After quiz 4. LB Plus Flashcards
Neuropraxia
Loss of conduction at the compression point with no axonal degeneration
Thoracic Outlet Syndrome
Compression of brachial plexus (almost always), subclavian artery and/or subclavian vein
Causes neuropraxia
Most commonly caused by poor posture
Double crush
Neurovascular bundle compressed at more than one site.
Seen in TOS but not specific to it.
Level of cervical plexus
Above C5
Level of brachial plexus
C5-T1
Classification of TOS
Cervical rib syndrome
Anterior scalene syndrome
Costoclavicular syndrome
Pectoralis minor syndrome
Anterior scalene syndrome
Form of TOS in which brachial plexus and/or subclavian artery are compressed in between anterior and middle scalenes.
Trophic change
Change resulting from interruption of nerve supply
Compartment syndrome
Muscle and nerve ischemia caused by fascia not accommodating swelling in muscular compartment.
Most commonly deep posterior compartment of leg, flexor compartment of forearm.
Volkmann’s Ischemic contracture
Permanent contracture deformity of hand and fingers caused by ischemia.
Can be complication of compartment syndrome.
CRPS
Chronic regional pain syndrome
Pain that persists after trauma has healed
Trophic changes Allodynia Atrophy Focal osteoporosis Pain Dystonia Hyperhydrosis Neurogenic inflammation
Two types of CRPS
Type 1 (90%)
Reflex syndrome dystrophy
No identifiable nerve injury
Type 2
Causalgia
Involves major nerve injury
Also “hot” and “cold”
Allodynia
Hurts where it shouldn’t hurt
Valgus deformity
Distal bone deviates away from midline
Varus deformity
Distal limb deviates towards midline
Coxa vara
Angle between head and neck of femur less than 120 degree
Mild shortening of limb
Coxa valga
Femoral neck-shaft angle greater than 135 degrees
Muscle weakness, neuromuscular disorders, slipped epiphysis of femoral head
Genu valgum
Knock kneed.
Normal in children 2-3, should straighten out by 5-6
Hypermobility of knee joint
Genu varum
Bow legs
Normal in infants, grow out by adulthood.
Hallux valgus
Valgus orientation of big toe
Most commonly associated with medial deviation of MT#1 and bunion at 1st MTP jt.
Poor footwear, injuries, neuromuscular problems.
Hallux rigidus
Pain and stiffness at 1st MTP jt
Form of degenerative arthritis
Hallux limitus –> hallux rigidus –> frozen joint.
Biomechanics, structural abnormalities, genetics, overuse, trauma
Torsion (structural)
Anterior aspect of distal end of long bone is twisted.
External femoral torsion – toe out
Internal tibial torsion - toe in
Fracture at epiphyseal plate of femur
Stunts growth
Can lead to avascular necrosis
Fracture at femoral neck
Can lead to avascular necrosis
Fracture at proximal femur
Osteoporosis a risk factor
Tibial plateau fracture
Mostly crush injuries in people over 60
Severe abduction injury
Lateral blow to knee when foot is planted –> forced valgus –> femoral condyle driven into lateral tibial plateau
Hip dislocation
Posterior – most common; present shortened and internally rotated
Anterior –least common, present externally rotated
Central – definitely fractured.
Trochanteric bursitis
Bursa between glute max and trochanter
Affects lateral hip
Can be caused by IT band issues
Ischiogluteal bursitis
Pain in sit bones
Can get sciatic symptoms.
Bursa of the knee
Prepatellar
Suprapatellar
Infrapatellar
IT band contracture
Contracture or thickening of iT band.
Biomechanics altered, compensation at SI jt or ankle
IT band friction syndrome
Inflammation and pain where IT band crosses lateral femoral condyle.
Can be caused by repetitive hip and knee flexion.
Chondromalacia Patella
Softening and degeneration of cartilage under patella
Often due to tracking/instability.
Females > makes (q angle)
Shin splints can be caused by:
1 periostitis
2 tibial stress fracture
3 chronic compartment syndrome
Chandlers Disease
Legg-Calves Perthes in adults
Osteochondrosis of femoral head
SCFE
Slipped capital femoral epiphysis
Idiopathic
Epiphysis slips off femur
More often in adolescent boys
Achilles tendinitis
Most common tendonitis of the foot
Just above attachment points
Achilles rupture
Pop!
Retro calcaneal bursitis, tendonitis predisposing factors
Pes Planus
Flat feet.
Pronated hind foot.
Functional (ligament laxity and/or muscle weakness) or structural (bony malformation)
Pes cavus
Claw foot
Increased arch, forefoot drops below hind foot when not weight bearing
Plantar fasciitis
Most common heel pain.
Inflammation of plantar fascia
Stabbing pain, worse in morning
Heel Spurs
Bone spurs, osteophytes, exostosis
On calcaneus
May be associated with plantar fasciitis.
Freiberg’s disease
Osteochondrosis of metatarsal head
Most common in girls, and 2nd MT head
Hammer toe
MTP hyperextension
PIP flexion
DIP hyperextension
Claw toe
MTP hyperextension
PIP Flexion
DIP flexion
Mallet toe
DIP flexion
Lisfranc’s fracture
Fracture to TMT joint with dorsal and lateral dislocation.
Piriformis syndrome
Compression/irritation of sciatic nerve by piriformis
Numbness, pain, tingling down buttocks and thigh
Sciatic nerve compression
Strongest and longest peripheral nerve
Tibial and peroneal branches
Foot drop, claw toe, CRPS, anesthia, paresthesia
Common peroneal nerve compression
Compressed at opening of Fibularis
Change in sensation to lateral leg and dorsum of foot
Affects eversion and dorsiflexion
Posterior tibial nerve compression
Entrapped in tarsal tunnel
Affect plantar surface of foot and dorsum of toes.
Intermittent claudication
Distinct pain or cramping on calf with walking. Stops with rest.
Often symptom of peripheral arterial disease. Aggravated by cold, medications
Cyanosis, pain, Trophic changes , decreased pulse, cold
Hindfoot varus
Calcaneal inversion
Hindfoot valgus
Calcaneal eversion
Forefoot varus
Inversion of forefoot on the Hindfoot at the mid tarsal joint
Forefoot valgus
Eversion of forefoot on the Hindfoot at the midtarsal joint.
Calcaneus dorsalis
Perma-dorsiflexion
Equines plantaris
Perma-platarflexion
Talipes equinovarus
Clubfoot
Inversion + plantar flexion
Osteoid osteoma
Benign bone tumour often found in long bones
Enchondroma
Common benign tumour or cartilage
Often found in hands, feet, long bones
Osteochondroma
Most common benign primary neoplasm of bone
Most common in distal femur
Chondrosarcoma
Malignant neoplasm
Slow
Often in femur
Osteosarcoma
Malignant bone tumour most frequently found in long bones.
Sever’s Disease
Osteochondrosis of calcaneus
AKa calcaneal apophysitis
Most common cause of heel pain in growing athletes.
