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MSK > Lower limb anatomical regions > Flashcards

Lower limb anatomical regions Flashcards

1
Q

What forms the superior boarder of the femoral triangle?

A

inguinal ligament (from superior iliac to pubis tubercle)

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2
Q

What forms the lateral boarder of the femoral triangle?

A

the medial boarder of the satorius muscle

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3
Q

What forms the medial boarder of the femoral triangle?

A

The adductor longus muscle- the rest of this muscle forms the floor of the triangle

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4
Q

What forms the roof of the femoral triangle?

A

fascia lata

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5
Q

What does the inguinal ligament do?

A

acts as a flexor retinaculum- supports the contents of the femoral triangle in hip flexion
also defines the superior boarder of the femoral triangle

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6
Q

What is inside the femoral triangle from lateral to medial?

A
  • femoral Nerve
  • femoral Artery
  • femoral Vein
  • femoral canal- contains lymphnodes and vessels
    NAVY
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7
Q

What is found within the femoral sheath?

A

femoral artery, fermoral vein and femoral canal

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8
Q

What forms the superomedial boarder of the popliteal fossa?

A

semi membranosus

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9
Q

What forms the superolateral boarder of the popliteal fossa?

A

biceps femoris

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10
Q

What forms the inferomedial boarder of the popliteal fossa?

A

medial head of gastrocnemicus

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11
Q

What forms the inferolateral boarder of the popliteal fossa?

A

lateral head of gastrocnemicus

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12
Q

What are the popliteal fossas contents from medial to lateral?

A
  • popliteal artery
  • popliteal vein
  • tibial nerve
  • common fibular nerve
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13
Q

What is usually the first movement to me lost on arthiritis of the hip?

A

Internal rotation

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14
Q

How can intracapsular fractures of the femur occur?

A

in elderly- fall/ blow onto side of hip

teens- high energy collidions

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15
Q

Which artery is most at risk when intracapsular fracture of femur?

A

medial circumflex artery

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16
Q

What are 3 treatment options for femoral head/ neck fractures?

A
  • total hip replacement (of head and acetabulum), always done when displaced due to necrosis risk. Often done in young people as lasts the longest
  • Hemiarthoplasty- only femoral head replaced, most commonly done in elderly
  • Dynamic hip screw- only done in young people and undisplaced fractures where there is good blood supply
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17
Q

What is the appearance of a displaced femoral neck/ head fracture and why?

A
  • leg shortened and externally rotated
  • external rotator muscles all attach to intertrochantor crest and pull it laterally and upwards
  • When head is displaced there is nothing to oppose this movement
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18
Q

What events can cause hip dislocations?

A

car accidents, significant falls in children and elderly and those with prosthesis are more likely
Major force to a flexed knee and hip (car accident)

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19
Q

In what direction are most hip dislocations?

A

posterior

20
Q

What does a posterior hip dislocation look like and why?

A

leg shortened, in flexion, internal rotation and adduction
This is due to glut medius and minimus acting unopposed to pull it up and in and also adductors action to pull it up and into adduction

21
Q

What does an anterior hip dislocation look like?

A

Hip is externally rotated, abducted and extended

22
Q

What is a major complication of a posterior hip dislocation?

A

high likelyhood of the sciatic nerve which runs behind it- leads to loss of sensation of posterior leg and foot and loss of dorsal and planter flexion and knee flexion

23
Q

How can you detect damage to the superior gluteal nerve?

A

Hip drop sign- ask them to stand on one leg and pelvis will drop when standing on affected leg

24
Q

What is affected in damage to the superior gluteal nerve?

A
  • lack of motor control to glut medius and minimus and tensor fascia lata (loss of hip abduction and medial rotation.
25
Q

Where do you do an intramuscular injection into the gluteal region for someone over the age of 7?

A

The ventrogluteal site:
Put hand on greater trochanter
point thumb towards inguial region and index finger towards anterior superior iliac crest
Spread index and middle fingers to make a V so that middle finger points upwards
Inject between PIPJ of index and middle fingers

26
Q

Where would you do a gluteal intramusclar injection for someone between 3-7 yrs?

A

the dorsogluteal site

either one of the superior lateral quadrants of the buttocks below the illiac crest

27
Q

What causes a pulled hamstring?

A

rapid extension- running, jumping when not warmed up

28
Q

What nerves are at risk for gluteal IM injection?

A

sciatic

superior gluteal

29
Q

What is experienced in a achilles tendonitis? What causes it?

A

pain along back of leg near heel, worse in morning and with activity
generally overuse and degradation with age means some fibres tear

30
Q

What causes an achilles tendon rupture? Where does it rupture, and in who?

A
  • fast forceful dorsiflexion
  • about 6cm from insertion as there is a vascular watershed here making it weak
  • in 30-50 yr old active ppl
31
Q

What is experienced in an achilles tendon rupture?

A
  • intense pain like being shot
  • popping heard
    they then walk flat flooted, unable to go onto tip toes, a gap may be seen and/ or felt but this may be hidden by bruising or swelling
32
Q

How can achilles tendon ruptures be diagnosed?

A
  • positive thompsons test (squeeze calf of flexed knee that is resting on chair, if normal the ankle will planterflex)
  • MRI/ ultrasound scan
33
Q

What is a claw toe?

A

The MTP joint is permenantly hyperextended, the IPJs are flexed

34
Q

What is a hammer toe?

A

the MTP joint is permanently hyperextended, the PIPJ is flexed and the DIPJ is normal

35
Q

What causes claw/ hammertoes?

A

Not sure- genetic, high arched feet, poorly fitted shoes (too short), rheumatoid arthiritis, tendon imbalence or traumatic injuries

36
Q

What is flat footedness? Where is the pain and what causes is?

A
  • Loss of the medial arch
  • more common in middle aged females but can be normal in children and will go away with development
  • pain in medial malleolus
  • Tibialis posterior dysfunctions cause it which is generally age related
37
Q

How can flat footedness be diagnosed on xray?

A
  • The talus appears lower down
  • and pointing down rather than towards to toe
  • it will be inline with the metacarples and not below it
38
Q

How can a sprained ankle occur and what are symptoms?

A

Due to excessive inversion or eversion leading to ligament damage- usually inversion of a planterflexed foot
tenderness, swelling, bruising, functional loss, mechanical instability

39
Q

What can cause a 5th metatarsal fracture?

A
  • bone pulled off my metatarsal ligament (in ankle sprains)
  • repeated stress
  • trauma
40
Q

What is a hallux valgus and what causes it?

A

A bunion causing lump on outside of large toe due to its metatarsal being pushed out and the phalangies being pushed in (lateral deviation)
Caused by wearing inappropriate footwear putting pressure where it shouldn’t be. Also due to ligaments becoming lax in old age

41
Q

What is a talar shift?

A

There should be a equal distance between the talus and the tibia and fibula but in an unstable break (2 ligament/ bone breaks) there will not be an equal distance

42
Q

What actions can cause ankle fractures?

A
  • excessive twisting, rotation, rolling, tripping, falling, impact
43
Q

What are ottowa rules on when to get an ankle xray?

A
  • tenderness on posterior edge of lateral or medial malleolus
  • pain at base of 5th metatarsal
  • pain at navicular
  • unable to weight bear immediatly after injury
  • admittance to A&E
44
Q

Where is most common site of osteoarthiritis in foot?

A

Big toe

45
Q

Why do diabetics loose sensation in foot?

A

high blood glucose damages nerves in foot

46
Q

What is charcots arthropathy?

A

Where diabetics loose sensation in foot but they keep on using it as they done know and damage gets very severe

MSK (9 decks)

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