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RA1 (2) > Applied Clinical Anatomy of Lower Limb > Flashcards

Applied Clinical Anatomy of Lower Limb Flashcards

1
Q

Hip joint type

A

Ball and socket synovial

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2
Q

Articulating bones in hip

A
  • Innominate hip bone
    > Ileum
    > Ischium
    > Pubis
  • Femur
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3
Q

Which ligament completes the acetabulum?

A

Transverse acetabular ligament

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4
Q

Intertrochanteric line vs crest

A
  • Line = anterior, slightly raised
  • Crest = posterior, more prominent
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5
Q

Where does the hip joint capsule attach to the femur?

A
  • Intertrochanteric line (anterior)
  • 1.5cm above intertrochanteric crest (posterior)
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6
Q

Ligaments supporting the hip joint

A
  • Iliofemoral
  • Ischiofemoral
  • Pubofemoral
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7
Q

Why are posterior hip dislocations more common?

A
  • Iliofemoral ligament strongest
  • Much less support from this on posterior aspect
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8
Q

Which people are hip fractures most common in?

A

Elderly females

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9
Q

Vascular supply to head of femur

A
  • Originally from medial/lateral circumflex arteries
  • Retinacular vessels branch from these and supply distal to proximal
  • Artery of ligamentum teres branches off obturator artery to supply fovea capitis
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10
Q

What forms Shenton’s line?

A
  • Medial border of femoral neck
  • Inferior border of superior pubic ramus
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11
Q

What does loss of Shenton’s line suggest?

A
  • Femoral neck fracture
  • Superior pubic ramus fracture
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12
Q

Position of lower limb after hip fracture

A
  • Shortened
  • Externally rotated
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13
Q

Garden classification of femoral neck fractures

A
  • I = incomplete/impacted bone injury with valgus angulation of distal component
  • II = complete + undisplaced
  • III = complete + partially displaced
  • IV = complete + totally displaced
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14
Q

Basic management principles of femoral neck fracture

A
  • Resuscitation
  • Analgesia
  • Investigate cause
  • Surgery (urgent reduction + internal fixation)
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15
Q

What internal fixation is used to treat a non-displaced hip fracture?

A

In-situ pinning with screws

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16
Q

What internal fixation is used to treat a displaced hip fracture?

A

Partial hip replacement (hemiarthroplasty)

17
Q

Causes of posterior hip dislocation

A
  • Trauma
  • Developmental (eg. acetabular fossa not well developed)
  • Hip replacement surgery
18
Q

What neurovasculature is contained in each compartment of the thigh?

A
  • Anterior = femoral artery, vein + nerve, great saphenous vein
  • Medial = profunda femoris artery + vein, sciatic nerve
  • Posterior = sciatic nerve, perforating branches of femoral vessels
19
Q

What neurovasculature is contained in each compartment of the leg?

A
  • Anterior = deep fibular nerve, anterior tibial vessels
  • Lateral = superficial fibular nerve
  • Posterior = tibial nerve, posterior tibial vessels
20
Q

Causes of compartment syndrome

A
  • Extremity fractures (open/closed)
  • Direct blow to extremity
  • Crush mechanism
  • Patients on coagulation
  • Reperfusion injuries
  • Tight bandages/dressings
  • Burns
21
Q

Warning signs/symptoms of compartment syndrome

A
  • Significant swelling
  • Pain out of proportion of injury
  • Increasing pain medication needs
  • Pain with movement of fingers/toes
  • Numbness/tingling nerves within compartment
  • Motor weakness
  • Cooler temperature of extremity
22
Q

How are all 4 of the leg compartments decompressed in compartment syndrome?

A
  • Bilateral fasciotomy:
    > Anterolateral incision for anterior + lateral compartments
    > Posteromedial incision for deep + superficial posterior compartments
23
Q

Contents of the femoral triangle (lateral to medial)

A
  • Femoral nerve
  • Femoral artery
  • Femoral vein
  • Lymphatics
24
Q

Where is the femoral pulse felt?

A

Mid-inguinal point

25
Q

Contents of the popliteal fossa (lateral to medial)

A
  • Common fibular nerve
  • Tibial nerve
  • Popliteal vein
  • Popliteal artery
26
Q

How is the popliteal pulse felt?

A
  • Flex knee
  • Press deep
27
Q

How is the dorsalis pedis pulse felt?

A
  • Look for EHL tendon
  • Dorsalis pedis artery just lateral to it
  • Palpate proximally as artery has a deeper course distally
28
Q

Contents of the tarsal tunnel (anterior to posterior)

A
  • Tibialis posterior tendon
  • FDL tendon
  • Posterior tibial artery
  • Tibial nerve
  • FHL tendon
29
Q

Where is the posterior tibial pulse felt?

A

1/3 along the line from posterior border of medial malleolus to calcaneal tendon

30
Q

What does the great saphenous vein empty through, where is this, and what does it empty into?

A
  • Saphenous opening
  • 3cm lateral to distal pubic tubercle
  • Femoral vein
31
Q

What does the small saphenous vein empty into, where, and how?

A
  • Popliteal vein
  • Popliteal fossa
  • Pierces through deep fascia
32
Q

What assist the openings in the saphenous veins in draining blood from superficial to deep veins?

A

Perforators

33
Q

Perforators of the leg, and where they are located

A
  • Hunterian perforator (proximal thigh)
  • Dodd perforator (distal thigh)
  • Boyd’s perforator (around knee)
  • Cockett’s perforator (posterior arch vein)
34
Q

How do varicose veins arise?

A
  • Incompetent valve in perforator
  • Blood flows from higher pressure in deep vein to lower in superficial
  • Swelling of superficial makes visible
35
Q

Types of cause of DVT

A
  • Blood flow
  • Hypercoagulability
  • Endothelial injury
36
Q

Causes of DVT

A

THROMBOSIS:
- Trauma
- Hormones - OCPs
- Road traffic accident
- Operations - cholecystectomy
- Malignancy
- Blood disorders - polycythemia
- Obesity, old age, orthopaedic surgery
- Serious illness
- Immobilisation
- Splenectomy

37
Q

Presentation of DVT

A
  • Swollen, tender calf
  • Fever
38
Q

Complications of DVT

A

Pulmonary embolism

39
Q

Management of DVT

A
  • Risk assessment
  • Anticoagulation

RA1 (2) (15 decks)

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