Lower limb - common conditions and anatomy Flashcards
How do you test for a fixed flexion deformity?
Thomas’ test
How is hip pain normally experienced?
Groin pain
Which is the frequently the first movement raange to be reduced in hip injury (especially osteoarthritis)?
Internal rotation
When considering hip Xrays, what is important to think about?
Reproductive organs
What is the most useful imaging modality when assessing avascular necrosis?
MRI
What operation would you perform to realign load transfer across the hip?
Osteotomy
Name one medication and one condition that will increase your risk of avascular neeccros?
Steroid, Gaucher disease
Name 1 lifestyle choice and one activity that can increase your risk of avascular necrosis?
Alcohol intake
Deep sea diving
Name a very common cause of hip pain where the hip joint itself is (generally) normal, and is frequently associated with lower back pain?
Trochanteric bursitis (inflammation of trachanteric bursa)
What is the commonest site of primary bone tumours in children and adolescents?
Knee
What is true knee locking?
When the knee cannot be extended due to a mechanical block (eg. torn meniscus or loose body).
What is pseudolocking of the knee?
Patient unable to flex or extend knee due to pain
Pain in the following areas of the knee are normally due to pathology in which area?
- front of the knee
- joint line (young? old?)
- popliteal fossa on squatting (2)
- patella
- meniscal pathology (young), osteoarthritis (old)
- Posterior meniscal tear, arthritis
What kind of arthritis does a varus knee often lead to?
Medial tibiofemoral osteoarthritis due to local overloading
What is the proper latin name for club foot?
Talipes
Which of talipes calcaneo valgus and talipes equino varus is self correcting?
Talipes calcaneo varus
What nerve mainly supplies the fro front of the upper leg?
Femoral
Which nerve supplies back of thigh and the whole lower legend foot?
Sciatic nerve
When is the sciatic nerve vulnerable to injury? Name 2 medical procedures, and 1 injury that can damage it?
When it runs behind the hip joint
- intramuscular injejection
- hip replacement (retractor)
- hip dislocation
Which nerve can be damaged by obstetric stirrups?
Peroneal nerve
In the elderly, what kind of fracture frequently leads to AVN of the femoral head?
Sub-capital fracture (displaced fracture across the upper femoral neck)
How can you tell that hip pain is coming from the hip and not from the knee or the back?
Pastry roll test (one hand on thigh, one hand on shin), if there is hip pain the patient will resist the rolling.
Blood to the leg is supplied mainly through the __ artery which passes from the groin to the back of the __ where it become the __ artery and then divides into __ branches.
Femoral
Knee
Popliteal
3
Which vein is a constant feature and is useful for venous access? Where is it?
Long saphenous vein
1 finger superior and anterior of medial malleolus
What is the proper name of the ankle joint?
Subtalar joint
What is the action of ACL?
Stop tibia sliding forwards and rotating on the femur
Why can cruciate ligaments not heal?
They have no blood supply
If an elderly patient suffers a sub-capital fracture of the femur neck, what is the treatment?
Hemi-arthroplasty
In an extra articular fracture, what is the operative treatment?
Dynamic hip screw
Which direction does the patella normally dislocate?
Laterally
When the knee dislocates (rarely, only in severe trauma), what can be a serious consequence?
Popliteal artery damage
What is the nerve and blood supply of the knee menisci?
None
How do torn menisci cause problems?
They are normally painless but come times fragments can jam in the joint –> locking and pain
How can you non surgically treat a torn ACL?
Physio to build up the quadriceps muscles etc so that they patient can have enough control over knew despite no AC:
How can you surgically treat an ACL?
Insertion of a substitute cruciate ligament
