepatellar (people working on knees)

pes anserine

Question 14

What nerve can be injured along with the LCL?

Answer 14

peroneal nerve (fibular)

Question 15

What physical exam tests indicate ACL injury?

Answer 15

Lachman

anterior drawer

Question 16

Why is the fibular nerve more commonly injured than the tibial?

Answer 16

it wraps around the fibular head

Question 17

What are common symptoms of meniscal injury?

Answer 17

mechanical symptoms:
locking/catching
knee effusion

Question 18

What are complications of meniscal injury?

Answer 18

poor healing

early arthritis

Question 19

What is injured in an unhappy triad injury?

Answer 19

ACL
MCL
medial meniscus

Question 20

Which meniscus is more commonly injured with an ACL tear?

Answer 20

lateral meniscus

Question 21

What is a complication of a tibia fracture?

Answer 21

compartment syndrome

Question 22

What are the 6 P’s of compartment syndrome?

Answer 22

pain
pallor
paresthesias
pulseless
paralysis
pain out of proportion (escalating)

Question 23

In compartment syndrome, passive flexion or extension hurt worse?

Answer 23

passive extension (stretching)

Question 24

What are the most commonly sprained ankle ligaments?

Answer 24

anterior talofibular ligament (ATFL)

deltoid

Question 25

What is the underlying cause and pathophys of Charcot foot?

Answer 25

neuropathy (diabetes) arch swells and collapses due to repetitive trauma looks like infection acutely

Question 26

What is a complication of talus fracture?

Answer 26

AVN

Question 27

What is a common MOI for talus fracture?

Answer 27

forced dorsiflexion (MVA)

Question 28

What are two common causes of great toe pain?

Answer 28

``` gout hallux rigidus (OA) ```

Question 29

What are classic X-ray findings for OA (4)?

Answer 29

joint space narrowing sclerosis osteophytes (spurs) cysts