Hip conditions Flashcards by Naseem Basit

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

Injury to sciatic nerve

How well did you know this?

Not at all

Perfectly

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

Dorsogluteal site

Ventrogluteal site

How well did you know this?

Not at all

Perfectly

Which site is used for children 3-7 years?

Dorsogluteal site

How well did you know this?

Not at all

Perfectly

What is the dorsogluteal site?

Posterior surface

Upper lateral quadrant

How well did you know this?

Not at all

Perfectly

Which site is for children aged 7+ and adults?

Ventrogluteal site

How well did you know this?

Not at all

Perfectly

What is the ventrogluteal site?

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

Inject between PIP joints of index and middle finger

How well did you know this?

Not at all

Perfectly

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

Past injury to hip joint
Obesity
Genetic component

How well did you know this?

Not at all

Perfectly

What are the symptoms of osteoarthritis of the hip joint?

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

How well did you know this?

Not at all

Perfectly

What are the signs of osteoarthritis of the hip joint?

Joint deformity

How well did you know this?

Not at all

Perfectly

What is a pelvic fracture?

Fracture of the hip bone

How well did you know this?

Not at all

Perfectly

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

Multiple fractures

Polo mint principle

How well did you know this?

Not at all

Perfectly

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

Direct trauma to hip bone e.g. car accident

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

How well did you know this?

Not at all

Perfectly

Why are hip bone fractures often complicated?

Nearby soft tissues

easily damaged

How well did you know this?

Not at all

Perfectly

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

Nerves, vessels

Bladder, urethra

How well did you know this?

Not at all

Perfectly

Forces to anterior of hip bone will fracture the…?

Pubic rami

How well did you know this?

Not at all

Perfectly

Forces to lateral hip bone will fracture the…?

Ilium

Acetabulum

How well did you know this?

Not at all

Perfectly

Forces transmitted up lower limb will fracture the…?

Acetabulum

How well did you know this?

Not at all

Perfectly

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

Through the triradiate cartilage

bones have not yet fused

How well did you know this?

Not at all

Perfectly

How are proximal femur fractures classified?

Intracapsular

Extracapsular

How well did you know this?

Not at all

Perfectly

What is an intracapsular fracture of femur?

Occurs within hip joint capsule

How well did you know this?

Not at all

Perfectly

What is an example of an intracapsular fractures?

Neck of femur fractures

How well did you know this?

Not at all

Perfectly

What is a complication of intracapsular fractures?

Damage to medial circumflex artery and its branches

How well did you know this?

Not at all

Perfectly

What is the risk of a damaged medial circumflex artery?

Avascular necrosis of head of

because artery to ligament of femoral head is inadequate

How well did you know this?

Not at all

Perfectly

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

Weakest part of femur, narrowest part of bone

At an oblique angle to femoral shaft

How well did you know this?

Not at all

Perfectly

What group of people are intracapsular fractures common in?

Elderly women with osteoporosis | fracture results from a minor fall

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

Total hip replacement Hemiarthroplasty Dynamic hip screw

What is a total hip replacement?

Surgically removing acetabular cartilage femoral head replace them with artifical structures

When is total hip replacement used for treatment?

When avascular necrosis of head of femur has occurred Non-subsiding osteoarthritis

What is hemiarthroplasty?

Removing femoral head replacing it with artifical structure

When is hemiarthroplasty used for treatment?

Avascular necrosis of head of femur has occurred

What is a dynamic hip screw?

Involves screw in neck and head of femur | can slide over plate in femoral shaft

When is dynamic hip screw used for treatment?

Undisplaced fractures Extra-capsular fractures

What are extracapsular fractures?

Occur outside of hip joint capsule

What are some examples of extracapsular fractures?

Intertrochanteric fractures Subtrochanteric fractures

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

Impacted fractures

Are proximal femur fractures usually displaced or undisplaced?

Displaced

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

Distal fragment is pulled upwards by flexors, adductors | Laterally rotated by ilopsoas

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

Yes they do | because bony fragments override each other

What causes a femoral shaft fracture?

Direct trauma

What type of fractures are femoral shaft fractures usually?

Spiral fractures Comminuted fractures

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

Yes bony fragments override each other by pull of muscles

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

Yes | due to pull of muscles attached on the fragments

What are the cimplications of femoral shaft fractures?

Injury to neurovascular structures | e.g. femoral nerve, artery

What is a hip dislocation?

Femoral head not properly located in acetabulum

What are the types of hip dislocations?

Congenital Acquired - anterior - posterior

What is congenital hip dislocation?

Hip joint does not develop properly in utero

What are the clinical features of congenital hip dislocation?

Limited abduction at hip joint Affected lower limb is shorter - femoral head is superior to acetabulum Positive tredelenburg sign - looks like it

What causes a posterior hip dislocation?

Force on femur | drives it posteriorly through acetabulum

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

Torn posteriorly and inferiorly

Where does the femoral head lie in a posterior dislocation?

Posterior to acetabulum

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

Yes | Because femoral head has moved further up along the hip bone

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

Shortened Medially rotated

What is a complication of a posterior hip dislocation?

Injury to sciatic nerve

What are the consequences of injury to sciatic nerve?

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

What causes anterior hip dislocations?

Hip is forced into extension, abduction, lateral rotation

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

Anteriorly and inferiorly to acetabulum

What are anterior hip dislocations associated with?

Fracture to femoral head | giving fracture-dislocation of hip joint

What are the features of superior gluteal nerve injury?

Positive tredelenburg sign Tredelenburg gait Weakened medial rotation

What is a pulled hamstring?

Stretched posterior thigh muscles | partial or complete tear

What causes a pulled hamstring?

Sudden exertion of posterior thigh muscles | e.g. sprinting

What are some complications of pulled hamstrings?

Rupturing of blood vessels, haematoma Avulsion fracture of ischial tuberosity

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

Baker's cyst - inflammation of semimembranosus bursa Popliteal aneurysm Abscess Enlarged lymph nodes Benign or malignant tumour of bone, muscle, connective tissue