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LOCO2 > Anatomy Practical 2 > Flashcards

Anatomy Practical 2 Flashcards

1
Q

What is the most common cause of degeneration of the hip joint?

A
  • osteoarthritis (wear and tear arthritis)

- then avascular necrosis of the femoral head so dies from lack of blood supply

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2
Q

What has avascular necrosis of the femoral head been linked to?

A
  • alcoholism
  • fractures
  • dislocations of the hip
  • LT cortisone treatment
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3
Q

What are some symptoms of osteoarthritis?

A
  • pain whilst bearing
  • reduction in range of motion
  • develop bony spurs which can limit movement
  • pain may be present all the time as condition develops affecting sleep
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4
Q

How is osteoarthritis diagnosed?

A
  • complete history and physical exam
  • x-rays determine extent of degenerative process and suggest a cause
  • MRI may be necessary to determine whether avascular necrosis is cause of hip condition
  • blood tests to rule out systemic arthritis or infection in hip
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5
Q

What are the 2 major hip replacement types?

A
  • cemented prosthesis
  • uncemented prosthesis
    (choice made by surgeon based on age/lifestyle/personal preferences)
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6
Q

What is each prosthesis made up of?

A
  • acetabular component

- femoral component (may be femoral stem and head joined or separate)

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7
Q

What is the prosthesis made of?

A

Femoral - metal
Acetabular - metal shell with plastic inner socket liner acting like a bearing
(plastic is tough, smooth and slick)

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8
Q

What are the components of a knee prosthesis?

A
  • tibial component (replacing top of tibia)
  • femoral component (replaces 2 femoral condyles and patella groove)
  • patellar component (replaces joint surface on bottom of patella rubbing against femur)
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9
Q

What is the knee prosthesis made up of?

A
  • femoral component = metal

- tibial component = metal tray attached to bone and plastic spacer between replacing menisci

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10
Q

What is traction?

A
  • rarely used for fracture/dislocation management
  • skeletal = pin placed through bone distal to fracture and apply weights to pin and place patient in apparatus
  • common in femur fractures = pin in distal femur or proximal tibia posterior to tibial tuberosity
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11
Q

What is plaster of Paris used for?

A
  • treatment of bone fracture, soft tissue injuries and immobilisation
  • being replaced by newer fibreglass based casts which are lighter, more water resistant and more colours
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12
Q

What is external fixation?

A
  • frame used with pins passing through skin and sometimes muscles to connect external fixator to bone
  • 2 or more pins placed on either side of broken bone to hold in place and to anchor fixor
  • external fixator used to place broken bone in correct position and alignment until bone healing occurs
  • 6 weeks approx. for simple fracture
  • up to 1 year for more complicated
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13
Q

What is internal fixation?

A
  • bone fragments fixed with K-wires, screws, transfixing pins or nails, metal plate held by screws, long intramedullary nail, circumferential bands
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14
Q

What are K-wires?

A
  • hold fracture fragments together
  • used where fracture healing is predictably quick
  • external splintage (cast) applied as supplementary support
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15
Q

What are plates and screws?

A
  • for treating metaphyseal fractures of long bones and diaphyseal fractures of the radius and ulna
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16
Q

What are intra-medullary nails?

A
  • IM nails suitable for long bones
  • nail inserted into medullary canal to splint the fracture
  • rotational forces resisted by introducing locking screws
17
Q

Define arthrodesis?

A
  • surgical fusion of a joint
  • by clearing articular cartilage and bringing bone together and holding it in place until fusion occurs OR extra articular where fusion by-passes joint
18
Q

Define ankylosis?

A
  • spontaneous fusion of a joint
19
Q

Why is arthrodesis performed?

A
  • pain relief in severely damaged joint

- stabilisation of a joint which has lost stability from ligamentous damage or paralysis

20
Q

What is arthroscopy?

A
  • looking inside joint
  • diagnostic and therapeutic purposes
  • most useful in knee, shoulder, wrist, ankle and hip
  • rigid telescope fitted with fibreoptic illumination
21
Q

What is osteotomy?

A

Dividing a bone by open reduction

  • corrects a bone deformity and joint contracture
  • unite with external plaster fixation or by internal fixation
  • used to relieve pain in OA of hip and knee
22
Q

What is kyphoplasty?

A
  • restores height of compression fractures
  • improves angle of kyphosis
  • vertebral body inflated with balloon then injected with bone filler
  • benefits patients with spinal fractures
  • ## alternative is vertebroplasty
23
Q

What is vertebroplasty?

A
  • cement directly injected into vertebral body with no prior balloon inflation
  • mainly ineffective as prevents any further collapse of vertebra not restoring original height
24
Q

What is congenital dysplasia of the hip?

A
  • dislocated at birth
  • developmental dysplasia similar
  • check soon after birth for evidence of instability and categorise into 5 groups on basis of Barlow test
  • more common in girls
  • common after a breach delivery and in first-born
  • genetic component
25
Q

How is CDH managed?

A
  • newborn: splintage in abduction

- 6 to 18 months: closed reduction (traction, splintage), open reduction and splintage

26
Q

Why should you nose force a reduction in children who are detected late?

A
  • may cause AVN of femoral head
  • if close reduction not possible, open reduction through anterolateral approach carried out maintaining reduction using hip spica
27
Q

What is SUFE?

A
  • slipped upper femoral epiphysis
  • cause of limp in early adolescence rather than childhood
  • spontaneous posterior slippage of the femoral head
  • femoral neck rotated externally off head
  • changes in hormonal levels and secondary sexual development may impact
  • boys more prone and develop slightly earlier 11-12 years
  • presents with limp and pain referred to knee
  • xray diagnosis
  • shortening of leg and deformity restricting movement
  • OA develop earlier
  • reversing slip = risk of AVN to femoral head

LOCO2 (26 decks)

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