Blue Boxes Flashcards
Coxa Vara and Coxa Valga
Coxa vara decreased angle of inclination (perpendicular) and Coxa valga is an increased angle of inclination (obtuse angle).
Dislocated epiphysis of femoral head
In older children, the epiphysis of femoral head may slip away from epiphyseal plate from acute trauma or chronic microtrauma. Can eventually result in coxa vara.
Femoral fractures Proximal fx Intracapsular fx Greater trochanter or femoral shaft fx Distal femur fx
- Usually from indirect trauma.
- Very complicated and can lead to vascular trauma.
- Usually from direct blows.
- Can be complicated by fx of condyles or rupture of popliteal a.
Fibular fractures
Occur most often 2-6 cm proximal to lateral malleolus and associated with fx-dislocations of ankle joint.
Fx of talar neck
May occur due to severe dorsiflexion of the ankle. Body of talus can be posteriorly dislocated.
Dancer’s fx
Occurs when a dancer loses balance and puts all body weight on one metatarsal, causing a fx.
Fatigue fx of metatarsals
Usually from prolonged walking.
Avulsion of tuberosity of 5th metatarsal
Can be avulsed due to rapid inversion by the tendon of the fibularis brevis m.
Os trigonum
Lateral tubercle of the talus (from secondary ossification center fails to unite with the talar body. Occurs in 14-25% of adults.
Fx of sesamoid bones
Sesamoid bones of great toe where FHL m. bear the weight. Caused from crushing injury.
Compartment syndrome
Hemorrhage, edema, and inflammation can put pressure on the septa and increase the pressure. This can put extreme pressure on nerves, vessels, etc.
Saphenous v. is used in bypasses because:
Very accessable, good distance between tributaries and perforating branches, contains a higher percentage of muscular and elastic fibers than other superficial veins.
Saphenous cutdown
Making an incision anterior to medial malleous can locate the saphenous v. This can be used to administer blood, plasma, electrolytes, drugs.
Regional nerve blocks of femoral n.
Blocked 2 cm inferiorly to the inguinal l. Interrupts the conduction of impulses in peripheral ns via perineural injections.
Hip pointer
Contusion of the iliac crest usually at ASIS.
Cause bleeding from ruptures capillaries and infiltration of blood into tissues.
Most hip pointers are actually avulsions.
Psoas abscess
Caused by a retroperitoneal infection in pelvis, usually associated with TB, or secondary to Crohn’s Dz. Should be considered when edema persists in the proximal thigh.
Chondromalacia patellae (Runner’s knee)
Results from overuse of knee. Common in runners. Patellar soreness/pain.
Calcaneal fx
From falls. Produces a comminuted fx. Disrupts the subtalar joint.
Thrombophlebitis
Varicosis of great saphenous v. and its tributaries. Common in posteriomedial parts of LL. Valves in veins no longer function and blood flows inferiorly.
Patellar fx
Usually transverse. Proximal fragment gets pulled superiorly with quad tendon, and distal fragment remains within patellar L.
Gracilis m. transplantation
Gracilis m. is a weak adductor. It can be removed easily and transplanted in the hand.
Groin pull
Pull of anteriomedial muscles (adductors, thigh flexors).
“Superficial femoral a.”
Some clinicians use this to term the femoral a. after branch to deep femoral a.
Saphenous varix
Localized dilation of saphenous v. Can cause edema in femoral triangle. Associated with varicose vs.
Femoral hernia
Abdominal visecra protrudes trough femoral ring into femoral canal.
Trochanteric bursitis
Inflammation of trachanteric bursa due to repetitive actions like clinbing, walking uphill, etc. Can cause diffuse pain in LE.
Ischial bursitis
Microtrauma overwhelms ischial bursa, causing inflammation. Ex: cycling.
Injury to superior gluteal n.
Causes weakness in gluteus medius m. Causes Trendelenburg gait
Anesthetic block of sciatic n.
Done at midpoint of joining PSIS and greater trochanter.
Injections in buttocks should be done:
Superolaterally.
Popliteal abscess/tumor
Pain is severe. Tends to spread superiorly and inferiorly.
Popliteal aneurysm
Causes edema and pain in politeal fossa. Can strectch and impair the tibial n and referred pain to LL.
Popliteal hemorrhage
Usually due to fx of the distal femur or femoral dislocation.
Shin splints
Tibialis anterior strain. Edema and pain in the distal 2/3 of tibia. Caused by small tears in periosteum of tibia
Fibular ms. and evolution ms. and the human foot
Most primates walk on outside of foot and have inverted feet. Human feet are more everted and pronated. This is due to fibularis longus m. and fibularis tertius m.
Foot drop
Injury to common fibular n.
Deep fibular n. entrapment
Causes pain and swelling in anterior compartment. “Ski boot syndrome”.
Superficial fibular n. entrapment
Can be from chronic ankle sprains and create pain on lateral side of leg and dorsum of ankle and foot.
Fabella in gastrocnemius m.
Lateral head of gastrocnemius m. may contain a sesamoid bone called a fabella which articulates with the lateral femoral condyle.
Calcaneal reflex tests:
S1 and S2
Absence of plantarflexion
Due to problem with calcaneal t. Gluteus maximius m. can aid in producing some degree of plantarflexion.
Gastrocnemius strain
Painful acute injury in partial tearing of medial belly of gastrocnemius m.
Accessory soleus m.
Occurs in 3% of people. Accessory muscle appears as a distal belly medial to calcaneal t. Can becomes swollen and painful in prolonged exercise.
Contusion of EDB m.
Can cause hematoma. EDB and EHB muscles are functionally unimportant.
Sural n. grafts
Sural n. often used due to its ease of location next to small saphenous n.
Plantar reflex tests:
L4-S2
Q angle
Angle between femur and tibia at knee joint. Line drawn from ASIS to patella to assess. Genu valgum and genu varum.
Patellar dislocation
More common in FM likely due to greater q-angle. Usually tends to dislocate laterall, but vastus medialis m. counteracts that.
Function of ACL
Prevents the femur from sliding posteriorly on the tibia and hyperextension of the knee and limits medial rotation of the femur.
Anterior drawer test is used.
Function of PCL
Prevents the femur from sliding anteriorly on the tibia.
Popliteal cyst
Usually from chronic effusion in knee joint.
Sprained ankles are usually from:
Inversion, causing tearing in the lateral ligaments.
Pott fx-dislocation
Occurs when foot is forcefully everted. Fx of the fibula and tears the tibiofibular L.
Hallux valgus
Caused by increased pressure in footwear. Lateral deviation of great toe is common and can overlap the 2nd toe. Can be associated with corns.
Hammer toe
Proximal phalanx is permanently dorsiflexed at the the metatarsal joint and is permanently plantarflexed at the PIP joint.
Claw toes
Hyperextension of the metatarsophalangeal joints and flexion at the DIP.
Pes planus
Flat feet.
Flexible flat feet are from degenerated intrinsic ligaments, whereas rigid flat feet are from a bone deformity.
