MSK Flashcards
What parts of the hip are affected by developmental dysplasia of the hip (DDH)
proximal femur and acetabulum
What can DDH lead to
subluxation (partial dislocation) and dislocation
risk factors for developmental hip displasia
female first-born frank breech presentation family hx oligohydramnios
Hip laxity is common at birth so sonograohic evaluation is typically performed after ____ weeks.
4
What planes are used to evaluate DDH
COR and TRV
Which hip is typically affected?
3x more common in the left
Normal alpha and beta angle of a hip?
alpha >60
beta <55
_____ angle is lateral next to TDx
beta, alpha is medial
What are the stress maneuvers for DDh called
barlow
ortalani
Barlow stress maneuver
determine is hip is subluxable
dislocation of the hip by adducting (rolling in) and pushing the leg posteriorly
Ortalani stress maneuver
relocation of the dislocated hip by abducting (roll open) the leg
a palpable and audible “clunk” is noted as the femoral head slips back into the socket
_______ _______ is a collection of synovial fluid in the popliteal fossa and is commonly located on the _____ aspect of the fossa. They can also extend down into the _____
Baker’s Cyst
media
calf muscle
Causes of Baker’s cyst
rheumatoid arthritis
osteoarthritis
oversuse of the knees
Most common tumor of the hand and wrist
ganglion cysts
Second most common tumor of the hand and wrist
giant cell tumor
Tumor of the tendon sheath
giant cell tumor
appearance of a giant cell tumor
solid mass with varying appearances
Appeance of a ganglion cyst
simple cyst with sound enhancement
Why do you have to be careful with a cystic appearning mass in the hand or wirst that does not have sound enhancement
could be a giant cell tumor
_____ ______ is two muscles that extend from the zyphoid process to the public bone and join at the midline to form the _____ _____, which is a complete partition for this compartment.
rectus abdominus
linea alba
The rectus abdominus is encased in a sheath ______ and _______. The anterior and posterior sheath extend from the costal margin to the ______ line, which is located midway between the umbilicus and symphysis pubis, where the posterior wall of the sheath ends.
anteriorly and posteriorly
arcuate line
A rectus sheath heamtoma is the result of bleeding from the ______ or _______ ________ vessels (superior and inferior to umbilicus) or frome a _____ of the rectus muscle.
superior or inferior epigastric vessels
tear
If a rectus shealth hematoma is superior to the arcuate line, the heamtoma is confined within teh anterior and posterior sheath and does not move across the ____ due to the ____ ______.
midline
linea alba
A rectus sheath hematoma inferior to the arcuate line will extend into the ____ of ______ within the pelvis casuing external compression and irratation of the urinary bladder.
space of retzius (retropubic space)
- inferior to the arcuate line, the posterior sheath is absent with only a weak transversalis fascia and peritoneum sperating the abdominal wall muscle from the abdominal viscera
- these bleeds are more extensive, the bleed does not tamponade as it does above the arcuate line
Although most rectus sheath hematomas are self-limiting, extensive bleeding can result in a _______ in ______ and hypovolemic shock
decrease hematocrit
Where is the arcuate line
below the belly button, midway between the umbilicus and pubic bone
rectus sheath hematomas occur due to
external trauma trauma from surgery vigorous msucle contraction valsalva with severe coughing/vomiting pregnancy
Rectus sheath heamtoma is a recognized complication of ______ _____.
anticoagulation therapy
epigastric hernia
due to a weakness on the ML of the upper abd wall, on the line extending from the breast bone to the umbilicus
Incisional hernia
result of poast operative weakening of the abdominla wall
Umbilical hernia
occurs near the umbilicus due to the natural weakness of the abdominal wall from the umbilical cord
femoral hernia
within the femoral canal adjacent to the femoral vein just below the groin crease and is usually associated with pregnancy
Obturator hernia
protrudes from the pelvic cavity through the opening in the pelvic bone (obturator foramen). Becasue of the lack visible bulging, difficult to Dx
inguinal hernia
most common abd wall hernia occuring more often in men
indirect inguinal hernia
follows the inguinal canal descending from the abdomen into the scrotum. Pathway normally closes before birth but may remain a possible site for hernia in later life. Sometimes the hernia sac protrudes into the scrotum
Direct inguinal hernia
occurs slightly to the inside of the site of the indirect hernia, in an area where the abdominal wall is naturally slightly thinner, rarely protruding into the scrotum
Spigelian hernia
along the edge of the rectus abdominus muscle through the spigelian fascia, which is serveal inches lateral to the middle of the abdomen
What are the 4 patterns of muscle fiber organization
Parallell (Fusiform)
Convergent (Triangular)
Pennate
Circular
Parallell
fusifirm
long axis of muscle fiber runs with longitudinal axis of muscle
biceps, sartorius
Convergent
trangular
muscle fibers converge toward a single tendon
pectoralis major
peenate
muscle fibers branch from central tendon diagonally (feather-like)
rectus femoris, deltoid
circular
msucle fibers are arranged in concentric rings
obicularis oris
artifact you will encounter when not quite perpendicular to smal super structures that will make it look like there is a break or tear so need to use dynamic imaging (moving around)
anisotropy
full/complete tears may occur in
tendons, where muscle are connected to bone
What muscles make up the rotator cuff muscles
supraspinatous
subscapularis
infraspinatous
teres minor
What should you always do in the presence of a popliteal cyst?
Color Doppler to check for popliteal arterial anneurysm
