FINAL gross clinical notes

Question 1

when the hip joint can be found to be normal at birth but found abnormal later it is known as?

Answer 1

developmental dysplasia

congenital dislocation

Question 2

what is the frequency of developmental dysplasia?

Answer 2

1.5 per 1000 births

Question 3

is developmental dysplasia more common in males or females?

Answer 3

8x more common in females

Question 4

ligamentous laxity is associated with developmental dysplasia and is responsible for what?

Answer 4

causes the hip to become unstable and slip out of position

Question 5

the majority of infants with developmental dysplasia were born in what position?

Answer 5

breech position

Question 6

if developmental dysplasia isnt corrected what may occur?

Answer 6

pain
abnormal gait
unequal leg length
osteroarthritis
twisting of the femur (femoral anteversion)
contracture of hip muscles

Question 7

acquired or traumatic dislocation is rare but due to the strong and stable articulation of the hip, but what might cause this to happen?

Answer 7

trauma when the hip is flexed, adducted, and medially rotated

Question 8

what type of hip dislocation are the most common?

Answer 8

posterior dislocation

Question 9

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?

Answer 9

posterior dislocation

Question 10

what nerve might be damaged in a posterior hip dislocation?

Answer 10

sciatic nerve

Question 11

when the femoral head ends up in the obturator foramen. this is what type of hip dislocation?

Answer 11

anterior dislocation

Question 12

what nerve might be damaged in an anterior hip discloation?

Answer 12

obturator nerve

Question 13

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

Answer 13

prepatellar (housemaid’s knee)

Question 14

what will happen if prepatellar bursitis becomes chronic?

Answer 14

the bursae will become distended with fluid and form a swelling anterior to the knee

Question 15

what is caused by excessive friction between the skin and the tibial tubercle? used to be called clergyman’s knee.

Answer 15

subcutaneous infrapatellar
(now common in roofers and florr tilers who do not wear knee pads)

Question 16

what type of knee bursitis is caused by bacteria from an abrasion or penetrating wound?

Answer 16

suprapatellar

Question 17

where might the suprapatellar infection spread and what would it cause?

Answer 17

spread to knee joint cavity, causing local redness,swelling and pain along with enlarged lymph nodes.

Question 18

what is very common when the foot is fixed on the ground and a force is applied against the knee?

Answer 18

ligament sprains

Question 19

what is the term that refers to a blow to the lateral aspect of the joint while in weight bearing?

Answer 19

unhappy triad

Question 20

the unhappy triad can cause damage to what three things?

Answer 20

medial collateral ligament
anterior cruciate
medial meniscus

Question 21

what is the most commonly injured ligament of the knee joint cavity?

Answer 21

medial collateral

Question 22

what can cause an injury to the medial collateral to occur?

Answer 22

lateral blow to the knee joint
or
rotational forces during trauma

Question 23

what will patients complain of when they have damaged their medial meniscus?

Answer 23

clicking knee
locking up
pain going up stairs or rising from chair

Question 24

small tears of the medial meniscus can sometimes repair themselves with?

Answer 24

4 to 6 weeks of physical therapy

Question 25

when would the medial meniscus need to be repaired surgically?

Answer 25

large tears

Question 26

if large parts of the medial meniscus are removed where would forces now be transmitted?

Answer 26

to the condyles of the tibia and can lead to the articular cartilage, leading to osteoarthritis

Question 27

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?

Answer 27

anterior cruciate

Question 28

within a few hours of injurying the anterior cruciate what will happen?

Answer 28

the joint cavity will fill with blood and swell

Question 29

what type of injury will produce a condition where the tibia can be pulled excessively forward under the femur?

Answer 29

anterior cruciate injury | positive anterior drawer test

Question 30

with what type of injury the tibia can be pulled or moved excessively backward under the femur?

Answer 30

posterior cruciate | positive posterior drawer test

Question 31

knee replacements might be _______ or ________.

Answer 31

total or partial

Question 32

what is the main criteria for a knee replacement?

Answer 32

-pain of osteroarthritis cannot be controlled or -the individual is functionally disabled

Question 33

a complete knee replacement will consist of a metal and plastic component that are cemented where?

Answer 33

both ends of the joint

Question 34

what is the life span of a knee prosthetic?

Answer 34

15-20 years

Question 35

what is the disruption of the epiphyseal plate of the tibia tuberosity that occurs around puberty in active adolescents?

Answer 35

osgood-schlatter's disease | usually bilateral

Question 36

osgood-schlatters is an example of what?

Answer 36

apophyseal injury or traction apophysitis

Question 37

what is an apophyses?

Answer 37

a secondary ossification center that develops with growth. | seen in active adolescents

Question 38

avulsion fractures of the tuberosity are common with what disease?

Answer 38

osgood-schlatters

Question 39

osgood-schlatters is usually self limiting but can take how long to run its course?

Answer 39

two years

Question 40

what are the hairline fractures that appear with out evidence of soft tissue damage?

Answer 40

stress fractures

Question 41

stress fractures are often difficult to diagnose on an x-ray and may not become visible til when?

Answer 41

3 to 4 weeks after the fracture has occurred

Question 42

in the foot stress fractures are typically found where?

Answer 42

- shaft of the tibia (runners) - 2nd, 3rd, 4th metatarsals (walkers) - navicular bone (high impact sports)

Question 43

what are the two types of stress fractures?

Answer 43

- 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

Question 44

what results from increase pressure within a myofascial compartment, resulting in ischemia and pain?

Answer 44

compartment syndrome

Question 45

during compartment syndrome the muscles will swell from overuse and the edema and muscle inflammation will reduce what?

Answer 45

blood flow to the muscles

Question 46

acute compartment syndrome most commonly occurs due to?

Answer 46

trauma suchs as - fractures - crush injuries - severe burns

Question 47

chronic compartment syndrome is often referred to as?

Answer 47

external compartment syndrome

Question 48

what compartments of the leg are most commonly affected by chronic compartment syndrome?

Answer 48

anterior and deep posterior

Question 49

how is chronic compartment syndrome diagnosed?

Answer 49

measuring the compartmental pressure before and after exercise

Question 50

what is the criteria measurements to diagnose chronic compartment syndrome?

Answer 50

a resting pressure of more than 12mmhg and a one minute exercise pressure higher than 20mmHg

Question 51

what is the outdated general term for pain in the anterior compartment of the leg?

Answer 51

shin splints

Question 52

shin splints is now known as what?

Answer 52

medial tibial stress syndrome

Question 53

what muscle is associated with medial tibial stress syndrome (shin splints) according to the new guidelines?

Answer 53

tibialis anterior

Question 54

what are the 5 ways you could possible damage the common fibular nerve?

Answer 54

1. plaster casts 2. fractures at proximal end of the fibula 3. prolonged kneeling or squatting 4. prolonged kneeling with legs cross 5. stretching when knee joint is injured

Question 55

what are some of the clinical problems associated with damage to the common fibular nerve?

Answer 55

- 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

Question 56

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?

Answer 56

ski boot syndrome | due to tight fitting ski boots or other types of shoes

Question 57

what are the motor clinical considerations of ski boot syndrome?

Answer 57

loss of dorsal flexion of foot and extension of toes | -diminished inversion of foot

Question 58

what are the sensory clinical considerations of ski boot syndrome?

Answer 58

loss of sensation to the skin in the web space | -both digits 1 and 2