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Lower Limb > Hip conditions > Flashcards

Hip conditions Flashcards

1
Q

What is the risk of intramuscular injection in the gluteal region?

A

Injury to sciatic nerve

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2
Q

What are the two safe sites of intramuscular injection in the gluteal region?

A

Dorsogluteal site

Ventrogluteal site

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3
Q

Which site is used for children 3-7 years?

A

Dorsogluteal site

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4
Q

What is the dorsogluteal site?

A

Posterior surface

Upper lateral quadrant

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5
Q

Which site is for children aged 7+ and adults?

A

Ventrogluteal site

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6
Q

What is the ventrogluteal site?

A

Palm over greater trochanter
Thumb toward inguinal region
Index finger to ASIS
Spread out finger

Inject between PIP joints of index and middle finger

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7
Q

What are the risk factors of osteoarthritis to the hip joint?

A

Past injury to hip joint
Obesity
Genetic component

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8
Q

What are the symptoms of osteoarthritis of the hip joint?

A

Joint pain, and pain in gluteal region, groin
Joint stiffness
Joint grinding

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9
Q

What are the signs of osteoarthritis of the hip joint?

A

Joint deformity

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10
Q

What is a pelvic fracture?

A

Fracture of the hip bone

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11
Q

Do fractures of the hip bone involve a single fracture or multiple fractures? Why?

A

Multiple fractures

Polo mint principle

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12
Q

How do fractures of the hip bone occur? Give some examples of each

A

Direct trauma to hip bone e.g. car accident

Force transmitted from lower limb e.g. fall on feet

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13
Q

Why are hip bone fractures often complicated?

A

Nearby soft tissues

easily damaged

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14
Q

Which soft tissues tend to be damaged in hip bone fractures?

A

Nerves, vessels

Bladder, urethra

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15
Q

Forces to anterior of hip bone will fracture the…?

A

Pubic rami

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16
Q

Forces to lateral hip bone will fracture the…?

A

Ilium

Acetabulum

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17
Q

Forces transmitted up lower limb will fracture the…?

A

Acetabulum

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18
Q

In people younger than 17, how does the acetabulum fracture?

A

Through the triradiate cartilage

bones have not yet fused

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19
Q

How are proximal femur fractures classified?

A

Intracapsular

Extracapsular

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20
Q

What is an intracapsular fracture of femur?

A

Occurs within hip joint capsule

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21
Q

What is an example of an intracapsular fractures?

A

Neck of femur fractures

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22
Q

What is a complication of intracapsular fractures?

A

Damage to medial circumflex artery and its branches

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23
Q

What is the risk of a damaged medial circumflex artery?

A

Avascular necrosis of head of

because artery to ligament of femoral head is inadequate

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24
Q

Why is the neck of femur a commonly fractured site on the femur?

A

Weakest part of femur, narrowest part of bone

At an oblique angle to femoral shaft

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25
Q

What group of people are intracapsular fractures common in?

A

Elderly women with osteoporosis

fracture results from a minor fall

26
Q

What are the possible treatment options for neck of femur fractures?

A

Total hip replacement

Hemiarthroplasty

Dynamic hip screw

27
Q

What is a total hip replacement?

A

Surgically removing acetabular cartilage
femoral head

replace them with artifical structures

28
Q

When is total hip replacement used for treatment?

A

When avascular necrosis of head of femur has occurred

Non-subsiding osteoarthritis

29
Q

What is hemiarthroplasty?

A

Removing femoral head

replacing it with artifical structure

30
Q

When is hemiarthroplasty used for treatment?

A

Avascular necrosis of head of femur has occurred

31
Q

What is a dynamic hip screw?

A

Involves screw in neck and head of femur

can slide over plate in femoral shaft

32
Q

When is dynamic hip screw used for treatment?

A

Undisplaced fractures

Extra-capsular fractures

33
Q

What are extracapsular fractures?

A

Occur outside of hip joint capsule

34
Q

What are some examples of extracapsular fractures?

A

Intertrochanteric fractures

Subtrochanteric fractures

35
Q

What type of fracture pattern do proximal femur fractures usually show?

A

Impacted fractures

36
Q

Are proximal femur fractures usually displaced or undisplaced?

A

Displaced

37
Q

How are the bony fragments displaced in a proximal femur fracture?

A

Distal fragment is pulled upwards by flexors, adductors

Laterally rotated by ilopsoas

38
Q

Do proximal femur fractures show shortening of the thigh or not? Why?

A

Yes they do

because bony fragments override each other

39
Q

What causes a femoral shaft fracture?

A

Direct trauma

40
Q

What type of fractures are femoral shaft fractures usually?

A

Spiral fractures

Comminuted fractures

41
Q

Is there shortening of the thigh with spiral fractures or not? Why?

A

Yes
bony fragments override each other
by pull of muscles

42
Q

Do the fragments in a comminuted fracture of the thigh displace or not? Why?

A

Yes

due to pull of muscles attached on the fragments

43
Q

What are the cimplications of femoral shaft fractures?

A

Injury to neurovascular structures

e.g. femoral nerve, artery

44
Q

What is a hip dislocation?

A

Femoral head not properly located in acetabulum

45
Q

What are the types of hip dislocations?

A

Congenital

Acquired

  • anterior
  • posterior
46
Q

What is congenital hip dislocation?

A

Hip joint does not develop properly in utero

47
Q

What are the clinical features of congenital hip dislocation?

A

Limited abduction at hip joint

Affected lower limb is shorter - femoral head is superior to acetabulum

Positive tredelenburg sign - looks like it

48
Q

What causes a posterior hip dislocation?

A

Force on femur

drives it posteriorly through acetabulum

49
Q

How is the joint capsule affected in a posterior hip dislocation?

A

Torn posteriorly and inferiorly

50
Q

Where does the femoral head lie in a posterior dislocation?

A

Posterior to acetabulum

51
Q

Is there shortening of the thigh with a posterior hip dislocation or not? Why?

A

Yes

Because femoral head has moved further up along the hip bone

52
Q

What does the lower limb look like with a posterior hip dislocation?

A

Shortened

Medially rotated

53
Q

What is a complication of a posterior hip dislocation?

A

Injury to sciatic nerve

54
Q

What are the consequences of injury to sciatic nerve?

A

Loss of function in posterior thigh muscles, all leg muscles

Loss of sensation in all of leg
apart from medial leg and medial foot which is supplied by saphenous nerve, branch of femoral nerve

55
Q

What causes anterior hip dislocations?

A

Hip is forced into extension, abduction, lateral rotation

56
Q

Where does the femoral head lie with an anterior hip dislocation?

A

Anteriorly and inferiorly to acetabulum

57
Q

What are anterior hip dislocations associated with?

A

Fracture to femoral head

giving fracture-dislocation of hip joint

58
Q

What are the features of superior gluteal nerve injury?

A

Positive tredelenburg sign

Tredelenburg gait

Weakened medial rotation

59
Q

What is a pulled hamstring?

A

Stretched posterior thigh muscles

partial or complete tear

60
Q

What causes a pulled hamstring?

A

Sudden exertion of posterior thigh muscles

e.g. sprinting

61
Q

What are some complications of pulled hamstrings?

A

Rupturing of blood vessels, haematoma

Avulsion fracture of ischial tuberosity

62
Q

What are the possible causes of swelling in the popliteal fossa?

A

Baker’s cyst - inflammation of semimembranosus bursa

Popliteal aneurysm

Abscess

Enlarged lymph nodes

Benign or malignant tumour of bone, muscle, connective tissue

Lower Limb (26 decks)

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