Lower limb injuries

Question 1

If the superior gluteal nerve is damaged which muscles are paralysed ? & what becomes unsteady ?

Answer 1

• gluteus medius, minimus
• pelvis becomes unsteady

Question 2

what is a characteristic finding of gluteal muscle weakness ?

Answer 2

Trendelenburg sign

Question 3

What is a postive sign of trendelenburg sign ?

Answer 3

pelvic drop will occur on the unsupported leg

Question 4

How can pelvic drop (postivie sign for trendelenburg sign) be recognised ?

Answer 4

by observing the level of the iliac crests on both sides

Question 5

How will the trendelenburg sign present if the right gluteal muscles are weak on a patient ?

Answer 5

left side of pelvis will drop when the patient stands on their right leg , & left lef is unsupported

Question 6

Children affected with sciatic nerve injury may be unable to ….1…. and a significant proportion present with ..2..

Answer 6

1. walk or crawl
2. foot drop

Question 7

what’s the range of effects of injection-related sciatic nerve injury ?

Answer 7

transient sensory disturbance to permanent paralysis and numbness

Question 8

Where is intramuscular injection into the buttock aimed at ?

Answer 8

upper outer qudrant

Question 9

Why may an intracapsular fracture the hip joint result in the blood supply being cut off and avascular necrosis of the head of the femur ?

Answer 9

most of the blood supply to the hip joint enters distally

Question 10

Trochanteric bursitis is a cause of ….1… pain and often occurs in ..2…

Answer 10

1. hip
2. middle-aged women

Question 11

Give examples of when the ischiogluteal bursa can become inflamed ?

Answer 11

due to excessive friction in riding a bicycle or a horse

Question 12

what pain is inflammation to ischiogluteal bursa associated with ?

Answer 12

sitting and deep palpation

Question 13

What is a valgus deformity ?

Answer 13

when distal part of bone is directed away from the midline

Question 14

what is valgus deformity in hip called ?

Answer 14

coxa valga

Question 15

what is a varus deformity ?

Answer 15

when distal part of the hip bone is directed toward the midline

Question 16

what is a varus deformity in hip called ?

Answer 16

coxa vara

Question 17

femoral neck fractures …

Question 18

developmental dysplasia of the hip …. (DDH)

Question 19

acquired dislocation ….

Question 20

posterior dislocation of hip…

Question 21

anterior dislocaiton of hip…

Question 22

Main actions of muscles innervated by the femoral nerve ?

Answer 22

hip flexion (sartorius, pectineus, iliacus)
knee extension (quadriceps femoris)

Question 23

Injury to inferior gluteal nerve would result in ?

Answer 23

loss of hip extension

innervation to glutues maximus - one of major extensors of hip joint

Question 24

Injury to obturator nerve results in ?

Answer 24

loss of sensation to medial thigh & hip adduction also impaired

Question 25

Superior gluteal nerve injury would loss in ?

Answer 25

loss of hip abduction , positive trendelenburg sign

superior gluteal nerve innervates gluteus medius + minimus