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Immune and Lymphatic System > Lower limb > Flashcards

Lower limb Flashcards

1
Q

What is compartment syndrome

A

pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells

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2
Q

3 Bones of the hip

A

ilium
ischium
pubis

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3
Q

what is the innominate bone

A

hip bone

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4
Q

What is the ASIS

A

anterior superior iliac spine

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5
Q

Difference between condyle and epicondyle

A

Condyle forms an articulation with another bone

epicondyle provides site of attachment of muscles

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6
Q

Difference between and intracapuslar and extracapsular fractures in the hip joint.

A

Can damage the medial femoral circumflex artery + cause avascular necrosis of femoral head
whereas in the extra the blood supply is intact

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7
Q

In a femoral shaft fracture what can be injured?

A

Femoral nerve and artery

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8
Q

patella fractures - what ligaments pull what

A

Proximal fragment displaced superiorly by quadriceps tendon

Distal fragment displaced inferiorly by patellar ligament

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9
Q

In a tibia injury what do you need to look out for (2)

A

fibula fractures and monitor compartment syndrome

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10
Q

How can the medial malleolus be fractured

A

over-inversion (ankle being twisted inwards)

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11
Q

How can the lateral malleolus be fractured

A

eversion (ankle being twisted outwards)

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12
Q

If the talus is forced against the medial malleolus what type of fracture can occur

A

spiral fracture

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13
Q

If the talus is forced against the lateral malleolus what type of fracture can occur?

A

transverse fracture

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14
Q

Two main places for interosseous access

A

Anteromedial surface, 2-3 cm below tibial tuberosity

Proximal to the medial malleolus

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15
Q

Complications of interosseous access?

A

osteomyelitis- infection of the bone marrow
iatrogenic fracture- doctor caused fracture
compartment syndrome- within the fascia

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16
Q

Why do we need to have interosseous access?

A

Allows administration of fluid, blood products and medications directly into bone marrow

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17
Q

Two most frequent tarsal bone fractures?

A

Talus and calcareous

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18
Q

Why is a neck of the talus fracture caused by high energy injuries by excessive dorsiflexion so important?

A

avascular necrosis

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19
Q

What part of the talus can be injured when jumping

A

Talar body

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20
Q

What is the most common cause of a calcaneus fracture?What type of fracture? and what other associated injures do you need to look for?

A

Fractured as result of axial loading (typically fall from height)
comminuted fracture
Assess these patients for associated injuries - lower limb/lumbar spine fractures

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21
Q

What are the 3 mechanisms to fractures to the metatarsal bones

A

Stress fractures
direct blow
over inversion

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22
Q

Often seen in runners what it is Iliotibial band syndrome?

A

(ITBS) is a common knee injury that usually presents with pain and/or tenderness on palpation of the lateral aspect of the knee, superior to the joint line and inferior to the lateral femoral epicondyle

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23
Q

where do the all the hamstring muscles attach to

A

ischial tuberosity and epicondyle

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24
Q

What is piriformis syndrome

A

is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).

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25
Q

What does the tensor fascia lata do

A

The tensor fascia lata is a gluteal muscle that acts as a flexor, abductor, and internal rotator of the hip.

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26
Q

dorsal interossei in the foot

two movements

A

spreading the toes apart

flexing the metatarsophalangeal joints of the second to the fifth toe.

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27
Q

plantar interossei muscles

A

adduct the third to fifth toe

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28
Q

what is deep vein thrombosis

A

blood clot in the vein

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29
Q

symptoms of deep vein thrombosis

A 
Throbbing/cramping 
Swelling
Warm skin
Dark red skin
Swollen veins
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30
Q

risk factors of deep vein thrombosis

A 
Over 60
Overweight
Smokers
Contraceptive pill 
Cancer/heart failure
Varicose Veins- pools of venous blood, valves normally legs don't work 
Confined in bed (after hospital op)
Long journey (>3 hours)
Pregnant or up to 6 weeks post pregnancy
Dehydratio
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31
Q

Treatments for deep vein thrombosis

A

Anticoagulants injection before ultrasound to diagnose = heparin
Anticoagulants tablets = warfarin, rivaroxaban
IVC filter

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32
Q

complication of deep vein thrombosis

A

Pulmonary embolism (PE)

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33
Q

compartment syndrome 5 ps

A 
Pain (disproportionate)
Pain refractory to analgesia
Pain on passive stretch
Paraesthesia - “pins & needles”
Pulses NORMAL
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34
Q

critical ischemia 6 ps

no repeats

A 
Pain
Paraesthesia
Paralysis
Pale 
Pulseless
Perishingly cold
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35
Q

baker cyst

A

inflammation of semimembranous bursa atone - can’t flex

similar to deep vein thrombosis

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36
Q

popliteal aneurysm compressing what nerve

A

dilation of the artery - tibial nerve compression

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37
Q

popliteal artery entrapment syndrome

A

muscles compress artery restricting blood flow

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38
Q

Femoral nerve
roots
sensory
motor

A

L2,3,4
anterior thigh muscles that flex hip and extend knee
sensory to cutaneous branches to antermedial thigh, medial leg and foot (saphenous nerve ) ((adductor canal))

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39
Q

obturator nerve
roots
sensory
motor

A

L2,3,4
innervates the medial thigh
sensory to skin over the medial thigh

40
Q

Damage to the obturator nerve can affect gaits how?

A

because medial aspects paralysed so loss of adduction

41
Q

Lateral cutaneous nerve
roots
motor
sensory

A

L2,3
no motor
sensory to anterior and lateral thigh
enters at the lateral inguinal ligament

42
Q

iliohypogasTric nerve
nerve roots
motor and sensory

A

L1, and T12
innervates the internal oblique and transverses abdominus
sensory to skin posterolaterla gluteal skin

43
Q

ilioinguinal nerve
root
motor and sensory

A

L1
same as illiohypogastric
sensory to anteromedial thigh , root of the penis and the scrotum

44
Q

gentiofemoral nerve
roots
and supply

A

L1,L2

scrotum and upper anterior thigh

45
Q

what is Lumbosaral plexopathy

can symptoms be localised ?

A

caused by damage to nerve bundles and suspected when symptoms cannot be localised

46
Q

parsonage turner syndorme

A

brachial plexus, neuritis(inflammation)

47
Q

Sciatic nerve
roots
motor
sensory

A

L4-S3
posterior thigh and adductor Magnus , indirectly all muscles of the leg and foot
sensory no direct but indirect to lateral leg and dorsal and plantar surfaces of the foot

48
Q

piriformis syndrome

how is pain made worse

A

compression of the sciatic nerve by piriformis muscle , pain made worse by internal rotation

49
Q

common fibular nerve
roots
motor and sensory

A

L4-S2
lateral and anterior compartment of leg and bit of bicep femoris
sensory to skin of lateral leg and dorsum of the foot

50
Q

Tibial nerve
roots
motor
sensory

A

L4-S3
posterior compartment of the leg and intrinsic foot muscles
sensory to posteroolateral surface , lateral foot and sole

51
Q

Tarsal tunnel syndrome what compressed

A

tibial nerve compressed

52
Q

3 joints in the hip

A

Pubic symphysis
sacroiliac joint
hip joint

53
Q

Intracapsular - what does the transverse acetabular ligament do

A

bridges the acetabular notch

54
Q

(intracapsular) what does the ligamentum teres do

A

carries blood supply to head of femur and prevents inferior sublimation during flexion and abduction

55
Q

iliofemoral ligament

A

prevents hyperextension of the hip joint

56
Q

pubofemoral ligament

A

prevents abduction and extension

57
Q

ischi-femorale ligament

A

holds femoral head and prevents hyperextension

58
Q

blood supply to femoral head in adults

A

reticular branches

59
Q

Legg-Calve perthes disease

symptoms are limping, limited range of movement

A

childhood condition where blood supply to the femoral head is interrupted and dies

60
Q

idiopathic osteonecrosis of capital femoral epiphysis

A

shortening of one leg

61
Q

if you fracture the proximal neck of the femur does it move?

A

NO

62
Q

if you fracture the distal neck of the femur does it move?

A

yes the distal femur is pulled proximally by the Quad and Ham , also pulled laterally by gluteus Maximus

63
Q

If you fracture the mid shaft of the femur if distally does it move?

A

Yes pulled anterioly by quads and posteriorly by gastro

64
Q

medial collateral ligament function

A

primary stabiliser and if injured puts pressure on acl

65
Q

Lateral collateral ligament function

A

stabilises lateral side , resistant to varus rotation

66
Q

posterior cruciate ligament symptoms of injury

A

stiffness and swelling

67
Q

anterior cruciate ligament function

A

restraining force of anterior translation and rotation , stabilises rotational movements

68
Q

How to test the ACL

A

hip 45degree, knee at 90degree and pull should be about 6cm

69
Q

What are the meniscuses

A

2 pieces of cartilage between the bones in knee and act as shock absorbers

70
Q

Which vein goes down the medial malleolus?

A

Great saphenous vein

71
Q

What is varicose veins

are the valves faulty

A

dilated and tortus veins due to increased intraluminal pressure , lots of blood and faulty valves

72
Q

What is bunion

A

vagus strain on 1st metatarsal

73
Q

How is a bunion caused and treated

A

tight fitting shoes or arthritis

and treated by reduced standing and foot pads and spacious shoes

74
Q

What is hammer toe

how is it treated

A

dorsiflex MTPJ and plantar flexed IPJ caused by

loss of adduction of lumbricals

treated with foot pads and exercise

75
Q

Clubfoot (talipes equinovarus)

A

strong (plantarflexion) and inversion, seen at brith , tightness of deep posterior leg

76
Q

Treatment for clubfoot

A

realign the bones using plaster of panis

77
Q

pes planus

A

longitudinal arch collapse , flat feet , plantar aponeurosis

78
Q

shin splints

A

excessive force cause muscle to swell and put pressure on bones - Tibilais anterior on periosteum

79
Q

jumpers knee

A

patellar tendonitis

80
Q

What pneumonic describes fractures through the epiphyseal plate?

A

SALTER harris fractures
straight across through the growth plate
above through metaphysics too
lower through epiphysis and growth plate
Through Everything
crush injury growth plate

81
Q

what common injury occurs with an olecranon fracture

A

avulsion injury of the triceps tendons , ulna nerve and radial nerve

82
Q

hill-sachs lesion

A

cortical depression in posterolateral head of the humerus resulting from forceful impact

83
Q

What clinical implication result of humeral shaft fracture

A

radial nerve damage causing wrist drop in the radial groove

84
Q

What two classifications can be used for ankle injuries

A

webers

ottawa

85
Q

Ottawa ankle rules to assess for what?

A

So shouldn’t need to do an X-ray or any type of imaging technique

  • bony tenderness along distal 6cm of posterior edge of the fibular or tip of lateral malleolus
  • bony tendernsss along distal 6cm of posterior edge of tibia of medial malleolus
  • bony tenderness at base of 5th metatarsal
  • bony tenderness at the navicular
  • inability to bear weight both immediately after injury and for 4 steps during initial evaluation
86
Q

Which fracture results in leg shortened and externally rotated>

A

neck of the femur fracture

87
Q

how do you locate the inguinal ligament and what two structures does it run between

A

anterior superior iliac crest of the ilium

to the pubic tubercle of the pubic bone

88
Q

what is sciatica

symptoms

A

Sciatica is a type of pain caused by an irritated nerve. It’s felt from your bottom down to your feet and toes- slipped disc -

tingling numb and weakness
shooting pain in your bottom and the backs of your legs.

89
Q

treatment for sciatica

A

Treatment for sciatica includes exercise, stretches and painkillers.

90
Q

A 48 year old man complains of pain radiating from his back down the outside of his right leg. He is a nurse and the pain typically manifests when he bends over to lift patients.

What is the most likely diagnosis?

A

S1 nerve root compression- sciatica

91
Q

what is Guillian-barre syndrome

symptoms

A

bodies immune system attack your nerves
weakness and tingling in your extremities
rapid onset

92
Q

what is acute motor axonal neuropathy

A

AMAN is a variant of the guillian-Barre syndrome. It is characterised by acute paralysis and loss of reflexes without any sensory loss.

93
Q

what is prolapsed disk

A

A slipped disc is when a soft cushion of tissue between the bones in your spine pushes out(herniates).
It is painful as it presses on the nerves and gets better with rest and gentle exercise with the use of painkillers.

94
Q

what is caudal equina syndrome

A

nerves at the very bottom of the spinal cord are pressed on
causing back pain
Problems with bowel and bladder function (usually inability to pass urine).
Numbness in the saddle area around the back passage (anus).
Weakness in one or both legs.

95
Q

two congenital abnormalities of the spine

A

Separation of S1 from sacrum termed lumbarisation

Fusion of L5 to sacrum is termed sacralisation

96
Q

what is the difference between the mid inguinal point and the midpoint of the inguinal ligament

A

mid inguinal point at artery bit

97
Q

what are the pedal pulses

A

dorsalis pedis artery

posterior tibial artery

Immune and Lymphatic System (19 decks)

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