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Anatomy Exam 3 > Lower Limb 2 > Flashcards

Lower Limb 2 Flashcards

1
Q

Vascular dx of leg pain

A
  • DVT (constant/assymetrical pain)

- PVD (intermittent bilateral pain)

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2
Q

Neurospinal dx of leg pain

A
  • disc disease

- spinal stenosis

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3
Q

Neuropathic dx of leg pain

A
  • diabetes (increased sorbitol, myelin sheat gets holes leading to parathesia)
  • chronic etoh abuse
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4
Q

Musculoskeletal dx of leg pain

A

-chronic compartment syndrome

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5
Q

Ankle brachial index (ABI)

A

systolic BP in ankle/systolic BP in brachial artery

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6
Q

ABI values

A
  • > 0.9 is normal
  • ## .5-.9 intermitent claudication
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7
Q

Risk factor modifications of leg pain

A
  • smoking cessation
  • BSL control
  • BP control
  • lipid lowering medicine
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8
Q

Exercise modification for leg pain

A
  • claudication exercise (leads to collateral circulation)
  • 45-60min 3x weekly for 12 weeks
  • 6 months later + 6.5 min walking time before pain
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9
Q

Medical mgmt of leg pain

A
  • antiplatelet meds
  • phosphodiesterase inhibitor
  • foot care
  • pt education
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10
Q

PCI/SX required when?

A
  • poor response to exercise rehab and meds
  • significant disability by claudication
  • morphology of lesion
  • bypass
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11
Q

5 Ps of acute ischemic limb

A
  • pain
  • pallor
  • pulselessness
  • perishing cold (poikilothermia)
  • parathesias
  • paralysis is an extra one that is rare
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12
Q

Further history of pts w/ PVD reveal

A
  • lot of cigs
  • 4 months of “leg cramps” in both legs
  • 2-3 weeks of intermittent chest pain
  • no doctor visits in last month
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13
Q

Examination finding of PVD

A
  • below knee is pale/col
  • irregulary irregular pulse
  • slow capillary refill
  • reduced pulse
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14
Q

Type I salter harris

A
  • through physis
  • child has point tenderness at epiphyseal plate
  • no growth disturbance
  • SCFE
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15
Q

Type II SH fracture

A
  • through physis and metaphysis
  • most common SH fracture
  • rarely results in functional limitations
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16
Q

Type III SH fracture

A
  • through physis and epiphysis
  • prone to chronic disability bc it extends into articular surface of the bone
  • rarely results in significant deformity
  • Tillaux fracute is this type prone to disability
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17
Q

Type IV SH fracture

A
  • through epiphysis, physis, metaphysis

- can cause deformity and result in chronic disability

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18
Q

Type V SH fracture

A
  • Compression/crush injury of epiphyseal plate
  • associated w/growth disturbance at the physis
  • axial load injury
  • poor functional prognosis
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19
Q

Ossification of Femur

A 
center of shaft-7th week IU
lower end of femur-9th month IU
head-first year
greater trochanter-4th year
lesser trochanter-12th year
upper 3 fuses w/shaft around 18 years old
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20
Q

Retinacular arteries

A

supply NOF and the head

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21
Q

Subcapital fracture

A
  • fracture of neck of femur occurs very close to femur head

- most common intrascapular fracture

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22
Q

cervical fracture

A

fracture of neck of femur occurs cery close to midpoint of femur

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23
Q

basal fracture

A

fracture of the neck of femur occurs very close to the shaft

24
Q

If the femur neck fracture is not impacted this deformity will be present

A

shortening of the limb bc the distal fragment is pulled upward by the rectus femoris, adductors and hamstrings resulting in overlaps

25
Q

Proximall fragment goes where from a femur fracture

A
  • abducted by glut medius/minimus
  • laterally rotated by glut max, piriformus, obturators, and quadratus femoris
  • flexed by iliopsoas
26
Q

Distal fragment goes where from a femur fracture

A
  • pulled upward behind proximal fragment by hamstirngs and quadriceps femoris
  • adducted and laterally rotated by adductors
  • drawn back by gastrocs which may injure popliteal artery
27
Q

largest sesamoid bone

A

patella, acts as a fulcrum for other muslces

28
Q

Patella stabilized superiorly by….

inferiorly. ..
medially. …
laterally. ..

A
  • quadriceps
  • patellar ligament
  • vastus medialis
  • lateral condyle
29
Q

In a patella dislocation, it goes where? more common in whom?

A
  • laterally from a twisting motion

- women, due to shape of hips (cause genu valgum or knock kneed appearance)

30
Q

Direct patella fracture

A
  • considerable comminution
  • little displacement of fractured fragments
  • fall onto knee/hits dashboard
31
Q

Indirect patella fracture

A
  • less comminuted
  • displaced and often transverse
  • jumping/rapid flexion of knee joint against fully contracts quads
32
Q

In tib/fib fracture the distal fragments are drawn where?

A

upward behind the proximal fragments by the gastroc and soleus

33
Q

Potts fracture

A
  • lateral or medial malleolus fracture

- forcible eversion of the ankle

34
Q

Bi-malleolar fracture

A

both medial and lateral malleolus

35
Q

Dupuytren’s fracture

A

talus thrust upward between tib/fib

36
Q

syndesmosis

A
  • cord of fibrous tissue called a ligament
  • common in football/skiing
  • painful external rotation
37
Q

high ankle sprain

A
  • aka syndesmotic sprain
  • injury to distal tib/fib joint, injuring the interosseus of syndesmotic ligaments from excessive dorsi or plantar flexion
38
Q

Weber classification A

A
  • fracture inferior to syndesmosis
  • syndesmosis intact
  • medial malleolus may be fractured
  • usually stable
39
Q

Weber classification B

A
  • fracture at level of syndesmosis
  • syndesmosis intact or partial tear
  • possible medial fracture or deltoid damage
  • stability variable
40
Q

Weber classification C

A
  • fracture above level of ankle joint
  • tibfib syndesmosis injured
  • usually medial fracture or deltoid injuy
  • unstable
41
Q

Metatarsal stress fracture

A
  • occurs in distal 1/3 of metatarsals
  • most common in 2nd and 3rd metatarsal
  • minimal displacement
  • aka march fracture
42
Q

SCFE

A

-posterior and medial displacement of femoral capital epiphysis

43
Q

mechanical etiology of SCFE

A
  • thinning of perichondral ring complex
  • relative or absolute femoral retroversion
  • change in inclination of adolescent proximal femoral physis relative to femoral neck and shaft
44
Q

predispositions to SCPE

A
  • obesity
  • rapid growth
  • endorcinopathies
45
Q

Stable SCFE

A
  • pain in groin, referred to anteromedial aspect of thigh and knee
  • loss of internal rotation w/ complaints of pain at limit of internal rotation
46
Q

Unstable acute SCFE

A
  • severe fracture like pain in hip region as a result of a fall or twisting injury
  • unable to bear weight
47
Q

intracapsular hip fracture

A
  • includes femoral head and neck fractures (subcapital, transvervical, basicervical)
  • at risk of non union and avascular necrosis from disrupted blood supply to femoral head
48
Q

extracapsular hip fracture

A

which includes trochanteric, intertrochanteric, and subtrochanteric fractures

49
Q

hip fracture stats

A
  • highest in elderly pts
  • 15-20% die within 1 year of fracture
  • more common in females
50
Q

risk factors of hip fracture

A
  • nutrition (lack of Vit D, eating disorder, high caffeine)
  • smoking/etoh
  • medications (steroids, diuretics, anticonvulsants
  • environmental factors
51
Q

Garden I

A

incomplete fracture of femoral neck

52
Q

Garden II

A

complete fracture w/o displacement

53
Q

Garden III

A

complete fracture w/partial displacement

54
Q

Garden IV

A

complete fracture w/full displacement

55
Q

Pauwels classification

A

more vertical the line, the greater the risk of non union b/c increased shear stresses across the fracture

56
Q

Achilles tendon rupture

A
  • largest, most powerful tendon in body
  • primarily seen in males w/sporting event with sudden starting and stopping
  • weak plantarflexion, positive thompson test
57
Q

Assocaited achiiles tendon rupture conditionss

A
  • ochronosis
  • steroid use
  • quinolones
  • inflammatory arthritis

Anatomy Exam 3 (3 decks)

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