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Mally's extremities > Lower extremiteis: diff di > Flashcards

Lower extremiteis: diff di Flashcards

0
Q

what is posterior tibialis tenosynovitis? pg. 96

A

an inflammation of the sheath that surrounds the posterior tibialis tendon

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1
Q

what is the most common cause of aquired pes planus? pg. 96

A

ruptured posterior tibialis

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2
Q

When does tarsal tunnel syndrome occur? pg 96

A

when the posterior tibial nerve is constricted beneath the tunnel roof formed by the flexor retinaculum

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3
Q

what is the most common finding of Achilles tendonitis? pg 97

A

malaligned calcaneous

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4
Q

what is the common etiology of achilles tendonitis?

A

chronic overuse injury

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5
Q

Achilles’ tendon pain is also referred to as what? pg 97

A

achillodynia

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6
Q

Achilles’ tendon pain is a significant source of disability for whom? pg 97

A

many people taking part in sports

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7
Q

what is the definition, etiology, signs/symptoms, and orthepedic tests of bursitis. pg 103

A

def: inflammation of the bursae
etiology: superficial bursa irritation by friction from shoe slippage and retrocalcaneal bursa irritation from calcaneal angulation
signs/symptoms: localized pain and swelling at superficial bursa or retrocalcaneal bursa
ortho tests: entire foot exam

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8
Q

what is an expected positive of bursitis? pg 103

A

may have palpable edema, pain, or tenderness

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9
Q

what is the most common finding with bursitis?

A

calcaneal subluxation

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10
Q

what is the definition, etiology, and S and S of hallux valgus? pg 105

A

def: lateral deviation of the great toe at the metatarophalangeal joint
etiology: obesity, misfitted shoes, trauma, heredity
SS: cosmetic deformity, swelling, calluses, disabling pain

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11
Q

What is the most common finding for a hallux valgus? pg 105

A

increased intermetatarsal angle

increased meatarsophalangeal angle

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12
Q

What degree is a congrous metatarsophalangeal (hallux valgus) joint? 106

A

20-30

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13
Q

what degree is a pathologic hallux valgus joint?

A

20-60

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14
Q

what degree is a normal metatarsophalangeal angle?

A

8-20 degrees

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15
Q

What degree is metatarsus primus varus?

A

increases intermetatarsal angle greater than 15 degrees

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16
Q

what is a bunionette or tailors bunion?

A

bunion on the 5th metatarsal

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17
Q

what is the most common toe involved toe involved in hammer toe, mallet toe, and claw toe?

A

the second toe

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18
Q

flexion deformities of the phalanges, phalangeal tippage, and painful calluses is indicative of what? pg 107

A

hammer toe, claw toe, and mallet toe

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19
Q

what is metatarsalgia? 109

A

inferior metatarsal head pain

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20
Q

burning and cramping in the inferior metatarsal head, which can be relieved by rest, and possibly accompanied by calluses can cause what?

A

metatarsalgia

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21
Q

what is the most common finding with metatarsalgia?

A

misaligned metatarsals

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22
Q

what is mortons neuroma? 110

A

forefoot interdigital pain. caused by pressure on plantar digital nerves. will have pain and palpable neuronal swelling and burning, or anesthesia exacerbated by usage and compression remitted by rest and massage.

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23
Q

what is an expected positive of mortons neuroma? 110

A

mortons test

24
Q

what is the most common finding in mortons neuroma? 110

A

misaligned metatarsals

25
Q

where is mortons neuroma most commonly located? second most common?

A

3rd and 4th metatarsal is most common, 2nd and 3rd is second most common

26
Q

where is surgical treatment of mortons neuroma done? 110

A

excision of neuroma or swelling proximal to the site of distal nerve bifurcation

27
Q

what is the definition, SS, and common findings of pes cavus? 112

A

def: high rigid longitudinal arch characterized by plantar flexion of forefoot on the hindfoot
SS: high rigid arch, clawing of toes, calluses on dorsum of toes
common findings: high arches

28
Q

what is the etiology of pes cavus? 112

A

locking midtarsal joint linkage system, congential or idiopathic reduced normal tibial torsion, forefoot pronation and compensatory biomechanical secondary inversion of hindfoot

29
Q

what is the definition of pes planus? 113

A

depression or loss of medial longitudinal arch. usually associated with calcaneal (valgus) eversion and forefoot abduction accompanied with hypertrophied fat pad

30
Q

flexible pes planus

A

hereditary, tight Achilles’ tendon.

pain, burning, weight bearing collapses the arch. associated with genu valgum and internal tibial torsion

31
Q

rigid pes planus

A

peroneal spasticity, usually secondary to hindfoot arthritis or tarsal coalation.
reduced hindfoot motion, irritation and resultant peroneal myospastic activity, painful limp

32
Q

what are orthapedic tests performed for either pes planus or pes cavus?

A

medial and lateral stability tests, draw sign, mortons test, and strunskys test

33
Q

an overstretching of the plantar fascia with possible fascial microtears and some inflammation can diagnose what?

A

plantar fascitis

34
Q

what is the SS of plantar fascitis?

A

pain localized to the calcaneous (at the medial plantar tuberosity)

35
Q

pes cavus and pes planus is the most common finding of what diagnosis?

A

plantar fascitis

36
Q

calcaneal heal spur can be associated with inflammation of what?

A

plantar aponeurosis

37
Q

plantar fascitis is easily misdiagnosed as what? 116

A

plantar bursitis, heel spur syndrome, calcaneal neuritis, or abductor hallicus myositis

38
Q

increased forces over a period of time at a vector angle on a specific improperly weight-borne joint createing a periosteal interruption defines what?

A

stress fractures

39
Q

an overuse injury, related to improper conditioning with localized tenderness is indicative to what?

A

stress fracture

40
Q

what is an expected positive of a stress fracture?

A

tuning fork exam

41
Q

treatment for a stress fracture?

A

rest, ice, elevation and bracing if necessary

42
Q

What is the definition of tarsal tunnel syndrome?

A

posterior tibial nerve entrapment in the lacinate (retinaculuni) ligament

43
Q

what are the SS of TTS?

A

burning, numbness and tingling in the sole of the foot, exacerbated by activity and may radiate into the tricep surae musculature

44
Q

what is an expected positive of tarsal tunnel syndrome?

A

tinels tap over the posterior tibial nerve

45
Q

what is the most common finding of tarsal tunnel syndrome? 122

A

misaligned calcaneus and talus

46
Q

What are the borders of the tarsal tunnel?

A

flexor retinaculum (lacinate ligament)
medial malleolus
posterior aspect of talus
medial aspect of calcaneus

48
Q

shin splints are most commonly caused by a subluxation of what bone?

A

talus

49
Q

Surface irregularities and softening of the retropatellar articular cartilage indicates what?

A

chondromalacia patella

50
Q

with progression of chondromalacia patella what happens?

A

the superficial layer of cartilage separates further form the deeper layer with the formation of a blister. This blister can rupture leading to ulceration and fragmentation of the articular cartilage. Finally, there is a complete loss of articular cartilage with exposure of bone in some areas. Gives appearance of crater around the rim of frayed cartilage.

51
Q

What can predispose the knee to chondromalacia and ultimately osteoarthritic changes?

A

abnormal anatomic relationships between the patella and femoral condyles (pg. 222)

52
Q

The eitiology: “may be latent from repeated microtrauma and become sympotmatic after a greater trauma; as well as, prolonged loading force on the cartilage which compresses the tissue and causes decreased elasticity with diminution of nutrition of cartilage” describes what?

A

chondromalacia patella

53
Q

Signs and symptoms of chondromalacia patella are what?

A

anterior knee pain, audible retropatellar crepitis, reactive synovitis, increased Q angle, abnormal patellar position etc…

54
Q

Expected positives of chondromalacia patella are what?

A
  • apprehension test of patella: feels like patella will dislocate, patient pulls away by flexing quads
  • clarkes patellar scrape test: retropatellar pain
  • patella ballotment test: swollen joint, will have a floating sensation of the patella
  • fouchets sign: point tenderness and pain along the patellar margin upon compression
  • perkins sign: peripheral tenderness upon medial and lateral displacement f the patella
55
Q

What radiology views are needed for chondromalacia patella?

A

Axial patella
A-P knee
Lateral knee

56
Q

what are common findings of chondromalacia patella?

A

decreased joint space btwn femur and tibia, malposition of patella, and rotation of tibia

57
Q

Is chondromalacia progressive?

A

yes. A “blister” or soft area forms initially. If the blister breaks, chunks erupt to produce an ulcer. as the knee cap slides laterally, the chunks are eroded to expose bone.

58
Q

an increase in pressure within a myofacial compartment that compromises capillary flow, and subsequently, neuromuscular function is known as what?

A

exercise-induced compartment syndrome

59
Q

What is the etiology of exercise-induced compartment syndrome?

A

excessively taught fascia! if muscle compartment cannot increase in volume then intracompartmental pressure rises and thus, the capillary blood flow to the muscle becomes compromised. Fluid will shift from vascular to interstitial space (further increasing pressure). ischemia will result and cause a temporary decrease in muscle and nerve function. may also cause inflammatory changes in muscle and fascia

Mally's extremities (4 decks)

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