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EO 009 - Lower MSK Flashcards

1
Q

What is the inguinal triangle?

ppt EO 009.03 (a)

A

A structure bordered by the inguinal ligament, sartorius muscle, and adductor longus.

Slide 5

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2
Q

What does the inguinal triangle contain?

ppt EO 009.03 (a)

A

The femoral nerve, artery, vein, as well as the great saphenous and external pudendal vein.

Slide 5

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3
Q

What deep, non-palpable muscle runs through and under the inguinal ligament?

ppt EO 009.03 (a)

A

Psoas major

Slide 6

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4
Q

What criteria constitutes a pelvic fracture?

ppt EO 009.03 (a)

A

One of the following:
1. A break in the pelvic ring
2. # of a bone without a break in the ring
3. Acetabular # (articulating region of pelvis -> femur)

Slide 9, look at visual for #3

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5
Q

What is the difference between stable and unstable # of pelvis?

ppt EO 009.03 (a)

A

A stable #is a single break in the pelvic ring.

An unstable # is two breaks in the pelvic ring, risking displacement.

Slide 10

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6
Q

What are the three pelvic # patterns?

ppt EO 009.03 (a)

A
  1. Anterior-posterior compression (APC)
  2. Lateral compression (LC)
  3. Vertical shear (VS)

Slide 11, see for visuals

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7
Q

Which sort of pelvic fracture is typically commonly seen in conjunction with multiple lower MSK fractures?

ppt EO 009.03 (a)

A

Acetabular #s

Slide 12. Typically secondary to MVC

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8
Q

What is a hip #?

ppt EO 009.03 (a)

A

A fracture of the femur in or near the hip joint.

Slide 16

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9
Q

What are the four classifications of hip fractures?

ppt EO 009.03 (a)

A
  1. Femoral head + neck
  2. Trochanteric
  3. Intertrochanteric
  4. Subtrochanteric

Slide 16, does no elaborate on each classification.

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10
Q

Why is hip dislocation considered a true orthopedic emergency, and what is the time frame for surgery?

ppt EO 009.03 (a)

A

Delays in reduction increase incidences of avascular necrosis, should be seen within 6 hours.

Slide 20.

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11
Q

What is the technical name for bursitis in the hip?

ppt EO 009.03(a)

A

Trochanteric bursitis

Slide 22

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12
Q

What are some tx options for trochanteric bursitis?

ppt EO 009.03(a)

A
  1. Rest/MELs
  2. NSAIDs/analgesics
  3. Heat/cooling

For MO:
1. Corticosteroid
2. ABx (septic)

Slide 23

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13
Q

Which movements cause medial knee injuries?

ppt EO 009.03(b)

A

Abduction, flexion, and internal rotation of femur.

Slide 6

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14
Q

Which movements cause lateral injuries of the knee?

A

Adduction, flexion, and external rotation of the femur

Slide 6

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15
Q

What causes meniscal injuries?

ppt EO 009.03(b)

A

Cutting, squatting, or twisting movements.
(rotary + extension/flexion)

Slide 7

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16
Q

List the types of meniscus tears.

A
  1. Longitudinal
  2. Bucket and handle (also longitudinal)
  3. Flap
  4. Transverse
  5. Torn horn

Slide 7, visuals

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17
Q

Which type of meniscus tear is most common?

ppt EO 009.03(b)

A

Bucket handle tear

Slide does say longitudinal, but specifies horn-to-horn tears

Slide 8

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18
Q

What is the triad of symptoms for meniscal tears?

ppt EO 009.03(b)

A
  1. Joint line pain on palp (75%)
  2. Joint effusion
  3. Locking on flex/extension

Slide 9. Example of effusion on slide 10

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19
Q

What are some pertinent findings for meniscal tears?

ppt EO 009.03(b)

A
  1. Locking of knee
  2. Popping, clicking, snapping
  3. Instability with activity
  4. Tenderness in anterior joint space after activity
  5. Age/degenerative disease
  6. Trauma

Slide 11

20
Q

What is varus stress?

https://my.clevelandclinic.org/health/diagnostics/25145-valgus-and-varus-stress-tests

A

Force pushing away from the center of the bodybody

Related to slide 14 of ppt EO 009.03(b)

21
Q

What is valgus stress?

https://my.clevelandclinic.org/health/diagnostics/25145-valgus-and-varus-stress-tests

A

Force pushing into the midline or center of the body.

Related to slide 14 of ppt EO 009.03(b)

22
Q

Which ligament is affected by valgus stress?

ppt EO 009.03(b)

A

The medial collateral ligament. Also most commonly injured.

Slide 14

23
Q

Which ligament is affected by varus stress?

ppt EO 009.03(b)

A

Lateral collateral ligament.

Slide 14

24
Q

What is the “unhappy triad” injury of the knee?

ppt EO 009.03(b)

A

An injury involving the medial collateral ligament (MCL), anterior cruciate ligament (ACL), and medial meniscus.

Slide 15

25
Q

What structures are injured with hyperextension?

ppt EO 009.03(b)

A

Anterior cruciate ligament and posterior cruciate ligament.

Slide 16

26
Q

Which test is used for cruciate ligaments?

ppt EO 009.03(b)

A

The drawer test (anterior and posterior)

Slide 19

27
Q

What is patellofemoral syndrome (PFS)?

ppt EO 009.03(b)

A

Anterior knee pain.

Slide 22

28
Q

What are the three typical causes of PFS?

ppt EO 009.03(b)

A
  1. Overuse
  2. Abnormal patellar tracking
  3. Focal trauma

Slide 22

29
Q

What is chondromalacia patellae?

ppt EO 009.03(b)

A

Softening or erosion of posterior surface cartilage on patella.

Slide 23

30
Q

What is the most common cause of chondromalacia patellae?

ppt EO 009.03(b)

A

Chronic PFS

Slide 23

31
Q

What is the Q angle?

ppt EO 009.03(b)

A

The angle from the anterior superior iliac spine to the central patella.

Slide 24

32
Q

Why is a Q angle important?

ppt EO 009.03(b)

A

An increased Q angle increases risk of patellar subluxation and knee injuries.

Slide 24

33
Q

What test is best used for PFS and chondromalacia?

ppt EO 009.03(b)

A

Valgus/Varus of the patella, shifts Q angle.

Slide 26

34
Q

What is patellar tendonitis?

ppt EO 009.03(b)

A

Inflammation of the patellar tendon.

Slide 28

35
Q

What is the most common cause of patellar tendonitis?

ppt EO 009.03(b)

A

Jumping causing microtears in the tendon. Known as Jumper’s Knee.

Slide 28

36
Q

What are some causes of ankle/foot fractures?

ppt EO 009.03(c)

A

Blunt trauma, rolled ankle, high impact, repetitive stress

Slide 6

37
Q

What are some findings on physical exam typical of an ankle/foot fracture?

ppt EO 009.03(c)

A

Pain on palp, unable to weight bear, instability in joint, positive Ottawa ankle/foot

Slide 8

38
Q

What is a positive for the Ottawa ankle rules?

ppt EO 009.03(c)

A

Pain in malleolus accompanied by one or more of:
1. Bone tenderness at posterior edge of distal 6cm lateral malleolus
2. Bone tenderness at posterior edge of distal 6cm medial malleolus
3. Inability to bear weight for minimum 4 steps.

Slide 9

39
Q

What is a positive finding for Ottawa foot rules?

ppt EO 009.03(c)

A

Pain in the midfoot region with one or more of the following:
1. Bone tenderness at navicular
2. Bone tenderness at base of 5th metatarsal
3. Inability to bear weight for 4 steps.

Slide 9

40
Q

What is achilles tendonitis?

ppt EO 009.03(c)

A

Inflammation of the achilles tendon

Slide 11

41
Q

What is metatarsalgia?

ppt EO 009.03(c)

A

Pain around the metatarsal heads.

It’s a symptom, not a disease

Slide 15

42
Q

What causes metatarsalgia?

ppt EO 009.03(c)

A

When the transverse arch is depressed and middle metatarsals bear disproportionate weight.

Slide 15

43
Q

What are some S/S of metatarsalgia?

ppt EO 009.03(c)

A
  1. Decreased weight bearing
  2. Edema
  3. Pain on flexion/extension
  4. Cavus deformity
  5. Hammertoe deformity

Slide 16, visuals for cavus deformity and hammertoe deformity.

44
Q

What is plantar fasciitis?

ppt EO 009.03(c)

A

Inflammation of the plantar aponeurosis.

Slide 19

45
Q

What is the plantar aponeurosis?

ppt EO 009.03(c)

A

A strong layer of white fibrous tissue situatied beneath the skin of the sole of the foot.

Slide 19

QL5 (13 decks)

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