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Ortho > Lower Extremity Disorders > Flashcards

Lower Extremity Disorders Flashcards

1
Q

Which nerves create the sciatic nerve?

A

L4-S3

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2
Q

Which nerves create the femoral nerve?

A

L2-4

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3
Q

Which nerve create the lateral femoral cutaneous nerve?

A

L3-4

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4
Q

Blood Supply to the Hip

A

Circumflex
Profunda femoris
Posterior division of the obturator artery
Femoral head

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5
Q

Possible Reasons for AVN

A 
Fracture
Dislocation
Slipped capital femoral epiphysis
Steroids
ETOH
Perthes
Coagulopathy
Sickle cell
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6
Q

Hip Imaging

A 
X-rays: weight bearing if possible
Bone scan
CT
MRI
MRI arthrogram
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7
Q

Differential Diagnosis for Anterior Hip Pain

A 
Osteoarthritis
Inflammatory arthritis
Muscle/tendon strain
Tendinitis
Femoral neck stress fracture
Obturator/ilioinguinal nerve entrapment
Osteitis pubis
Acetabular labral tear
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8
Q

Differential for Pre-Pubescent Individuals

A

Legg Calve Perthes disease

Slipped capital femoral epiphysis (SCFE)

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9
Q

Differential for Hip Pain of Adolescence

A 
Avulsion fracture
Hip pointer
Contusion
Myositis ossificans
Femoral neck stress fracture
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10
Q

Differential of Hip Pain for Older Individuals

A 
Femoracetabular impingement (FAI)
Osteoid osteoma
ITB syndrome
Trochanteric bursitis
Piriformis syndrome
Iliopsoas bursitis
Meralgia paresthetica
Osteoarthritis
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11
Q

Clinical Presentation of Iliopsoas Bursitis or Tendinosis

A

Pain & snapping in groin & anterior hip with hip flexion & crunches

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12
Q

Evaluation of Iliopsoas Bursitis or Tendinosis

A

H&P
X-ray
MRI
R/o other diseases

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13
Q

Treatment of Iliopsoas Bursitis or Tendinosis

A 
Relative rest
Stretch
NSAIDs
PT
Injection, surgery??
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14
Q

Clinical Presentation of Acetabular Labrum Tear

A 
Hip pain
Deep click
Catching sensation
Worse with deep flexion & raising from seated position
Decreased ROM
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15
Q

Evaluation of an Acetabular Labrum Tear

A

H&P
Pain with hip flexion, add, and axial load
X-rays
MRI arthrogram

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16
Q

Treatment for Acetabular Labrum Tear

A

PT to maximize ROM & strength
Corticosteroid injection?
Surgery?

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17
Q

Clinical Presentation of Trochanteric Bursitis

A

Lateral hip pain
Gradual onset
Can’t lie on side

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18
Q

Evaluation of Trochanteric Bursitis

A

H&P
Tender to palpation over lateral thigh
Pain with Ober test
X-ray??

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19
Q

Treatment of Trochanteric Bursitis

A 
Ice
NSAIDs briefly
PT: stretch IT band, strengthen hip muscles
Evaluate biomechanics
Corticosteroid injection
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20
Q

Clinical Presentation of Osteoarthritis of the Hip

A

Progressive hip & groin pain

Decreased ROM

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21
Q

Evaluation of Osteoarthritis of the Hip

A

H&P

Weight bearing x-rays

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22
Q

Treatment of Osteoarthritis of the Hip

A

PT
Tylenol > NSAIDs
US guided hip injection
Surgery

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23
Q

Clinical Presentation of Pubic Ramus Stress Fracture

A

Pain with jumping, running, stretching, & landing

Increased pain with activity

24
Q

Evaluation of Pubic Ramus Stress Fracture

A 
Point-tender superior pubic ramus
Non-tender adductors
Normal physical exam
X-ray
Bone scan
MRI
25
Q

Treatment of Pubic Ramus Stress Fracture

A

Relative rest
Non-painful activity
Slowly increase
Address other fractures

26
Q

Other Problems Associated with Stress Fractures Besides Overuse

A

Estrogen deficiency
Hormonal abnormalities
Nutritional deficiencies
Metabolic disorders

27
Q

Presentation of a Stress Fracture

A

Gradual onset
Increased intensity/duration of activity
Change in footwear
Change in surface

28
Q

Evaluation of Stress Fractures

A

H&P
X-rays
Bone scan
MRI

29
Q

Key to Treatment of Stress Fractures

A

Pain free activity

30
Q

Treatment of Inferior Hip, Pelvis, or Thigh Stress Fractures

A

Non-painful activity

Gradual return to activity

31
Q

Treatment of Superior Hip, Pelvis, or Thigh Stress Fractures

A

Refer to ortho

32
Q

Address Causation of Hip, Pelvis, or Thigh Stress Fractures

A

Diet
Activity level
Maturity

33
Q

Clinical Presentation of Adductor Tendonopathy

A

Chronic groin pain
Increased training
Worse with resisted adduction

34
Q

Evaluation of Adductor Tendonopathy

A

H&P
Pain with resisted adduction
Tender to palpation medial groin at tendon insertion

35
Q

Treatment of Adductor Tendonopathy

A

Relative rest
Ice
Isometric & eccentric strengthening
PT

36
Q

Clinical Presentation of Athletic Pubalgia or Sports Hernia

A

Groin pain
Progressive symptoms
Worse with hip motion

37
Q

Evaluation of Athletic Pubalgia or Sports Hernia

A

Pain in hernia region without hernia

Possible dilated superficial ring

38
Q

Etiology of Athletic Pubalgia or Sports Hernia

A

Injury to conjoined tendon, internal oblique, external oblique, transversalis fascia, inguinal ligament, etc.

39
Q

Treatment of Athletic Pubalgia or Sports Hernia

A

Surgery

Only some surgeons do these

40
Q

Clinical Presentation of Piriformis Strain or Syndrome

A 
Buttocks pain
Insidious onset
Pain to sit
Increase after a run
Annoying
41
Q

Evaluation of Piriformis Strain or Syndrome

A

Painful resisted external rotation

Painful passive internal rotation

42
Q

Difference Between Piriformis Strain & Syndrome

A

Strain: no sciatica
Syndrome: sciatica

43
Q

Treatment of Piriformis Strain/Syndrome

A

Rule out other things
NSAIDs
Stretch/strengthen
PT: core strength program

44
Q

Evaluation of Femur Fractures

A

H&P
R/O other injuries
Shortened & external rotated
Internal rotation elicits pain

45
Q

Treatment of Femur Fracture

A

Pins
ORIF
Total hip
Hemi hip

46
Q

Things to Consider with Femur Fractures

A

DVT

Young: AVN

47
Q

Etiology of Femur Shaft Fractures

A

High energy

48
Q

Treatment of Femur Shaft Fractures

A

Surgery

49
Q

Something to Consider with Femur Shaft Fractures

A

Compartment syndrome

50
Q

Causes of Compartment Syndrome

A 
Fractures
Crush
Envenomation
Immobilization
Constrictive dressing
Infection
Burns
Tourniquets
Chronic exertional compartment syndrome (CECS)
51
Q

Treatment of Compartment Syndrome

A

Release of pressure

52
Q

Anterior Hip Dislocation

A

Dashboard with thigh abducted

Externally rotated position

53
Q

Posterior Hip Dislocation

A

Internally rotated position

54
Q

Treatment of Hip Dislocations

A

Reduction ASAP

Watch for s/s of AVN & sciatica

55
Q

What should one always think of with hip fracture or dislocation?

A

Concomitant injuries

Ortho (22 decks)

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