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MSK I clinical correlations > Lower Limb Clinical correlations > Flashcards

Lower Limb Clinical correlations Flashcards

1
Q
  • Intra-abdominal infection causing pain with extension/flexion of the thigh against resistance
  • commonly used as test for infection
  • can spread from these organs to the iliopsoas muscles producing pain upon stretch
A

Psoas abscess

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2
Q
  • lesion to this nerve would impact anterior cutaneous branch and saphenous nerve
  • Decreased flexion at hip
  • Decreased anterior and medial leg cutaneous sensation
  • Decreased medial and lateral rotation of thigh
  • Decrease leg extension
A

Femoral nerve lesion

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3
Q
  • Lesion to nerve
  • Difficulty for flexion and adduction of thigh for both anterior and posterior division
  • Difficulty medially rotating leg for anterior division
  • Difficulty laterally rotating leg for posterior division
  • Diminished cutaneous sensation to medial thigh
A

Obturator nerve lesions

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4
Q
  • Varices in vein causing fascia to bulge just below the inguinal ligament
  • May have pain with flexion, extension, or walking
A

Saphenous Varices

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5
Q
  • Injury/lesion to nerved can be caused by intragluteal injection
  • Decreased abduction of thigh
  • Decrease sacral leveling during ambulation
  • Can see Trendelenburg gait (effected side doesn’t level to normal during ambulation, appears as though effected side is longer, requires patient to lean toward the unaffected side during the swing phase of gait
  • May also see swing out gait (swing leg away from body and around to step down)
  • May also see steppage gait (patient hikes hip and thigh higher to clear ground)
A

Superior gluteal nerve lesion

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6
Q
  • lesion to nerve
  • Reduced extension of thigh
  • Ambulates with gluteus maximus gait/lurch (patient posteriorly leans the trunk at heel strike to keep hip extended during stance phase
A

Inferior gluteal nerve lesion

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7
Q
  • Pain and paresthesia radiating distally down posterior thigh and leg
  • Irritation of the sciatic nerve caused by muscle that it sometimes splits around or pierces before traversing down the leg
A

Piriformis syndrome

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8
Q
  • Nerve lesion

- may have diminished lateral thigh rotation due to decreased innervation to gemellus inferior and quadratus femoris

A

Lesions to nerve to quadratus femoris

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9
Q
  • Nerve lesion
  • Plantar flexors and intrinsic foot muscles paralyzed
  • loss of sensation to sole of foot
A

tibial nerve lesion

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10
Q
  • Nerve lesion
  • foot droop and compensation gait including swing out gait or steppage gait
  • Most commonly injured due to superficial position around fibular neck
  • Paralyzes lateral and anterior compartment muscles
  • diminished dorsiflexion and eversion
A

Common fibular nerve lesion

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11
Q
  • nerve lesion
  • foot droop and compensation gait including swing out gait or steppage gait
  • Paralyzes dorsiflexors
A

Deep fibular nerve lesion

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12
Q
  • Nerve lesion
  • Diminished sensation to distal anterior leg and most of dorsum of foot
  • likely to invert their ankle due to paralyzed everters
  • Lateral compartment muscles of the lower leg
A

Superficial fibular nerve lesion

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13
Q

Has two centers of ossification and can often be mistaken as a patellar fracture

A

Bipartite patella

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14
Q
  • Pain between femur and patella WITHOUT abnormality in articulation or structures
  • Likely caused from repetitive high impact activity
A

Patellofemoral pain syndrome

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15
Q
  • Pain between patella and femur
  • abnormal movement of patella due to a larger Q angle causing friction of articular surfaces between the patella and femur
A

Chondromalacia patellae

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16
Q
  • Paresthesia to anterolateral thigh
  • lateral femoral cutaneous nerve impingement in the inguinal region
  • aka tight jeans syndrome
A

Meralgia paresthetica

17
Q
  • Muscular weakness that gets worse during activity
  • Double vision, drooping eye lids, slurred speech and dysphagia
  • main mechanism B lymphocytes produce antibodies that bind N1 nicotinic acetylcholine receptors, blocking acetylcholine binding sites
  • other mechanisms: having less sensitive junctional folds and widened synaptic clefts and antibody binding causing cross linking of individual receptors tagging them for degradation, receptor turnover rate increases X3
A

Myasthenia gravis

18
Q
  • Muscle weakness typically worse in proximal arms and legs
  • B lymphocytes produce antibodies that interact with L, T and P type v-gated calcium channels
  • paraneoplastic syndrome due to associated with small cell cancer of the lung
A

Lambert-Eaton myasthenic syndrome

19
Q
  • Large loss of muscular tone in affected areas
  • gowers sign
  • muscular weakness
  • x-linked genetic disorder causing defect in 427 kD protein (dystrophin) which is responsible for transferring the force of muscle contraction to surrounding connective tissue
  • contraction not properly transferred causes tearing events and degeneration/necrosis with phagocytosis of muscle fibers
  • occurs in 1 in 3500 births
A

Duchenne Muscular Dystrophy

20
Q
  • Increased muscle mass
  • regular near maximal force exertion like weigh lifting
  • formation of TGF-B and IGF1-1 causes protein synthesis to create more actin and myosin forming new myofibrils, glycolysis enzymes, and less expression of myostatin (inhibitor of skeletal muscle growth)
A

Hypertrophy

21
Q
  • Increased muscle mass
  • formation of new muscle fibers
  • caused by endurance training
  • fairly rare
A

Hyperplasia

22
Q
  • Minimal muscle mass
  • Frail
  • Thin appearance
  • Death of motor neurons that are denervated causing muscle wasting
  • loss of myofibrils within each existing muscle fiber
A

SMA- Spinal muscular atrophy

23
Q
  • decreased muscle mass, frail and thin appearing
  • lack of use causing loss of myofibrils within each existing muscle fiber
  • Often seen in cancer patient with decreased appetite and lack of active muscles
A

Cachexia

24
Q
  • Pain and swelling
  • Weak/absent distal pulses like dorsalis pedis pulse due to compression of nerves and blood vessels in lower extremities
  • requires fasciotomies
A

compartment syndrome

25
Q
  • Dull ache in anterior leg
  • Pain develops during or after exercise
  • edema and pain in distal 2/3 of tibia due to microtears of periosteum secondary to tibialis anterior microtrauma
  • often seen in sedentary person who exercises vigorously or seasoned athlete who fails to warm up and cool down properly
A

Shin Splints

26
Q
  • enlarged superficial veins in lower extremities that can be painful and bleed easily
  • overtime gravity and build up blood in veins causes the valves to fail and blood backs up to the superficial veins in skin
A

varicose veins

27
Q
  • Swelling, pain and redness to area of clot formation
  • clot formation along lower limb vessels due to prolonged blood pooling
  • can break off and become pulmonary embolism
  • risk factors include tobacco use, contraception, long travel, recent hospitalization/surgeries
A

DVT- deep vein thrombosis

28
Q
  • Enlargement of lymph nodes

- indicates spread of infection

A

Lymphadenopathy

29
Q
  • Pain to anterior shin due to avulsion fracture of the tibial tuberosity
  • caused by overuse of quadriceps muscles pulling of the patellar ligament
  • common in adolescence
A

Osgood-Schlatter

30
Q
  • Pain with any movement of leg
  • Can occur during MVA while sitting in seat with hips slightly flexed and then hitting femurs on dashboard
  • Screw home effect not able to protect against
A

posterior dislocations of the hip

31
Q
  • trauma to head/neck of femur causes issues with the reticular branches of the medial circumflex femoral artery
  • decreased blood supply to head of femur
  • sometimes requires surgical replacement of head/neck of femur
A

avascular necrosis of the femoral head

32
Q
  • Stable patients can walk, likely with pain
  • Unstable patients cannot walk
  • most common in males at puberty
  • can occur overtime or with trauma
  • head of femur slips off the neck posterior due to inability to keep up with growth
A

Slipped capital femoral epiphysis

33
Q
  • Pain, swelling and likely joint effusion
  • inflammation from muscle overuse causing repetitive friction between muscle and bursa
  • occurs at joints due to lots of bursa located at joints
A

bursitis

MSK I clinical correlations (1 decks)

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