091514 lower extr injury Flashcards
obturator nerve sensory and motor
sensory: medial thigh
motor: thigh adduction
femoral nerve sensory and motor
sensory: anterior thigh and medial leg
motor: thigh felxion and leg extension
common peroneal nerve
sensory: anterolateral leg and dorsal aspect of foot
motor: foot eversion and dorsiflexion, toe extension, foot drop
tibial nerve
sensory: sole of foot
motor: foot inversion and plantarflexion
sciatic nerve
flexion at knee
common fibular branches
deep fibular nerve-lifting foot up, dorsiflex
superficial fibular nerve-eversion
which nerve is sensory for btwn big toe and 2nd toe
deep fibular nerve
tibial nerve is divided into
medial-3 and 1/4 muscles (for big toe)
lateral-everything else
slipped capital femoral epiphysis hx
overweight, early adolescent with hx of groin or knee pain (which can be referred to anteromedial thigh)
often bilateral (but not simulataneous)
etiology of slipped capital femoral epiphysis
repetitive overload
presentation of slipped capital femoral epiphysis
vague symptoms
worse with activity
exam of slipped capital femoral epiphysis-findings?
limitation of hip internal rotation
tests for slipped capital femoral epiphysis
XR
treatment for slipped capital femoral epiphysis
surgical fixation
transient synovitis of hip hx
age 3-10
etiology of transient synovitis of hip
viral, post vaccine, or drug induced
exam findings for transient synovitis of hip
hold hip slightly flexed and externally rotated-resist this action
any motion causes pain
positive log roll
refuses to bear weight
tests for transient synovitis of hip
sed rate 35-60 mm/hr
CBC-mild leukocytosis
treatment of transient synovitis of hip
NSAIDs for 1-3 wks
septic joint etiology
gonorrhea or skin flora
exam findgs of septic joint
swollen, pain
passive and activ ROM very painful
red, hot joint
usually has systemic signs, but may be absent in diabetic pt or immunosuppressed pt
treatment for septic joint
surgical incision and drainage followed by IV antibiotics
complication of septic joint
articular surface destruction
effusion
excessive fluid in joint
bursa
synovial lined sad that contains fluid and acts to reduce friction btwn structures
common locations of bursa
Achille’s
olecranon
subacromial
prepatellar and other knee locations
ganglion
fluid filled soft tissue mass filled with collection of synovial or peritendinous fluid that arises from joint or tendon sheath
common location: wrist
usually relatively small, less than 2 cm
usually near joints
usually tense
enthesopathy
disorder or muscular or tendinous bony attachment
tendinitis
acute inflam of tendon (trauma-blow or pull)
strain
muscle fiber damage from overstretch (eccentric loading)
lachman’s test
knee bent at 20 degrees
tibia pulled forward-if moves indicates ACL damage
valgus tests
MCL and lateral meniscus
done with knee slightly flexed so eliminate ACL and PCL stabilization
if knee completely extended, is it stabilized?
yes, by the ACL and PCL
test for meniscal tear
McMurray and circumduction tests-to rotate the knee joint, and positive test reproduces the pain
exertional compartment syndrome
only with heavy exercise
from hypertrophied muscle during exercise
which compartment in the leg is least likely to get exertional compartment syndrome
superficial posterior
treatment for compartment syndrome
if pressures are greater than 40 mm Hg, do surgical release
femoral acetabular impingement
spur on femoral head or acetabumlum that causes bones to hit each other
can see with extremes of motions-turning, twisting, squatting. can see pain at end ROM
