Lower limb conditions 2 Flashcards
‘unhappy triad?
where is it most commonly seen?
Which meniscus is most commonly torn and why?
Medial meniscus, cuz its firmly attachted to the medial collateral ligament! and joint capsule!
so if ligament tears, it pulls the menisci with it!
housemaids knee
suprapatellar bursitis
clergy mans knee
what keeps the patella irs groove?
Vastus medialis
that why when ppl who stopped excerising for a while, suddenly go for a jog, they can feel pain in their knee,
cuz vastas medialis is not that strong enough to hold the patella in place!
what is so special about the patella?
hint: it s sesamoid bone…
it develops intratendinously
a valgus force on a leg may cause injury to which ligaments?
-medial collateral ligaments
what is a baker’s cyst?
cystic outpouching of the joint capsule “synovial popliteal cyst”
this result mostly from joint effusion ex: RA causing a rise of intra-articular pressure
between the semimembranous tendon and head of gastrocnemius.
name the different bursitis of the knee
difference btw intracapsular and extracapsular
anything above the intertrochanteric line > intracapsular
Anything below it> extracapsualr
Describe the anatomical attacthments of he capsule of the joint!
what causes trendenburgs gait?
weakness or parlays pf the small gluteus muscles (gluteus medius and minimus), the pelvis can no longer be stabilised and is tilted towards the unaffected side.
normal, trendelburg and compensated
show the 3 moves
Types of hip fractures?
what does this fracture carry a risk of?
tratment
displaced Subacpital fracture
Avascular necrosis!
DHS
what is avascular necrosis?
Death of a segment of the bone
where is the important blood supply for the femoral neck located?
what type of fracture carries a high risk of Avascular necrosis?
Why is the risk of avascular necrosis of the femoral head much lower for an intertrochanteric fracture than a subcapital fracture?
In a patient with an intertrochanteric fracture of the femur, why do you often find shortening and external (lateral) rotation of the limb?
(Hint: think about the origins, insertions and the subsequent ‘line of pull’ of the muscles around the femoral trochanters and shaft)
What type of fixation is most often performed for an intertrochanteric fracture. Why?
DHS
posterioir dislocation of hip, how will the patients present?
Which peripheral nerve is most at risk of damage during posterior dislocation of the hip?
Shortened and internally/medially rotated
Sciatic
anterior dislocation of hip, how will the patients present?
Why, on examination of a patient with a posterior dislocation of the hip, will you often find shortening and internal (medial) rotation of the limb?
What is the most likely cause of this patient’s positive Trendelenburg sign?
L5 radiculopathy secondary to osteoarthritis
What course do the gluteal nerves follow to reach the muscles they innervate?
They leave the pelvis via the greater sciatic foramen.
Superior gluteal nerve passes superior to the piriformis muscle
inferior gluteal nerve passes inferior to the piriformis muscle
What types of activities are most likely to result in a pulled hamstring? In anatomical terms, what is the nature of this injury?
jumping, sprinting and lunging.
What is the differential diagnosis for a mass (swelling) in the popliteal fossa?
State 4 diagnoses.
1) Popliteal aneurysm
2) Baker’s cyst: herniation of the synovial membrane of the knee joint, usually in association with
3) osteoarthritis
4) Abscess
5) Enlarged lymph nodes
6) Thrombophlebitis of the popliteal vein or short saphenous vein
7) Any benign or malignant tumour of muscle, bone (femur or tibia) or connective tissue
shade areas affected in sciatic nerve injury
The axons of the sciatic nerve distal to the injury would undergo degeneration.
What is the name given to this type of degeneration?
Describe what happens to the proximal axons as they attempt to reinervate the affected muscles
Wallerian
( picture 3) Axons sprout from the proximal part of the severed nerve.
the shwann cells then help guide the sprouting axons to the denervated muscle
The patient develops a nodule at the site of the injury and is told they have a traumatic neuroma.
What is a traumatic neuroma?
Apart from the presence of a nodule what is the commonest symptom associated with this lesion?
A disordered proliferation of axons resulting in a tangled mass
Pain
