Clinical Correlations- Lower Limb

Question 1

compression of sciatic nerve

Answer 1

hypertrophy or spasm of piriformis muscle

most common in athletes

Question 2

sensory changes in thigh- femoral

Answer 2

anterior thigh, medial knee, medial aspect of leg

Question 3

sensory changes in thigh- obturator

Answer 3

medial thigh

Question 4

sensory changes in thigh- sciatic

Answer 4

mid-posterior thigh, knee, posterolateral leg, sole of foot

Question 5

fibular neck fracture

Answer 5

common fibular nerve winds around neck and divides into superficial and deep fibular
presents with foot-drop
inability to dorsiflex (deep) and evert (superficial)

Question 6

pes bursitis

Answer 6

overuse of muscles involved in pes anserinus

Question 7

pes anserina

Answer 7

semitendinosis
gracilis
sartorius

Question 8

test ACL/PCL damage

Answer 8

push/pull tibia, see if it moves backwards/forwards

Question 9

meniscal tears

Answer 9

common in sports injuries
can break off and wedge between bones, locks the joint
removal = more cartilage degeneration and arthritis

Question 10

unhappy triad injury

Answer 10

football

lateral force causes medial injury: medial meniscus, MCL, ACL

Question 11

dislocated knee

Answer 11

best seen in lateral view
caused by knee hitting dashboard in MVA
damage to PCL
⅔ have associated vascular injury
check for damage to popliteal artery

Question 12

over-inversion of ankle (sprain)

Answer 12

more common than over-eversion (weaker ligaments)

lateral ligaments prevent this- calcaneofibular, anterior talofibular ligaments

Question 13

trimalleolar fracture

Answer 13

both malleoli and distal fibula are fractured

can be caused by over-inversion

Question 14

calcaneal tendon injuries

Answer 14

achille’s tendon

basketball- jumping

Question 15

test for nerve damage in tibial fracture

Answer 15

deep fibular: 1st dorsal webspace

superficial fibular: rest of dorsal foot

Question 16

fracture associated w/ over-inversion

Answer 16

soccer

fibularis brevis pulls off bone at 5th metatarsal

Question 17

foot drop

Answer 17

damage to deep fibular nerve
inability to dorsiflex foot
test integrity of this nerve at 1st webspace

Question 18

foot drop (muscles affected)

Answer 18

tibialis anterior
extensor digitorum longus
extensor hallicus longus

Question 19

anterior (tibial) compartment syndrome

Answer 19

anterior or lateral shin splints
excessive contraction of muscles
pain radiates down ankle/dorsum of foot overlying extensor tendons

Question 20

damage to superficial fibular nerve results in

Answer 20

problem with eversion

Question 21

compartment syndrome

Answer 21

can occur in upper or lower limb
knick an artery, put cast on too tight
abnormally high levels of pain

Question 22

compartment syndrome course

Answer 22

functional nerve changes (weakness, numbness)
functional muscle changes (motor weakness)- w/in 2-4 hours
irreversible muscle damage 4-12 hrs

Question 23

lesion to tibial nerve

Answer 23

shuffling gait

loss of plantar flexion weakened inversion (tibialis posterior)

Question 24

trandellemburg test

Answer 24

dipping of hips when one leg is lifted

problem with gluteus medius and minims (hip abductors, stabilizers)

Question 25

cruciate anastamosis

Answer 25

anastamosis between internal iliac from superior and inferior gluteal arteries and femoral arteries

Question 26

site of femoral hernias

Answer 26

medial compartment

in femoral ring

Question 27

synovial cyst

Answer 27

forms from synovial sheath that surrounds the extensor tendons

Question 28

superior gluteal denervation

Answer 28

no gluteus medius, minimus, and tensor fascia latae

hip drop on uninsured side

Question 29

femoral nerve denervation

Answer 29

quads

unable to extend knee

Question 30

postero-medial dislocation of femur

Answer 30

sciatic nerve in danger

Question 31

weakness in climbing, jumping

Answer 31

inferior gluteal nerve to gluteus maximus (hip extendor)