Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2- MSK > Lower Limb Pathologies > Flashcards

Lower Limb Pathologies Flashcards

1
Q

What is osteoarthritis of the hip?

A

A degenerative disease of the synovial joint which results in the progressive loss of cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Give 4 risk factors for hip osteoarthritis

A 
Trauma
Muscle weakness
Manual job 
High impact sports player
Paediatric hip conditions
Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the pathophysiology of osteoarthritis

A

Over time there is less water and fewer proteoglycans in collagen
In the synovium this causes inflammation to occur
The synovium becomes more thick and vascularised over time
The bone tries to remodel and forms lytic lesions with sclerotic edges
In late disease, bone cysts can form around the joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give 3 symptoms of hip osteoarthritis

A

Limiting hip pain
Pain at night and at rest
Hip stiffness
Hip locking and instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What will be found on examination of the hip joint in hip osteoarthritis?

A

Altered gait
Leg length discrepancy
Unable to fully flex and extend
Limited internal rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is seen on x-rays in osteoarthritis?

A

Joint space narrowing
Osteophytes
Sclerosis
Bone cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give 4 non-operative ways hip osteoarthritis can be managed

A 
NSAIDs
Walking aids 
Weight loss
Activity modification 
Physiotherapy
Steroid injections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Give 4 ways hip osteoarthritis can be managed operatively

A 
Debridement of the joint 
Osteotomy 
Femoral head resection 
Hip resurfacing 
Total hip arthroscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When do neck of femur fractures occur?

A

Low energy falls in the elderly

High energy trauma in young patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do NOF# take a long time to heal?

A

Surrounded by a capsule
Bathed in synovial fluid
No periosteal layer –> limits callus formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is the mortality for NOF# so high?

A

Patients have long stays in hospital where they are immobilized and at risk of infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Give the main symptom of a NOF#

A

Pain in the groin referred to medial thigh and knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What finding will be present in a patient with a NOF#?

A

Leg shortened and externally rotated and abducted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are intracapsular NOF# classified?

A

Garden Classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is a Garden stage 1 NOF#?

A

Fracture is nondisplaced and incomplete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a Garden stage 2 NOF#?

A

Undisplaced but complete fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a Garden stage 3 NOF#?

A

Complete fracture but incompletely displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a Garden stage 4 NOF#?

A

Complete fracture which is completely displaced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What may be seen on x-ray of a NOF#?

A

Can see fracture line

Break in Shenton’s line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is an undisplaced intracapsular NOF# treated?

A

Internal fixation with screws

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is a displaced intracapsular NOF# treated?

A

Arthroplasty (either hemi or THR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is an extracapsular peritrochanteric NOF# treated?

A

Dynamic hip screw or intramedullary nail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is an extracapsular subtrochanteric NOF# treated?

A

IM nail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Give 2 potential complications of a NOF#

A

Avascular necrosis
Nonunion
Dislocation
Failure of surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the Nottingham Hip Score?

A

A score which predicts mortality following a hip fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What elements are included in the Nottingham Hip Score?

A 
Age (66-85 +3, >86 +4) 
Sex (if male +1)
Admission haemoglobin (if <10g/dL, +1)
Mini-mental test score (if <6/10, +1)
Living in an institution (+1)
Number of comorbidities (if >2 +1)
Malignancy (+1)

A score of above 6 puts patients at high risk of mortality from hip fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Why are hip dislocations rare?

A

Hip joint is very stable and supported by soft tissue constraints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

In which direction do 90% of hips dislocate?

A

Posteriorly

Usually due to hitting a flexed knee on a dashboard in a car crash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How will a posterior hip dislocation present?

A

Hip and leg in flexion
Adduction and internal rotation
May be sciatic nerve injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How will an anterior hip dislocation present?

A

Hip and leg in flexion
Abduction
External rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Give 4 possible complications after a hip dislocation

A

Post-traumatic hip arthritis
Femoral head osteonecrosis
Sciatic nerve injury
Recurrent dislocations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is sciatica?

A

Sciatica is the term used to describe discomfort from compression of the sciatic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Give 3 symptoms of sciatica

A 
Pain in buttocks and back of leg
Pain worse when sitting for long periods of time 
Weakness in the calf muscles 
Back pain 
Tingling in legs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which test can be done to assess sciatic pain?

A

Straight leg raise (sciatic stretch test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Give 3 potential causes of sciatica

A 
Spinal stenosis
Spondylolisthesis
Spinal injury 
Spinal tumour 
Cauda equina 
Bone spurs
Piriformis syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How is sciatica managed?

A

NSAIDs, stay active, heat/cold packs, physiotherapy, steroid injections, amitriptyline, gabapentin, diazepam

If a spinal cause is found, lumbar decompression surgery can be done

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Give 4 risk factors for knee osteoarthritis

A 
Articular trauma 
Repetitive knee bending 
Muscle weakness
Obesity 
Metabolic syndrome 
Female 
Elderly 
Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Give 4 symptoms of knee osteoarthritis

A 
Limiting knee pain 
Pain at night or at rest
Activity induced swelling 
Instability 
Locking 
Catching sensation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How is knee osteoarthritis managed?

A

Nonoperatively –> NSAIDs, rehabilitation, education, weight loss
Operatively –> High tibial osteotomy, unicompartmental arthroplasty, total knee arthroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What movement may cause a ruptured ACL?

A

High twisting force to the bent knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the symptoms of a ruptured ACL?

A

Load crack heard
Pain
Rapid joint swelling
Poor healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What movement may cause a ruptured PCL?

A

Hyperextension of the knee

43
Q

What movement may cause a ruptured MCL?

A

Leg forced into valgus from a blow to the lateral knee

44
Q

What are the symptoms of a meniscal tear?

A

Delayed knee swelling
Joint locking
Recurrent episodes of pain and effusions after minor injury

45
Q

What will be seen on examination of a patella fracture?

A

Palpable patella defect

Unable to raise leg

46
Q

Give 4 complications of a patella fracture

A 
Weakness and anterior knee pain 
Loss of reduction 
Nonunion 
Osteonecrosis
Infection 
Stiffness
47
Q

What nerve can be damaged in a dislocated patella?

A

Common peroneal nerve

48
Q

Give 2 common mechanisms for dislocating the patella

A

Dashboard injury in RTA

Fall from a height

49
Q

What is dimple sign in a patella dislocation?

A

Buttonholing of the medial femoral condyle through the medial capsule

50
Q

Give 4 complications of a patella dislocation?

A 
Stiffness
Laxity 
Instability 
Peroneal nerve injury 
Vascular compromise
51
Q

What is prepatellar bursitis?

A

Inflammation of the prepatellar bursa in the knee (Housemaid’s Knee)

52
Q

How is prepatellar bursitis managed?

A

Compression wrap
NSAIDs
Immobilisation
Can be aspirated

53
Q

What is Osgood-Schlatters disease?

A

Also known as tibial tubercle traction apophysitis. Inflammation and swelling at the distal attachment area of the patellar tendon

54
Q

How does Osgood-Schlatter disease present?

A

Pain on anterior knee worse on kneeling

Common in children and athletes who jump (basketball players)

55
Q

What is Sinding-Larsen-Johansson Syndrome?

A

Overuse injury causing pain at the inferior pole of the patella at the proximal attachment point of the patella tendon.

56
Q

What kind of fracture pattern are common in tibial fractures?

A

Spiral

57
Q

What classification system is used for tibial shaft fractures?

A

Tscherne Classification

58
Q

What is a grade 0 closed tibial fracture?

A

Minimal soft tissue injury, indirect injury, simple fracture pattern

59
Q

What is a grade 1 closed tibial fracture?

A

Superficial abrasion or contusion, mild fracture pattern

60
Q

What is a grade 2 closed tibial fracture?

A

Deep abrasion, skin or muscle contusion, severe fracture pattern, direct trauma

61
Q

What is a grade 3 closed tibial fracture?

A

Extensive skin contusion or crush injury, severe damage to underlying muscle, compartment syndrome, subcutaneous avulsion

62
Q

What is a grade I open tibial fracture?

A

Open fracture with a small puncture wound without skin contusion, negligible bacterial contamination, low-energy fracture pattern

63
Q

What is a grade II open tibial fracture?

A

Open injuries with small skin and soft tissue contusions, moderate contamination, variable fracture patterns

64
Q

What is a grade III open tibial fracture?

A

Open fractures with heavy contamination, extensive soft tissue damage, arterial or neural injuries

65
Q

What is a grade IV open tibial fracture?

A

Open fractures with incomplete or complete amputations

66
Q

What are the Ottawa ankle rules?

A

Rules for determining which patients with foot or ankle problems require an x-ray

67
Q

When does a patient with traumatic ankle pain qualify for an x-ray?

A

Point tenderness on lateral malleolus
Point tenderness on medial malleolus
Inability to weight bear for 4 continuous steps immediately after injury

68
Q

When does a patient with traumatic foot pain qualify for an x-ray?

A

Point tenderness on the base of the 5th metatarsal
Point tenderness on the navicular
Inability to weight bear for 4 continuous steps immediately after the injury

69
Q

How is a medial malleolus fracture treated?

A

Short leg walking cast or boot

ORIF

70
Q

How is a lateral malleolus fracture treated?

A

Short leg walking cast or boot

ORIF

71
Q

How are bilateral malleolus fractures treated?

A

Total contact casting

ORIF

72
Q

How is a posterior malleolus fracture treated?

A

Short leg walking cast or boot

ORIF

73
Q

How is an open malleolus fracture treated?

A

Emergency operative debridement
ORIF
External fixation

74
Q

What is a Webers A ankle fracture?

A

Fracture is below the ankle syndesmosis

75
Q

What is a Webers B ankle fracture?

A

Fracture at the level of the syndesmosis

76
Q

What is a Webers C ankle fracture?

A

Fracture above the ankle syndesmosis

77
Q

What is the most common direction for an ankle to dislocate?

A

Medial (80%)

78
Q

How will a medial ankle dislocation present?

A

Locked in supination

79
Q

How will a lateral ankle dislocation present?

A

Locked in pronation

80
Q

What is a high ankle sprain?

A

Syndesmosis injury to the soft tissue around the ankle. Commonly from external rotation injuries

81
Q

What signs will be found on examination of a high sprain injury?

A

Positive Hopkins test –> compression of tibia and fibula at the mid-calf causes pain at the syndesmosis
Pain over syndesmosis is elicited with external rotation of the foot with the knee and hip flexed at 90 degrees

82
Q

What is a low ankle sprain?

A

Injury to the anterior tibiofibular ligament and calcaneofibular ligament.

83
Q

How is a low ankle sprain managed?

A

RICE, Elastic bandage, 1 week of immobilisation

84
Q

Describe the phases of gait

A

Stance phase –> foot is on the floor

Swing phase –> foot is moving forward

85
Q

In gait what is the difference between a stride and a step?

A

Stride –> distance between consecutive ground contact of the same foot
Step –> distance between consecutive ground contact of alternating feet

86
Q

What is a hallux valgus?

A

Valgus deviation of the phalanx which promotes varus positioning of the metatarsal. Metatarsal head displaces medially and the sesamoid complex is laterally translated. This causes pain due to a shift in weight bearing.

87
Q

Give 2 symptoms of hallux valgus?

A

Difficulty wearing shoes
Obvious foot deformity
Pain

88
Q

How is hallux valgus managed?

A

Shoe modification
Pads
Spacers
Can have surgical correction

89
Q

What is achilles tendonitis?

A

Gradual onset of posterior heel pain worse following activity

90
Q

Give 2 risk factors for achilles tendon rupture

A

Quinolone antibiotics
Hypercholesterolaemia
Steroid injections
Athletes who do not train regularly

91
Q

How will an achilles tendon rupture present?

A 
Hear a pop 
Weakness
Difficulty walking 
Pain in heel 
Sudden onset
92
Q

What test is done to assess for an achilles tendon rupture?

A

Thompson/Simmonds test

Lack of plantar flexion when the calf is squezed

93
Q

How is an achilles tendon rupture managed?

A

Functional bracing

Surgical repair of the achilles tendon

94
Q

What is plantar fasciitis?

A

Inflammation of the plantar fascia aponeurosis at its attachment point on the calcaneus

95
Q

What patients are more at risk of plantar fasciitis?

A

Runners
Dancers
Obese people
Inactive patients

96
Q

What is the pathophysiology of plantar fasciitis?

A

Microtears in the plantar fascia from overuse lead to inflammation and chronic inflammation.

97
Q

Give 3 risk factors for plantar fasciitis

A 
Excessive pronation 
High arches 
Tight gastrocnemius and soleus
Prolonged standing 
Leg length discrepancy 
Unsupportive footwear
98
Q

What are the symptoms of plantar fasciitis?

A

Sharp pain in the heel
Worse in the morning and evening
Pain relieved when walking on heels and on ambulation

99
Q

How is plantar fasciitis managed?

A 
Pain control 
Splinting 
Good footwear
Steroid injection 
Gastrocnemius recession 
Plantar fasciotomy
100
Q

What is claw toe?

A

MTP hyperextension and PIP and DIP flexion

101
Q

What is a hammer toe?

A

PIP flexion, DIP extension, MTP neutral

102
Q

What is a mallet toe?

A

Hyperflexion of the DIP joint

103
Q

What is morton’s neuroma?

A

Compressive neuropathy of the interdigital nerve. Thickening of tissue around the nerve.

104
Q

Give 3 causes of morton’s neuroma?

A 
Wearing tight, pointed shoes 
Being active
Flat feet
High arches
Bunion 
Hammer toes

Phase 2- MSK (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions