Lower Limb Flashcards
(25 cards)
How many lordoses (curves) should be present in the spine, what are their names?
3 main (4 including pelvic)
How many lumbar ligaments are there?
6
Which nerve roots are contained within the cauda equina?
L1 - L5 & S1 - S5
What is the longest and widest nerve in the body?
Sciatic nerve
What are important Hx questions for back pain?
Full SOCRATES
Occupation?
Hobbies?
Exercise level?
PMHx of Ca
How has the patient been managing?
What are the important IPM features for the back?
Inspection:
- Posture
- Abnormal curvature (kyphosis/scoliosis)
Palpate:
- Spinal process
Move:
- Flexion + extension
- Lateral flexion L+R
- Rotation (Sitting)
What are the important IPM features for the back?
Inspection:
- Posture
- Abnormal curvature (kyphosis/scoliosis)
Palpate:
- Spinal process
Move:
- Flexion + extension
- Lateral flexion L+R
- Rotation (Sitting)
What is sciatica, what causes it?
General term for inflammation of sciatic nerve
It is the result of irritation not injury. Causes include:
- Disc disorders (≈90% cases)
- Muscle spasm
- Spondylitis
What is spinal stenosis and its risk factors?
Narrowing of the passage through which the spinal chord passes causing pressure and pain.
Rx:
Congenital narrowing
Hyperparathyroidism
Ankylosing spondylitis
Degeneration
Cushing’s syndrome
Acromegaly
Paget’s disease
Osteoarthritis
What are the red flags for possible spinal metastases?
Confirmed current or prev. primary Ca
Age under 20 or over 50
Pain for over 1 month
Failure to respond to conservative therapy
Raised ESR & anaemia
What are the risk factors/causes of infection related back pain?
IV drug use
HIV
Immunosuppressant
On corticosteroids
TB/fungal spondylitis
Referred pain from:
- Pylenephronitis
- Dissecting aortic aneurysm
What are the risk factors/causes of infection related back pain?
IV drug use
HIV
Immunosuppressant
On corticosteroids
TB/fungal spondylitis
Referred pain from:
- Pylenephronitis
- Dissecting aortic aneurysm
What management is recommended for simple lower back pain?
Keep gentle activity (ADLs)
Avoid bedrest
Regular drug therapy
Exercise and rehab (after at least 6 wks recovery period)
What are the TUNAFISH red flags for back pain?
Trauma
Unexplained weight loss
Neurological symptoms (6 Ps)
Age <20 or >50
Fever
IV drug use
Steroid use
Hx of Ca
What are you looking for when assessing the hip?
Joints above + below
DCAP-BTLS (Swelling of trochantic bursitis)
Neurovascular compromise (6 Ps)
Scarring
Atrophy
Asymmetry
Gait (antalgic, trendelenburg)
What are the 4 main ligaments of the knee?
Anterior cruciate ligament
Posterior cruciate ligament
Tibial collateral ligament
Fibular collateral ligament
What is Baker’s cyst?
A Baker’s cyst, also known as a popliteal cyst, is a type of fluid collection behind the knee. Often there are no symptoms. If symptoms do occur these may include swelling and pain behind the knee, or knee stiffness. If the cyst breaks open, pain may significantly increase with swelling of the calf.
How do you test for fluid in the knee?
Ballottlement test
Apply a series of downwards stroke from thigh to leg and then firmly grasps the upper part of the knee just above the patella. With one finger push the patella backward against the femur. An increased patella waving motion or spongy joint feeling suggests the test is positive for joint effusion
What are valgus varus knee deformities?
Changes in the alignment of the lower leg to the upper leg.
Why should you check for vastus medialis atrophy when examining the knee?
Vastus medialis atrophy can be a symptom of knee arthritis
Why is it important to check the fibula head following ankle injuries?
Fibula head avulsion fractures are a common secondary injuries to ankle injuries.
Ankle injuries are often very painful and distracting
What tests can be carried out for sciatica?
Straight leg raise (SLR) and slump test
Hip internal rotation
Electromyography
Nerve conduction therapy (NCS)
What is Iliotibial band syndrome?
Iliotibial band syndrome is the second most common knee injury, and is caused by inflammation located on the lateral aspect of the knee due to friction between the iliotibial band and the lateral epicondyle of the femur.
What test can you do for achilles tendon laxity?
Simmonds test
Squeeze calf and observe foot movement
