Clinical Aspects Exam 4 Flashcards
Developmental Dysplasia
Ongoing process causing dislocation of hip joint in which head of femur ends superior on external surface of ilium
Developmental Dysplasia more commonly seen in
Females
Developmental Dysplasia symptoms
Pain Abnormal gait Unequal leg length Femoral anteversion Contracture Osteoarthritis
Traumatic (Acquired) Dislocation
May occur during accidents when thigh if flexed, abducted, and medially rotated
___ dislocation of hip more common and may damage ___
Posterior
Sciatic
___ dislocation of hip rare and may damage ___
Anterior
Obturator Nerve
Prepatellar Bursitis
Housemaid’s Knee
Caused by friction between skin and patella
Subcutaneous Infrapatellar Bursitis
Clergyman’s knee
Inflammation between skin and tibial tubercle
Suprapatellar Bursitis
Inflammation of suprapatellar Bursae caused by abrasions or penetrating wounds
Infection may spread to knee joint
Unhappy Triad
Tear of medial collateral ligament, medial meniscus, and anterior cruciate ligament
Anterior Drawer Test
Tibia pulled forward under femur = positive = indicates torn ACL
Posterior Drawer Test
Tibia pushed backward under femur = positive= torn PCL
Osgood-Schlatter’s Disease
Avulsion injury of secondary growth center for tibial tuberosity
Pain in area of tibial tuberosity
Osgood-Schlatter’s Disease is an example of an __
Apophyseal Injury
Os Trigonum
Lateral tubercle does not unite with body of talus and ossified independently
Stress fractures
Fine hairline fractures that occur without evidence of soft tissue injury
Stress fractures commonly occur at
Shaft of tibia, navicular, 2nd, 3rd, 4th metatarsals
Stress Fracture types
- Bone normal; overloaded with sudden increase in activity
2. Bone abnormal; result of osteoporosis, drugs, metabolic disorder
Compartment syndrome
Increase of pressure within myofascial compartment
Causes pain and may result in ischemia
Types of compartment syndrome
Acute
Chronic
Acute compartment syndrome
Due to trauma
Chronic compartment syndrome AKA
External compartment syndrome
Chronic compartment syndrome usually occurs in ___ and ___ compartments
Anterior and deep posterior leg
Chronic compartment syndrome is ___ related
Exercise
Diagnosis of compartment syndrome
Resting pressure > 12 mm/hg
1 min exercise pressure > 20 mm/hg
Shin splints aka
Medial tibial stress syndrome
Shin splints
Generic term used to describe anterior leg pain not due to compartment syndrome or stress fractures
Ski Boot Syndrome
Compression neuropathy of deep fibular nerve
Symptoms of ski boot syndrome
Weakened dorsiflexion and extension of toes, as well as sensory loss between 1st and 2nd toes
High ankle sprain
Sprain involving inferior tibiofibular joint
Calcaneal tendon reflex
Tests segmental innervation S1 and S2
Foot should reflexively fall in plantar flexed position
Intermittent Claudication
Occlusive peripheral artery disease characterized by painful leg cramps which develop during walking and disappear with rest
Screening for intermittent claudication
Palpate Posterior tibial artery
Achilles Tendonitis
Microscopic tears in collagen fibers, just proximal to attachment on calcaneous
Flat feet more prone to get due to hypereversion
Rupture of Achilles Tendon
Audible snap and feel intense pain
Difficult carrying out plantar flexion
High heeled shoes
Develop shortening of calf muscles due to origin and insertion continually being brought closer together
Pott’s Fracture
Fracture dislocation of ankle, occurs when foot forcibly everted or externally rotated
Pott’s fracture may result in
Tear of deltoid ligament
Fracture of fibula
Fracture of lateral malleolus
Plantar Fasciitis
Overuse injury that causes pain on medial aspect of calcaneus and along medial longitudinal arch
Symptoms of Plantar Fasciitis
“First step pain”
Aponeurosis is stretched and tiny tears develop
Plantar Nerve Reflex
Stroking skin of lateral plantar aspect of foot- normal response is flexion of all digits
Abnormal plantar nerve reflex
Babinski sign (digits 2-5 will abduct and digit 1 will extend)
Segmental innervation tested in plantar nerve reflex
L4
L5
S1
S2
Tarsal Tunnel Syndrome
Tibial nerve or medial plantar nerve compressed as they pass deep to flexor retinaculum
In tarsal tunnel syndrome, pain is noted along
Medial malleolus and plantar aspect of foot and toes
Tarsal tunnel syndrome AKA
Joggers foot
Hallux Valgus
Enlargement and deforming of 1st MP joint in which joint deviates laterally
Hallux Rigidis
Sesamoid bone displaced by deviation and ends up between heads of 1st and 2nd metatarsals
Cannot move first digit away from second
Bunion
Inflamed Bursae that occurs from foot rubbing against shoe with additional bone growth occurring due to Hallux Valgus
Hammer Toe
Common deformity of 2nd and 3rd toes
MP and DIP joint are hyperextended while PIP joint flexed
Corns
Thickening of keratin layer of skin
Turf toe
Hyperextension injury to plantar capsular ligament of 1st MP joint
Club Foot
Structural foot deformity, usually congenital, involving subtalar joint
Club foot is more common in
Males
In club foot, foot is usually ___ and ___
Plantar flexed and inverted
The ___ bone is malformed in club feet, which can cause shortening and contracture of muscles and ligaments
Talus
Morton’s Neuroma
Plantar nerves are compressed between heads of metatarsals (MC between 3rd and 4th digits)
Pes Rectus
Normal foot with relation to arches
Main load on calcaneus
Pes Planus Flexible
Congenital condition resulting in flat feet only in weight bearing (due to loose/degenerative ligaments)
Pes Planus Rigid
Congenital or acquired flat feet seen in both weight bearing and non-weight bearing stances due to bone deformities
Pes cavus
Medial longitudinal arch unusual high resulting in claw foot
