FINAL gross clinical notes Flashcards
when the hip joint can be found to be normal at birth but found abnormal later it is known as?
developmental dysplasia
congenital dislocation
what is the frequency of developmental dysplasia?
1.5 per 1000 births
is developmental dysplasia more common in males or females?
8x more common in females
ligamentous laxity is associated with developmental dysplasia and is responsible for what?
causes the hip to become unstable and slip out of position
the majority of infants with developmental dysplasia were born in what position?
breech position
if developmental dysplasia isnt corrected what may occur?
pain abnormal gait unequal leg length osteroarthritis twisting of the femur (femoral anteversion) contracture of hip muscles
acquired or traumatic dislocation is rare but due to the strong and stable articulation of the hip, but what might cause this to happen?
trauma when the hip is flexed, adducted, and medially rotated
what type of hip dislocation are the most common?
posterior dislocation
when the femoral head passes through a tear in the capsular ligament and over the acetabulum, ending in the ilium. this is what type of hip dislocation?
posterior dislocation
what nerve might be damaged in a posterior hip dislocation?
sciatic nerve
when the femoral head ends up in the obturator foramen. this is what type of hip dislocation?
anterior dislocation
what nerve might be damaged in an anterior hip discloation?
obturator nerve
what type of knee bursitis is caused by friction between the skin and the patella, might also be caused from a direct blow or falling on a flexed knee
prepatellar (housemaid’s knee)
what will happen if prepatellar bursitis becomes chronic?
the bursae will become distended with fluid and form a swelling anterior to the knee
what is caused by excessive friction between the skin and the tibial tubercle? used to be called clergyman’s knee.
subcutaneous infrapatellar (now common in roofers and florr tilers who do not wear knee pads)
what type of knee bursitis is caused by bacteria from an abrasion or penetrating wound?
suprapatellar
where might the suprapatellar infection spread and what would it cause?
spread to knee joint cavity, causing local redness,swelling and pain along with enlarged lymph nodes.
what is very common when the foot is fixed on the ground and a force is applied against the knee?
ligament sprains
what is the term that refers to a blow to the lateral aspect of the joint while in weight bearing?
unhappy triad
the unhappy triad can cause damage to what three things?
medial collateral ligament
anterior cruciate
medial meniscus
what is the most commonly injured ligament of the knee joint cavity?
medial collateral
what can cause an injury to the medial collateral to occur?
lateral blow to the knee joint
or
rotational forces during trauma
what will patients complain of when they have damaged their medial meniscus?
clicking knee
locking up
pain going up stairs or rising from chair
small tears of the medial meniscus can sometimes repair themselves with?
4 to 6 weeks of physical therapy
when would the medial meniscus need to be repaired surgically?
large tears
if large parts of the medial meniscus are removed where would forces now be transmitted?
to the condyles of the tibia and can lead to the articular cartilage, leading to osteoarthritis
at the time of injury patients will often complain of hearing a pop and there is sensation that their knee has given out. this is a sign that what is damaged?
anterior cruciate
within a few hours of injurying the anterior cruciate what will happen?
the joint cavity will fill with blood and swell
what type of injury will produce a condition where the tibia can be pulled excessively forward under the femur?
anterior cruciate injury
positive anterior drawer test
with what type of injury the tibia can be pulled or moved excessively backward under the femur?
posterior cruciate
positive posterior drawer test
knee replacements might be _______ or ________.
total or partial
what is the main criteria for a knee replacement?
-pain of osteroarthritis cannot be controlled
or
-the individual is functionally disabled
a complete knee replacement will consist of a metal and plastic component that are cemented where?
both ends of the joint
what is the life span of a knee prosthetic?
15-20 years
what is the disruption of the epiphyseal plate of the tibia tuberosity that occurs around puberty in active adolescents?
osgood-schlatter’s disease
usually bilateral
osgood-schlatters is an example of what?
apophyseal injury
or
traction apophysitis
what is an apophyses?
a secondary ossification center that develops with growth.
seen in active adolescents
avulsion fractures of the tuberosity are common with what disease?
osgood-schlatters
osgood-schlatters is usually self limiting but can take how long to run its course?
two years
what are the hairline fractures that appear with out evidence of soft tissue damage?
stress fractures
stress fractures are often difficult to diagnose on an x-ray and may not become visible til when?
3 to 4 weeks after the fracture has occurred
in the foot stress fractures are typically found where?
- shaft of the tibia (runners)
- 2nd, 3rd, 4th metatarsals (walkers)
- navicular bone (high impact sports)
what are the two types of stress fractures?
- the bone is normal but is overloaded as a result of sudden increases in activity
- the bone is abnormal as a result of osteoporosis, drugs or some other metabolic disorder
what results from increase pressure within a myofascial compartment, resulting in ischemia and pain?
compartment syndrome
during compartment syndrome the muscles will swell from overuse and the edema and muscle inflammation will reduce what?
blood flow to the muscles
acute compartment syndrome most commonly occurs due to?
trauma suchs as
- fractures
- crush injuries
- severe burns
chronic compartment syndrome is often referred to as?
external compartment syndrome
what compartments of the leg are most commonly affected by chronic compartment syndrome?
anterior
and
deep posterior
how is chronic compartment syndrome diagnosed?
measuring the compartmental pressure before and after exercise
what is the criteria measurements to diagnose chronic compartment syndrome?
a resting pressure of more than 12mmhg and a one minute exercise pressure higher than 20mmHg
what is the outdated general term for pain in the anterior compartment of the leg?
shin splints
shin splints is now known as what?
medial tibial stress syndrome
what muscle is associated with medial tibial stress syndrome (shin splints) according to the new guidelines?
tibialis anterior
what are the 5 ways you could possible damage the common fibular nerve?
- plaster casts
- fractures at proximal end of the fibula
- prolonged kneeling or squatting
- prolonged kneeling with legs cross
- stretching when knee joint is injured
what are some of the clinical problems associated with damage to the common fibular nerve?
- loss of dorsal flexion of the foot causing foot drop
- loss of eversion of the foot
- loss of extension of the toes
- diminished foot inversion
- loss of sensation over the dorsum of the foot and lateral aspect of the leg
what is the term used to indicate compression neuropathy of the nerve as it leaves the anterior compartment and becomes superficial at the anterior aspect of the ankle joint?
ski boot syndrome
due to tight fitting ski boots or other types of shoes
what are the motor clinical considerations of ski boot syndrome?
loss of dorsal flexion of foot and extension of toes
-diminished inversion of foot
what are the sensory clinical considerations of ski boot syndrome?
loss of sensation to the skin in the web space
-both digits 1 and 2
