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Anatomy II > LE Clinical Conditions > Flashcards

LE Clinical Conditions Flashcards

1
Q

What boney structure might the IT band “snap” over causing Snapping Hip/Coxa Sultans?

A

Greater Trochanter
Especially the posterior fibers

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2
Q

What boney structure might the hamstrings snap over, causing Snapping Hip/Coxa Sultans?

A

Ischial Tuberosity

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3
Q

What contributes to the make up of the ITB?

A

Aponeurosis of the glute max and TFL
(inserts on Gerdy’s Tubercle)

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4
Q

What anterior tendon may also snap over bone or bursa sounding like an intra-articular issue?

A

Ileopectineal eminence (there is a bursa there)
Possibly anterior femoral head

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5
Q

What intra-articular structures might you consider for differential diagnosis of snapping hip/coxa sultans?

A
  • Labral tear
  • Ligamentum teres tear
  • Partial tear of the acetabular ligament
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6
Q

S1 and S2

A

Nerve to piriformis

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7
Q

Where does the sciatic nerve typically emerge?

A

inferior to the piriformis (Type A on the Beaton and Anson Classification)

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8
Q

According to Beaton and Anson Classification, what is the next most typical orientation of the sciatic nerve?

A

Type B
The divisions of the sciatic nerve are already divided with one division (usually common fibular n) going through the piriformis and the other going inferior to the piriformis

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9
Q

How might Type B present clinically?

A
  • Shooting/radiating pain down the lower limb, especially if piriformis is tight or spasmed
  • Shooting pain with deep palpation
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10
Q

Common locations of pelvic fractures

A
  • Iliac wing
  • Sacrum
  • Superior and inferior ramus of pubis
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11
Q

What specific pelvic structures would likely be injured/fracutred/torn due to a high energy vertical shear force?

A
  • Unstable pelvic ring fracture: superior and inferior ramus
  • lateral sacral facture
  • SI dislocation
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12
Q

What muscles arise from the iliac fossa?

A

Illiacus

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13
Q

What muscles arise from the pubis?

A

Gracilis, adductor longs and brevis, obturator externus and internus, pectineus

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14
Q

What muscles arise from the sacrum

A

pirifromis
coccygeus
some iliacus fibers

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15
Q

In the case of a pelvic ring fracture what muscles and ligamentous structures may be damaged?

A
  • Anterior and posterior sacroiliac ligaments
  • sacrospinous
  • sacrotuberous ligaments
  • muscles originating from iliac fossa, pubis, and coccyx
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16
Q

In the case of a pelvic ring fracture, what vessels and nerves are at high risk for injury?

A

Iliac arteries, gluteal arteries, lumbosacral trunk and upper sacral nerves

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17
Q

What muscles attach near the pubic symphysis?

A

All adductors and the obutator externus
- Adductor longus is the closest

18
Q

how would a disruption in the pubic symphysis present clinically?

A

limb length difference
pain w/ WB

19
Q

How is a pubic symphysis injury different from a fracture of the pubis?

A

You’re allowed to WB during healing process and the etiology of the injury (high impact vs low impact)

20
Q

Salter Harris Type 1

A

Slipped
Fracture WITHIN the growth plate
Splits epiphysis and metaphysis

21
Q

Slater Harris Type 2

A

Above
Fracture extends thru physis and metaphysis

22
Q

Salter Harris Type 3

A

Lower
Intra-articular and separating physis

23
Q

Salter Harris Type 4

A

Thru/Transverse
Also intra-articular usually in 3 planes
Includes epiphysis, physis, and metaphysis

24
Q

Salter Harris Type 5

A

Rammed/Ruined
Compression of growth plate (very rare)

25
Q

Salter Harris Type 6

A

Avulsion

26
Q

What are the major muscles along the anterior femur that may be interrupted in an anterior distal femur fracture

A

Quadriceps

27
Q

What other group of muscles may be disrupted by a distal femur fracture? Which muscle specifically due to its insertion on the femur?

A

Adductors
Specifically adductor magnus due to its insertion on supracondylar line

28
Q

What vascular structure may be disrupted by a distal femur fracture

A

popliteal artery and vein

29
Q

What muscles are involved in Pes Anserinus bursitis

A

Sartorius
Gracilis
Semitendinosus

30
Q

Where is the bursitis that is irritated in pes ansurinus bursitis?

A

Inferior to the tibial plateau and inferior/lateral to the tibial tuberosity

31
Q

What activities would cause the pes anserine tendons to become irritated?

A

Running
Repeated Knee Flexion
Kicking

32
Q

What nervous structure may get irritated in due to its location near the bursa? What would be the clinical signs of this nerve being irritated?

A

Saphenous n.
Sensory disruption medial leg

33
Q

What bones are involved in clubfoot?

A
  • Calcaneus, navicular and cuboids are medially rotated in relation to talus
  • First metatarsal is plantarflexed
34
Q

Given these structural changes of clubfoot which ligamentous structures receive increased tension (lengthened) and which ones are shortened?

A
  • Deltoid (medially) shortened
    –> tendons of tibialis posterior and FHL and FD often cannot be isolated from the ligaments
  • Lateral stretched
  • Plantar calcaneonavilcular will track more vertically due to change in position of the navicular bone
35
Q

How is the length-tension relationship of muscles changed in club foot?

A

o Fibularis tendons severely elongated
o Decreased tendon length for tibialis posterior
o Anterior tibialis tendon would deviate medially
o Triceps surae tendon slightly elongated

36
Q

Due to the structural changes of club foot, how does the foot’s arch change?

A

It is increased due to the medial rotation of the forefoot

37
Q

What creates the tarsal tunnel?

A

Medial malleolus antero/superiorly – talus and calcaneus laterally – held together by the flexor retinaculum on the outside

38
Q

What are the contents in the tarsal tunnel?

A

Tibialis post, FDH, tibial nerve, posterior artery and vein, and FHL

39
Q

What branch of the medial and lateral plantar nerves are likely to be entrapped if the tibial nerve splits early?

A

Medially
It comes off in the medial direction closer to the tunnel

40
Q

Hypertrophy of which muscle(s)/tendon can affect the posterior/lateral portion of the tunnel?

A

FHL (jumping, running, push off)
Tibialis Posterior (running)

41
Q

misalignment or deformity of which boney structures could narrow the tunnel?

A

Talus and Calcaneus

Anatomy II (8 decks)

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