Inside major lower limb joints Flashcards

1
Q

Teres

A

Sausage-shaped

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2
Q

Valgus

A

Deformity away from midline

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3
Q

Varus

A

Deformity towards midline

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4
Q

Genu valgus

A

Knock-knees

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5
Q

Genu varus

A

Bow legs

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6
Q

Coxa valgus

A

Increased angle between femoral neck and shaft

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7
Q

Coxa varus

A

Angle between femoral head and shaft is less than 120 degrees

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8
Q

Ligaments

A

Connect bone to bone

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9
Q

What is the innominate bone made from?

A

Ischium, ilium and pubic bone

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10
Q

What is the acetabulum fossa?

A

Depressed articular surface where bones meet

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11
Q

What are the trochanters?

A

Two tubercles, have greater and lesser trochanters

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12
Q

What is the trochanteric crest?

A

Connects trochanters

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13
Q

What is the intertrochanteric fossa?

A

Gap between condyles

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14
Q

Key features of innominate bone

A
  • Acetabular fossa
  • U-shaped articular surface
  • Superior pubic ramus
  • Anterior iliac spine
  • Ischial tuberosity
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15
Q

Key features of femur

A
  • Head
  • Neck
  • Greater and lesser trochanters
  • Intertrochanteric line
  • Intertrochanteric crest
  • Linear aspera
  • Medial and lateral condyles
  • Medial and lateral epicondyles
  • Intercondylar notch
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16
Q

What are the two intracapsular hip ligaments?

A

Transverse acetabulum ligament

Ligamentum teres

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17
Q

Where is the ligamentum teres?

A

Behind transverse acetabular ligament, supplies blood to femoral head and connects it to hip

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18
Q

What does transverse acetabular ligament do?

A

Joins acetabulum together

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19
Q

What are the extra capsular hip ligaments?

A

Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament

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20
Q

What does iliofemoral ligament do?

A

Prevents hyperextension of the hip

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21
Q

What does pubofemoral ligament do?

A

Reinforces capsule, limits abduction

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22
Q

What does ischiofemoral ligament do?

A

Holds femoral head in acetabulum, extension to 20 degrees

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23
Q

What are the main sources of blood to the head of the femur?

A

Artery inside ligamentum teres
Reticular branches
Osteological arteries

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24
Q

What is the main blood supply of the head of the demur in children?

A

Artery inside ligamentum teres - growth plate blocks reticular branches

25
Q

What is the main blood supply of the head of the femur in adults?

A

Reticular branches - growth plate replaced by Haversian bone

26
Q

From what type of fractures does AVN of the femoral head commonly occur?

A

Subcapital neck, transcervical and intertrochanteric fractures

27
Q

What happens when the neck of the femur is fractured?

A

Proximal femur: no movement

Distal femur: pulled proximally (quadriceps and hamstrings) and laterally (lateral rotators and gluteus Maximus)

28
Q

What happens when the shaft of the femur is fractured?

A

Proximal femur: generally neutral

Distal femur: pulled proximally (quadriceps and hamstrings) and posteriorly (gastrocnemius)

29
Q

What is Legg-Cathe-Perthes disease?

A
  • Idiopathic osteonecrosis of capital femoral epiphysis

- Idiopathic avascular necrosis of femoral head

30
Q

Characteristics of Legg-Cathes-Perthes disease

A
  • Common between 5-10 years
  • First symptoms include pain and a limp
  • Shortening of leg
  • Osteoarthritis develops later
  • More common in males than females
  • One leg starts and the other follows
  • Limited range of motion
31
Q

Key features of the knee

A
  • Medial and lateral supracondylar ridges
  • Medial and lateral condyles
  • Medial and lateral epicondyles
  • Popliteal surface
  • Intercondylar notch
  • Medial and lateral tibial plateaus, anterior and posterior intercondylar areas
  • Intercondylar eminece
  • Facet for head of fibula
  • Tibial tuberosity - caused by quads pulling on tibia
32
Q

What is Osgood-Schlatter syndrome?

A

Inflammation of patellae ligament at tibial tuberosity

33
Q

What are the boundaries of the joint capsule?

A
  • Proximal femoral condyles and intercondylar fossa posteriorly
  • Patellar retinaculum anteriorly
  • Articular margin of femur marginally
  • Femur laterally
34
Q

What are the five ligaments in the knee?

A
  • Patella ligament
  • Anterior cruciate ligament
  • Posterior cruciate ligament
  • Medial collateral ligament
  • Lateral collateral ligament
35
Q

What does patella ligament do?

A

Attaches patella to tibial tuberosity

36
Q

How is patella ligament injured?

A

Direct impact to front of knee

37
Q

How to test integrity of patella ligament

A

Tense and relax quads

38
Q

What does ACL connect?

A

Femur to tibia

39
Q

What does ACL do?

A

Restricts anterior movement of tibia relative to femur

40
Q

How to test ACL?

A

Pull tibia anteriorly

41
Q

How is ACL torn?

A

Sport

42
Q

What does PCL connect?

A

Femur to tibia

43
Q

What does PCL do?

A

Restricts posterior movement of tibia relative to femur

44
Q

How to test PCL?

A

Holding knees and hips at 90 degrees with foot in the air. Posterior sag in knee indicated PCL tear

45
Q

How to tear PCL?

A

Direct blow to front of knee when it is bent

46
Q

What does the medial collateral ligament connect?

A

Femur to tibia

47
Q

How is medial collateral ligament torn?

A

Direct blow to knee

48
Q

How is medial collateral ligament tested?

A

Bend affected leg to 30 degrees of flexion whilst applying valgus force. Positive test occurs when pain occurs

49
Q

What does medial collateral ligament do?

A

Prevents leg extending inwards, keeps knee stable and allows it to rotate

50
Q

How is lateral collateral ligament torn?

A

Twisting on side of foot

51
Q

What does lateral collateral ligament connect?

A

Femur to fibula

52
Q

What does lateral collateral ligament do?

A

Provides knee with stability

53
Q

How to test integrity of lateral collateral ligament

A

Varus stress test - bend knee to 30 degrees flexion whilst applying varus force. Positive test occurs when pain occurs

54
Q

Which muscles are used to extend the knee?

A

Quadriceps femoris

55
Q

Which muscles are used to flex the knee?

A

Hamstrings and gracilis, gastrocnemius and sartorius

56
Q

Where is the cartilage in the knee?

A

Meniscus behind patella

57
Q

Function of meniscus

A

Donut shaped to increase surface area between condyles and tibial plateaus

58
Q

How can you damage cartilage in knee?

A

Twist knee whilst bearing weight on it

59
Q

What are the two meniscus in the knee?

A

Medial and lateral (medial more susceptible to injury)