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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
What does the tensor fascia lata do
The tensor fascia lata is a gluteal muscle that acts as a flexor, abductor, and internal rotator of the hip.
26
dorsal interossei in the foot | two movements
spreading the toes apart | flexing the metatarsophalangeal joints of the second to the fifth toe.
27
plantar interossei muscles
adduct the third to fifth toe
28
what is deep vein thrombosis
blood clot in the vein
29
symptoms of deep vein thrombosis
``` Throbbing/cramping Swelling Warm skin Dark red skin Swollen veins ```
30
risk factors of deep vein thrombosis
``` 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 ```
31
Treatments for deep vein thrombosis
Anticoagulants injection before ultrasound to diagnose = heparin Anticoagulants tablets = warfarin, rivaroxaban IVC filter
32
complication of deep vein thrombosis
Pulmonary embolism (PE)
33
compartment syndrome 5 ps
``` Pain (disproportionate) Pain refractory to analgesia Pain on passive stretch Paraesthesia - “pins & needles” Pulses NORMAL ```
34
critical ischemia 6 ps | no repeats
``` Pain Paraesthesia Paralysis Pale Pulseless Perishingly cold ```
35
baker cyst
inflammation of semimembranous bursa atone - can't flex | similar to deep vein thrombosis
36
popliteal aneurysm compressing what nerve
dilation of the artery - tibial nerve compression
37
popliteal artery entrapment syndrome
muscles compress artery restricting blood flow
38
Femoral nerve roots sensory motor
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))
39
obturator nerve roots sensory motor
L2,3,4 innervates the medial thigh sensory to skin over the medial thigh
40
Damage to the obturator nerve can affect gaits how?
because medial aspects paralysed so loss of adduction
41
Lateral cutaneous nerve roots motor sensory
L2,3 no motor sensory to anterior and lateral thigh enters at the lateral inguinal ligament
42
iliohypogasTric nerve nerve roots motor and sensory
L1, and T12 innervates the internal oblique and transverses abdominus sensory to skin posterolaterla gluteal skin
43
ilioinguinal nerve root motor and sensory
L1 same as illiohypogastric sensory to anteromedial thigh , root of the penis and the scrotum
44
gentiofemoral nerve roots and supply
L1,L2 | scrotum and upper anterior thigh
45
what is Lumbosaral plexopathy can symptoms be localised ?
caused by damage to nerve bundles and suspected when symptoms cannot be localised
46
parsonage turner syndorme
brachial plexus, neuritis(inflammation)
47
Sciatic nerve roots motor sensory
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
piriformis syndrome how is pain made worse
compression of the sciatic nerve by piriformis muscle , pain made worse by internal rotation
49
common fibular nerve roots motor and sensory
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
Tibial nerve roots motor sensory
L4-S3 posterior compartment of the leg and intrinsic foot muscles sensory to posteroolateral surface , lateral foot and sole
51
Tarsal tunnel syndrome what compressed
tibial nerve compressed
52
3 joints in the hip
Pubic symphysis sacroiliac joint hip joint
53
Intracapsular - what does the transverse acetabular ligament do
bridges the acetabular notch
54
(intracapsular) what does the ligamentum teres do
carries blood supply to head of femur and prevents inferior sublimation during flexion and abduction
55
iliofemoral ligament
prevents hyperextension of the hip joint
56
pubofemoral ligament
prevents abduction and extension
57
ischi-femorale ligament
holds femoral head and prevents hyperextension
58
blood supply to femoral head in adults
reticular branches
59
Legg-Calve perthes disease symptoms are limping, limited range of movement
childhood condition where blood supply to the femoral head is interrupted and dies
60
idiopathic osteonecrosis of capital femoral epiphysis
shortening of one leg
61
if you fracture the proximal neck of the femur does it move?
NO
62
if you fracture the distal neck of the femur does it move?
yes the distal femur is pulled proximally by the Quad and Ham , also pulled laterally by gluteus Maximus
63
If you fracture the mid shaft of the femur if distally does it move?
Yes pulled anterioly by quads and posteriorly by gastro
64
medial collateral ligament function
primary stabiliser and if injured puts pressure on acl
65
Lateral collateral ligament function
stabilises lateral side , resistant to varus rotation
66
posterior cruciate ligament symptoms of injury
stiffness and swelling
67
anterior cruciate ligament function
restraining force of anterior translation and rotation , stabilises rotational movements
68
How to test the ACL
hip 45degree, knee at 90degree and pull should be about 6cm
69
What are the meniscuses
2 pieces of cartilage between the bones in knee and act as shock absorbers
70
Which vein goes down the medial malleolus?
Great saphenous vein
71
What is varicose veins are the valves faulty
dilated and tortus veins due to increased intraluminal pressure , lots of blood and faulty valves
72
What is bunion
vagus strain on 1st metatarsal
73
How is a bunion caused and treated
tight fitting shoes or arthritis | and treated by reduced standing and foot pads and spacious shoes
74
What is hammer toe how is it treated
dorsiflex MTPJ and plantar flexed IPJ caused by loss of adduction of lumbricals treated with foot pads and exercise
75
Clubfoot (talipes equinovarus)
strong (plantarflexion) and inversion, seen at brith , tightness of deep posterior leg
76
Treatment for clubfoot
realign the bones using plaster of panis
77
pes planus
longitudinal arch collapse , flat feet , plantar aponeurosis
78
shin splints
excessive force cause muscle to swell and put pressure on bones - Tibilais anterior on periosteum
79
jumpers knee
patellar tendonitis
80
What pneumonic describes fractures through the epiphyseal plate?
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
what common injury occurs with an olecranon fracture
avulsion injury of the triceps tendons , ulna nerve and radial nerve
82
hill-sachs lesion
cortical depression in posterolateral head of the humerus resulting from forceful impact
83
What clinical implication result of humeral shaft fracture
radial nerve damage causing wrist drop in the radial groove
84
What two classifications can be used for ankle injuries
webers | ottawa
85
Ottawa ankle rules to assess for what?
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
Which fracture results in leg shortened and externally rotated>
neck of the femur fracture
87
how do you locate the inguinal ligament and what two structures does it run between
anterior superior iliac crest of the ilium | to the pubic tubercle of the pubic bone
88
what is sciatica | symptoms
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
treatment for sciatica
Treatment for sciatica includes exercise, stretches and painkillers.
90
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?
S1 nerve root compression- sciatica
91
what is Guillian-barre syndrome | symptoms
bodies immune system attack your nerves weakness and tingling in your extremities rapid onset
92
what is acute motor axonal neuropathy
AMAN is a variant of the guillian-Barre syndrome. It is characterised by acute paralysis and loss of reflexes without any sensory loss.
93
what is prolapsed disk
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
what is caudal equina syndrome
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
two congenital abnormalities of the spine
Separation of S1 from sacrum termed lumbarisation | Fusion of L5 to sacrum is termed sacralisation
96
what is the difference between the mid inguinal point and the midpoint of the inguinal ligament
mid inguinal point at artery bit
97
what are the pedal pulses
dorsalis pedis artery | posterior tibial artery

Immune and Lymphatic System (19 decks)

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