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MSK (USMLE) > Hip > Flashcards

Hip Flashcards

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USMLE® Step 1 flashcards
1
Q

What does the iliohypogastric nerve innervate (sensory, motor)?

A

Sensory: suprapubic region
Motor: transverse abdominis, internal oblique

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2
Q

How does the iliohypogastric nerve get injured?

A

Abdominal surgery

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3
Q

Symptoms of iliohypogastric nerve damage

A

Burning/tingling pain in surgical incision site radiating to inguinal & supra pubic region

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4
Q

Sensory and motor innervation of genitofemoral nerve

A

Sensory: scrotum/labia majora, medial thigh
Motor: cremaster

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5
Q

How does injury to the genitofemoral nerve occur?

A

Laparoscopic surgery

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6
Q

Symptoms of injury to genitofemoral nerve

A

Decreased upper medial and anterior thigh sensation beneath inguinal ligament (lateral part of femoral triangle)
Absent cremasteric reflex

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7
Q

Innervation of lateral femoral cutaneous

A

Sensory: anterior & lateral thigh

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8
Q

Causes of injury to lateral femoral cutaneous nerve

A

Tight clothes, obesity, pregnancy, pelvic procedures

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9
Q

Presentation of injury to lateral femoral cutaneous nerve

A

Decreased thigh sensation (anterior, lateral)
Meralgia paresthetica: compression of nerve results in tingling, numbness, burning pain in anterolateral thigh

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10
Q

Sensory and motor innervation of obturator nerve

A

Sensory: medial thigh
Motor: obturator externus, adductors longus + magnus + brevis, gracilis, pectineus

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11
Q

Damage to obturator nerve

A

Pelvic surgery

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12
Q

Symptoms of obturator nerve damage

A

Decreased thigh sensation (medial) and adduction

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13
Q

Sensory & motor innervation of femoral nerve

A

Sensory: anterior thigh, medial leg
Motor: quadriceps, iliacus, pectineus, sartorius

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14
Q

Causes of injury to femoral nerve

A

Pelvic fracture

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15
Q

Symptoms of femoral nerve injury

A

Decreased leg extension (decreased patellar reflex)

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16
Q

Innervation of sciatic nerve

A

Motor: semitendinosus, semimembranosus, biceps femoris, adductor magnus

17
Q

Causes of injury to sciatic nerve

A

Herniated disc, posterior hip dislocation

18
Q

What does the sciatic nerve branch into

A

Common peroneal & tibial nerves

19
Q

Superficial and deep innervation of common (fibular) peroneal nerve

A

Superficial -
Sensory: dorsum of foot (except bw hallux & 2nd digit)
Motor: peroneus longus & brevis
Deep -
Sensory: webspace bw hallux & 2nd digit
Motor: tibialis anterior

20
Q

Causes of injury to common peroneal

A

Trauma/compression of lateral aspect of leg, fibula neck fracture

21
Q

Symptoms of common peroneal damage

A

Loss of sensation on dorsum of foot
Foot drop: inverted & plantarflexed at rest, loss of eversion & dorsiflexion; “steppage gait”

22
Q

Sensory & motor innervation of tibial nerve

A

Sensory: sole of foot
Motor: biceps femoris (long head), triceps surae (gastrocnemius, soleus), plantaris, popliteus, flexor muscles of the foot

23
Q

Causes of injury to tibial nerve

A

Knee trauma, Baker’s cyst (proximal lesion), tarsal tunnel syndrome (distal lesion)

24
Q

Symptoms of tibial nerve damage

A

Inability to curl toes & loss of sensation on sole
In proximal lesions (baker’s cyst), foot everted at rest w weakened inversion & plantarflexion

25
Q

Innervation of superior gluteal nerve

A

Motor: Gluteus medius & minimus, tensor fascia lata

26
Q

Causes of injury to superior gluteal nerve

A

Iatrogenic injury during IM injection to superomedial gluteal region (need to aim for anterolateral region)

27
Q

Signs of superior gluteal nerve damage

A

Trendelenberg gait: pelvis tilts because weight-bearing leg can’t maintain alignment of pelvis through hip abduction
Lesion is contralateral to the side of the hip that drops, ipsilateral to extremity on which the patient stands

28
Q

Innervation of inferior gluteal nerve

A

Motor: gluteus maximus

29
Q

Causes of injury to inferior gluteal nerve

A

Posterior hip dislocation

30
Q

Presentation of inferior gluteal nerve injury

A

Difficulty climbing stairs, rising from seated position
Loss of hip extension

31
Q

Sensory and motor innervation of pudendal nerve

A

Sensory: perineum
Motor: external urethral & anal sphincters

32
Q

Symptoms of pudendal nerve injury

A

Decreased sensation in perineum & genital area; can cause fecal &/or urinary incontinence
Can be blocked w local anesthetic during childbirth using ischial spine as landmark

33
Q

Attachments of ACL

A

Lateral femoral condyle to anterior tibia

34
Q

Attachments of PCL

A

Medial femoral condyle to posterior tibia

35
Q

What is the anterior drawer sign

A

Bend knee at 90 degrees, increased anterior gliding of tibia anteriorly due to ACL injury
Lachman test is more specific and done at 30 degrees

36
Q

What is the posterior drawer sign and what does it indicate?

A

Bend knee at 90 degrees, increased posterior gliding of tibia due to PCL injury

37
Q

Describe abnormal passive abduction in the knee

A

Aka valgus stress test
Knee extended at 30 degree, lateral (valgus) force results in medial space widening of tibia = MCL injury

38
Q

Describe abnormal passive adduction in the knee

A

Aka varus stress test
Knee at 30 degrees, medial (varus) force causes lateral space widening of tibia = LCL injury

39
Q

How is the McMurray Test conducted

A

During flexion/extension of the knee w rotation of tibia/foot (LIME)
- pain, “popping” on internal rotation & varus force = lateral meniscus tear
- pain, “popping” on external rotation & valgus force = medial meniscal tear

MSK (USMLE) (16 decks)

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