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MSK - Orthopedics > Lower Limb Coretext > Flashcards

Lower Limb Coretext Flashcards

1
Q

Where does hip pathology typically produce pain?

A

Groin

buttock

Knee

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2
Q

What range of motion is usually reduced first in hip pathology?

A

Internal Rotation

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3
Q

What does a positive trandellenburg test suggest?

A

Abductor weakness

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4
Q

What muscles are tested in the Trendellenburg test?

A

Gluteus Medius and Gluteus minimus

Abductors of the hip

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5
Q

How long do total hip replacements usually last?

A

15 - 20 years

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6
Q

What is Avascular Necrosis?

A

Poor blod suplly leading to cell death , common in the hip joint

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7
Q

How do people with Avascular Necrosis of the hip present ?

A

Groin pain

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8
Q

What happens if Avascuar Necrosis is left unoticed?

A

Patchy sclerosis of femoral head

Lytic sones resulting in “hanging rope sign” on xray

Femoral head collapse

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9
Q

What does sclerosis mean?

A

Abnormal hardening

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10
Q

What are the treatment options for Avascular Necrosis of the hip?

A

Pre collapse- drill holes can be made in an attempt to releive pressure and promote healing

Post collapse- total hip replacement

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11
Q

What is Trochanteric bursitis?

A

inflamation of the trochanteric bursa

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12
Q

What do people with trochanteric bursitis present with?

A

Pain and tenderness in the region of the greater trochanter with pain on resisted abduction

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13
Q

How do you treat Trochanteric Bursitis?

A

Analgesic

NSAIDs

Physiotherapy

Steroid injections

No surgical treatment has proven benefit

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14
Q

What are the four main ligaments in the knee joint?

A

ACL - anterior crustiate ligament

PCL - posterior crusiate ligament

MCL- Medial collateral ligament

LCL - lateral collateral ligament

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15
Q

What is the principle role of the ACL?

A

To prevent abnormal internal rotation of the tibia

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16
Q

What is the main function of the PCL?

A

Prevents hyperextension and anterior translation of the femur.

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17
Q

How do Meniscal Injuries usually occur?

A

twisting force on a loaded knee

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18
Q

Where will people with meniscal injuries feel the pain?

A

Medial or lateral joint line

Usually medial

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19
Q

What are common mechanical symptoms of meniscal tears?

A

Catching sensation

or

“Locking”

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20
Q

What is true knee locking ?

A

Mechanical block to full extension causes by a torn meniscus flipping over and being stuck in the joint line

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21
Q

What will the patient feel if they rupture their ACL?

A

Immediatly

Rotational force

they will hear a “POP”

Haemarthrosis

Chronically

Rotatory instability

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22
Q

What parts of the meniscur are supllied by blood?

A

Outer 1/3

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23
Q

What is more common, medial or lateral meniscal tears?

A

Medial

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24
Q

Which special physical examination test can be preformed to diagnose ACL rupture?

A

Anterior draw test

and

Lachmans test

25
Q

What is the 1/3 rule for ACL ruptures?

A

1/3 have no problems

1/3 manage by avoiding certain movements

1/3 will do poorly with frequent giving away

26
Q

What percentage of patients with a torn ACL will end up having reconstruction

A

4

27
Q

How are acute MCL tears usually treated?

A

Hinged knee brace

28
Q

How can chronic MCL instability be treated?

A

MCL tightening or with reconstruction with a tendon graft

29
Q

What is the usual treatment for LCL ruptures?

A

surgical

Early repair or late reconstruction with tendon graft

30
Q

What must you be aware of during reperfusion of a leg?

A

compartment syndrome

31
Q

what are osteochondral and chondral injuries?

A

Occour due to impaction or shearing of articular surfaces due to a direct blow

32
Q

What are the characterisitc symptoms of osteochondral and chondral injuries?

A

Ongoing pain and effusion after a knee injury

33
Q

What investigations would you consider in osteochonfral injuries?

A

MRI

Arthroscopy

X ray

34
Q

What structures are invloved in the extensor mechanisim of the knee?

A

quadriceps muscle

quadriceps tendon

patella

patellar tendon

tibial tuberosity

35
Q

How do you treat a extensor mechanism rupture?

A

Surgical repair

36
Q

what physcial examination is most useful in extensor mechanism ruptures?

A

Straight leg raise

37
Q

What is Patellofemoral dysfunction?

A

Disorders of the patellofemoral articulation resulting in anterior knee pain

38
Q

Which way does the patella usually dislocate?

A

Laterally

39
Q

What are the two surgical options for patients with advanced ankle osteoarthritis?

A

Arthrodesis

Ankle replacement

40
Q

What is hallux valgus also known as ?

A

Bunion

41
Q

What is a cheilectomy?

A

Removal of oesteophytes in the foot

42
Q

What is the gold standard surgical treatment for hallux rigidus?

A

Arthrodesis

43
Q

What is Morton’s Neuroma?

A

Neuroma forming from plantar interdigital nerves

44
Q

What is this?

A

Morton’s neuroma

45
Q

What would a patient with morton’s neuroma experiance?

A

tingiling and burning pain in affected toes

46
Q

What investigation is used to diagnose Mortons neuroma?

A

ultrasound looking for the swollen nerve

47
Q

What are the management options for morton’s neuroma?

A

Conservative

insoles

Steroids and anaesthetic

Surgical

Neurom can be excsied - patients may continue to feel pain

48
Q

What are the most common metatarsals to stress fracture?

A

2nd metatarsal followed by the 3rd metatarsal

49
Q

What is the treatment for metatarsal stressfractures?

A

prolonged rest for 6-12 weeks while wearing a rigid solid boot

50
Q

Why should steriod injection around the achillies tendon in achillies tendonitis be avoided?

A

Risk of tendon rupture

51
Q

what is simmonds test?

A

Plantar flexsion upon squeezing of the calf muscles

52
Q

What is plantar fasciitis?

A

Self-limiting repetative strain injury chracterised by pin with walking felt on the instep of the foot.

53
Q

What is pes planus ?

A

Flat feet

54
Q

Where does the tibialis posterior tendon attatch on to ?

A

Medial navicular

55
Q

How should Tibialis posterior tendonitis be treated?

A

a splint with a media arch support to avoid rupture

56
Q

What happens if the tibialis posterior tendon ruptures?

A

loss of the medial arch of the foot

57
Q

What is Pes cavus?

A

Abdnormally high arch of the foot

58
Q
A

MSK - Orthopedics (12 decks)

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