Clinical Correlates: Exam 1 Flashcards

1
Q

Saphenous cutdown

A

Use the saphenous vein to insert a catheter near the medial malleolus of the foot

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2
Q

Varicose veins

A

When valves of saphenous and perforating veins fail to function correctly, retrograde flow into superficial veins

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3
Q

Femoral hernia

A

When the intestines push through a weakness in the femoral canal, resulting in a direct inguinal hernia

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4
Q

Trendelenburg test

A

Injury to superior gluteal nerve - Gluteus medius/minimus work to pull hip down on supported side to lift leg off the ground. An abnormal case will not be able to pull hip up and leg will be dragging on unsupported side. Treat by giving a cane on the unaffected side.

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5
Q

Piriformis syndrome

A

compression of sciatic nerve by the piriformis, pain extends along the sciatic nerve and is worse when sitting (aka fat wallet syndrome)

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6
Q

Lumbar lordosis

A

hamstrings usually pull down on pelvis, tilting it superiorly to prevent it from falling forward, weak hamstrings allow hip flexors to pull pelvis anteriorly (tight hamstrings can cause flatback)

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7
Q

Hamstring pull

A

avulsion of hamstring tendon from ischial tuberosity

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8
Q

Iliotibial tract syndrome

A

inflammation of the IT tract causing pain on the lateral knee (from rubbing against lateral chondyle during flexion and extension)

also from excessive pronation that increases internal rotation of tibia, increasing friction

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9
Q

Gluteal injections

A

Inject in area between ASIS and ilial crest to avoid hitting sciatic nerve (upper lateral quadrant)

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10
Q

Sciatica

A

Lower back pain, with pain radiating down the leg and to the foot, from herniated disc, spinal stenosis, piriformis syndrome or hematoma

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11
Q

Popliteal artery aneurysm

A

pain behind the knee, edema in lower leg and foot, foot pain, can cause embolism and occlusion

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12
Q

Popliteal (Baker’s) cyst

A

herniation of synovial membrane of knee joint or distension of gastroc or semimembranosus bursae into popliteal fossa

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13
Q

Compartment syndrome

A

Increased pressure in a compartment - causes pain, paresthesia, pallor, paralysis and pulselessness, treated by releasing the pressure quickly (fasciotomy)

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14
Q

Achilles tendon rupture

A

Happens during dorsiflexion and extension of leg

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15
Q

Calcaneal tendon reflex

A

If absent, injury to S1 or S2, also have decreased sensation and weak plantarflexion of foor

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16
Q

Shin splints

A

microfractures in the tibia from extensor muscles of the anterior compartment

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17
Q

Stress fracture of the tibia

A

overuse causes injuries on bone, load exceeds ability to repair bone

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18
Q

Drop foot

A

damage to the deep peroneal nerve, results in inability to dorsiflex foot, loss of sensation in first web space, patients walk with high steppage gait

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19
Q

Pes planus

A

flat foot, from posterior tibial tendon dysfunction of spring ligament laxity - overpronation (eversion) and abduction of feet

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20
Q

High ankle sprain

A

sprain of the ligaments that join the tibia and fibula (anterior and posterior tibiofibular ligaments)

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21
Q

Low ankle sprain

A

tearing of deltoid ligaments on medial side of ankle (occurs when foot is inverted and plantar flexed) - more here

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22
Q

trimalleolar fracture

A

foot is everted and strong medial (deltoid) ligament breaks the medial malleolus - talus breaks free and breaks lateral malleolus - tibia breaks free and breaks at posterior distal end

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23
Q

plantar fasciitis

A

results from shorted Achilles or hypermobile forefoot, pain at the insertion of the plantar fascia into the calcaneous with or without bony formation

24
Q

bunion (hallux valgus)

A

swollen bursal sac or bony anomaly of the metatarsophalangeal joint, cause by flat feet, excessive flexibility of ligaments, abnormal bone structure

25
Q

Hip dislocation

A

femoral tears into the gluteal region, between iliofemoral and ischiofemoral ligaments, causing damage to sciatic nerve

26
Q

Developmental dysplasia of the hip

A

malformed socket, common in first born females (decrease amnionic fluid), requires hip replacement

27
Q

Coxa Vara/Valga

A
Vara = low angle of femoral neck to the acetabulum - shortening of limb and limp
Valga = higher angle
28
Q

avascular necrosis of femoral head

A

blood supply gets disrupted, causes death to osteocytes

29
Q

femoral neck fractures

A

need to be repaired within 8 hours to prevent avascular necrosis, type 1 - crack, type 2 - fracture, type 3 - displacement, type 4 - full displacement

concern is medial circumflex artery

leg appears shortened and laterally rotated

30
Q

types of hip repair

A

dynamic compression screw and plate and bipolar hip prosthesis

31
Q

hip pain

A

referred pain - great trochanter is trochanteric bursitis - buttocks = sciatic

causes = arthritis, bursitis, tendinitis, muscle strain, cancer, avascular necrosis

32
Q

Nursemaids knee

A

aseptic or septic prepatellar bursitis, swelling is more focal than effusion

33
Q

knee effusion

A

synovial fluid accumulation around knee joint

34
Q

Q-angle

A

angle that the femur makes relative to tibia

35
Q

Genu valgum/varum

A

Varum - low Q angle, stress on medial menisci and LCL

Valgum - high Q angle, stress on lateral menisci, MCL

36
Q

testing collateral ligaments

A

varus stress test angles leg medially to test LCL and valgus stress test angles leg laterally to test MCL

37
Q

ACL tear

A

forces directed from posterior side of the leg

  1. rapid cutting maneuver with foot on ground and knee flexed
  2. knee hyperextension with internal tibial rotation
38
Q

PCL tear

A

forces directed from anterior side of the leg, or forced flexion of knee with external rotation

39
Q

test of ACL tear

A

Anterior drawer sign, flex knee to 90 and pull leg forward, more then 1cm anterior displacement = ACL tear

40
Q

test of PCL tear

A

sag of the tibia posterior

41
Q

meniscus injuries

A

medial side injured most (when medial meniscus is more secured and foot is planted with excessive rotation)

42
Q

unhappy triad

A

medial meniscus is attache to MCL and both are torn during ACL tear (not LCL because of popliteus)

43
Q

Shoulder separation

A

tearing of acromioclavicular and coracoclavicular ligaments, piano key deformity

44
Q

winged scapula

A

damage to long thoracic nerve, medial scapula freely moves posteriorly, especially when pressing against wall, person has difficultly raising hands above head

45
Q

breast cancer

A

lower medial quadrant is the most dangerous because it crosses the midline and because parasternal lymph nodes cant be palpated

46
Q

rotator cuff injuries

A

supraspinatus and infraspinatus

47
Q

frozen shoulder (adhesive capulisitis)

A

loss of range of motion from tendinitis, bursitis, rotator cuff injury, inflammation, treat with steriod and PT

48
Q

biceps tendon reflex

A

tests musculocutaneous nerve

49
Q

wrist drop

A

damage to radial nerve and deep brachial artery in the spiral groove, paralyze the extensor muscles

50
Q

Erb palsy

A

C5 and C6 brachial plexus injury, limb will be adducted, extended and medially rotated

51
Q

Klumpke’s palsy

A

lower brachial plexus injury

52
Q

Nursemaids elbow

A

subluxation of the radial head

53
Q

Colles fracture

A

extension fracture of the radius (dinner fork)

54
Q

Smith fracture

A

flexion fracture of the radius

55
Q

nightstick fracture

A

ulna fracture

56
Q

scaphoid fracture

A

significant because of the limited blood supply

57
Q

carpal tunnel syndrome

A

compression of the median nerve, from inflammation of flexor tendons of digits