minor adult disorders Flashcards
tennis elbow is inflammation of the common origin of the flexors/extensors ?
extensors
If a steroid injection is given for enthesopathy, why must care be taken?
to prevent steroid leaking into the subcut fat or ski because this will exacerbate pain and leave an unsightly dimple
if surgery is undergone for enthesopathy what does it involve
scraping the origin of the muscle from the bone and letting it slide distally thus decompressing the area
what is it called if a nerve is compressed or stretched
neuropraxia
what will continued pressure on a nerve lead to? is this permanent?
atrophy
usually permanent
are neuropraxias usually intrinsic or extrinsic
intrinsic
name the most common site at risk from extrinsic neuropraxia
common peroneal nerve as it wraps around the head of the fibula
common sites at risk from intrinsic nerve entrapment
median nerve at wrist
ulnar nerve ar the elbow and wrist
posterior tibial nerve at the ankle
what is diagnostic of nerve entrapment?
weakness and real sensory loss
what is tenosynovitis
inflammation of tendons and their associated synovial sheaths
what is tenosynovitis often associated with
Rheumatoid arthritis
what is tenosynovitis usually precipitated by?
unusual levels of activity / overuse
what is a bursa
a small sac of fibrous tissue lined with synovial membrane and filled with fluid
most common sites of bursitis
knee and elbow
greater trochanter
infected bursae should be ?
incised and drained as this usually leads to spontaneous recovery through scarring and fibrosis
what may a very painful spasmodic flat foot be associated with?
what might examination reveal?
does it need intervention?
infection or chronic inflammatory disease
examination may reveal painful and tender swelling over the insertion of the tibialis posterior
yes, early intervention, as it may indicate acute or impending degenerative rupture
if painful flat feet is a persistent problem which joint may be fused to help the condition?
subtalar joint
shouldn’t be undertaken lightly as it disturbs foot and ankle function profoundly
what is hallux valgus
turning away of the pahalnges of the big toe from the midline
what is hallux rigidus
OA of the MTP joint
conservative mx of hallux rigidus in adolescents
metatarsal bar (to provide a rocker at the front of the foot so that the toe doesn’t need to bend during walking)
what do the terms claw foot and claw toes imply
wasted muscles making the bones and toe nails appear more prominent
on examination of claw foot, what may it imply if the patient has weak or denervated small muscles of the feet?
underlying minor spinal abnormality such as spina bifida occulta
what are hammer toes secondary to
disruption of MTP joints
what is often all thats required for hammer toes?
if surgery was undergone what would be done?
soft comfortable shoes
surgery would involve fusion of the interphalangeal joints in a straight position
what is a Mortons neuroma
cutaneous nerves to the toes becoming trapped or irritated between the metatarsal heads
What may a morton’s neuroma be secondary to
metatarsal head prolapse
type of pain in Mortons neuroma
dull and throbbing often with sharp exacerbations accompanied by tingling
what classically reproduces the symptoms of Mortons neuroma
sideways compression of the foot, producing a palpable click
is recurrence common with neuromas
yes
what is a serious consequence of an ingrown toenail
blood borne infection which can be serious if the patient has prosthetic joints or prosthetic heart valves
what is the surest way of relieving the problem of an ingrown toenail
removal of the nail bed using phenol after removing the nail
where does the plantar fascia run from/to
os calcis to each toe base
characteristic complaint of plantar fasciitis
soreness of the instep worse on rising or after sitting for prolonged period
what are symptoms of plantar fasciitis minimally relieved by
walking
but then persist as a debilitating ache, often exacerbated by change of direction or waking on rough surface
most cases of plantar fasciitis will settle on their own - true or false?
true
what can be done for plantar fasciitis if there is a marked tender point
local injection of steroid and long acting local anaesthetic
pain around the tendo-achilles where it inserts into the os calcis is seen in 2 groups of people - who?
young athletes
middle aged men
what part of the tendo achilles has a poor bloody supply
lower part
if the achilles tendon ruptures how can healing be encouraged?
if the ankle is kept in an equinus plaster for a minimum of EIGHT WEEKS
following achilles rupture what will help prevent re-rupture
wearing a felt raise inside the heel of the shoe for as long as possible
what is tenderness under active shoulder movement with a painful arc suggestive of?
supraspinatous inflammation or subacromial bursitis
why are repetitive injections not advised in rotator cuff tears
can cause further degeneration of the rotator cuff
2 possible aetiologies of frozen shoulder
epileptic fit
electric shock
what is “frozen shoulder”
a condition in which there is little or no glenohumeral movement. cause is often obscure and they eventually recover in 18m to 2 years
