Lower Extremity Flashcards
What disorder does not have Pez cavus as a feature? A. Polio myelitis B. Cerebral palsy C. Friedrich ataxia D. Peroneal spastic foot
D
The etiology of pes cavus includes malunion of the calcaneal or talar fractures, Burns, sequela resulting from compartment syndrome, residual clubfoot and neuromuscular disease. Neuromuscular diseases, such as muscular dystrophy, Charco Marie tooth disease, spinal Dysraphism, Polyneuritis, intraspinsltumors, polio myelitis, Suringomyelia, Friedrich ataxia, cerebral palsy and spinal cord tumors can have muscle imbalance that lead to elevated arches.
What exam findings is common for Morten’s neuroma?
Apply direct the inter digit web Space with one hand and apply lateral and medial pressure to the metatarsal heads together. Return isolated pain on plantar aspect of the web spaces is consistent with Morton’s neuroma.
When do hamstring injuries most commonly occur?
With eccentric contraction of the lateral hamstring.
The majority of hamstring injuries occur from indirect forces during running and sprinting activities. Most injuries occur at the myotendinous junction not at the osseous attachments, during eccentric contractions of the hamstring. The lateral hamstrings (biceps femoris) are affected more than the medial hamstring (semitendinosis and semimembranosus.
What muscles are in the anterior compartment of the leg?
4 Ankle Dorsiflexors, toe extensors and foot evertors and inverters
- ankle Dorsiflexors and foot inverters-
- tibialis anterior (the peroneal nerve L4 five )
- extensor hallucis longus (deep peroneal nerve L4 -5)
- ankle Dorsiflexors and foot evertors–
- extensor digitorum longus (deeper peroneal Nerve: L4 L5) toe extensor
- Peroneus tertius (the deep peroneal nerve: L4, L5)
What muscles make up the lateral compartment?
Foot evertors and weak plantar flexors
- Peroneus Brevus (superficial peroneal nerve: L5,S1)
- Peroneus longus (superficial peroneal nerve: L5, S1)
What is in the anterior compartment of the leg?
- Tibialis anterior, extensor digitorum longus, extensor hallucis longus, and Peroneus tertius muscles,
- the anterior tibial tibial artery and vein
- peroneal nerve
What muscles make up the posterior compartment of the leg?
Gastrocnemius (tibial nerve L4, L5, S1, S2) plantar flexor
- plantaris (tibial nerve, L5, S1, S2) weak plantarflexion
- Soleus (tibial nerve L5, S1, S2) plantar flexor
- flexor digitorum longus (tibial nerve, L5, S1, S2) flexion of the lateral four toes, inversion, plantarflexion
- tibialis posterior inversion and plantar flexor (tibial nerve L5, S1, S2)
- flexor hallucis longus (tibial nerve S2, s3)
- popliteus internal rotation of the leg on the femur (tibial nerve L5, S1, S2)
What makes up the lateral compartment of the leg?
Peroneus longus and Bevis muscles, the superficial peroneal nerve, and the common peroneal nerve dividing into superficial and deep branches
What comprises the Deep posterior compartment of the leg?
Flexor digitorum longus, flexor hallucis longus, tibialis posterior, and popliteus muscles; the posterior tibial artery and vein and the tibial nerve.
What comprises the superficial posterior compartment of the leg?
Gastrocnemius, Soleus, and plantaris muscles.
What makes the media longitudinal arch of the foot?
The deltoid ligament maintains a close proximity in the medial malleolus and talus preserving the medial longitudinal arch of the foot
- spring ligament
- the medial and posterior talocalcaneal ligaments
How do you support the medial longitudinal arch?
Scaphoid pads
arch cookies
navicular pad
What internship modification could you do in the setting of a calcaneal spur?
He’ll Christian relief or excavation
-soft pad with excavation under painful part of the heel
What shoe modification could you do for innersole excavation or relief?
A soft pad with excavation under one or more painful bony prominence is usually metatarsal head. Excavation is usually filled the compressible material.
What does a metatarsal pad do in the shoe?
Dome shaped pads glued to the innersole with the apex and of the metatarsal shaft release pressure from metatarsal heads by transferring the load to the metatarsal shaft.
What service doesn’t internal heel wedge provide?
Can be applied medially and promote hind foot inversion (in flexible pes planus) or laterally and promote hindfoot Eversion and relieve pressure on the cuboid (inflexible pez Verus) it also increases total plantar-bearing area and can be used in fixed pez varus.
Whatever’s factors for avascular necrosis in the femoral head?
-in children aged 2 to 12 this is known as Legg-Calve-Perthes disease. - the most common causes and adults are steroid use and alcohol abuse
MRI is indicated to detect early change
Treatment is to keep the acetabulum in proximity to the femoral head while healing and remodeling occurs
Adults may require arthroplasty
What is the benefit to a bipolar implant for hip arthroplasty?
It theoretically reduces friction and impact at the prosthetic acetabular junction by allowing motion at two sites: prosthetic inner bearing surface and prosthetic bearing acetabular surface.
-Acetabular erosion and protrusion should theoretically be reduced by reducing motion at the acetabulum
What is the most common type of hip fracture?
The most common type of hip fracture is intertrochanteric.
- Highly fragmented fractures may result in significant blood loss and hypovolemia
- postoperatively, a leg length discrepancy may result due to comminution status post fixation.
- Moderately high forces are generated in this area and a strong fixation is required
- fractures maybe I’m displaced, displaced 2 part fractures, or unstable three-part fractures
What are the two types of femoral neck stress fractures?
- Compression type or
- transverse /tension type.
How do you treat a compression type stress fracture of the femoral neck?
Because they’re more stable, they may be treated with bedrest.
When there’s no pain at rest and weight-bearing to limitation of pain is allowed.
If compression type fracture progress they may require internal fixation.
How do you treat a transverse or tension type stress fracture the femoral neck?
Internal fixation due to the high risk of displacement
What is the main predisposing factor to shinsplints Otherwise known as medial tibial stress syndrome?
Hyper pronation of the foot or 4 foot varus. (Calcaneal eversion)
Chronic traction on the periosteum at the periosteal fascial junction
What is the splatt procedure?
Split anterior tibialis tendon transfer is done for ankle varus or calcaneal supination caused by spasticity of the anterior tibialis and toe flexors. It is a transfer of the lateral portion of tibialis anterior to the third cuneiform or the cuboid bone transforming deforming forces to correcting forces.
