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NPTE Study Practice > MSK Patho LE > Flashcards

MSK Patho LE Flashcards

1
Q

Pathology of AVN of the hip

A
  • Multiple etiologies resulting in an impaired blood supply to the femoral head
  • Hip ROM decreased in flexion, IR, and abduction
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2
Q

Symptoms of AVN of the hip

A
  • Pain in the groin and/or thigh
  • Tenderness with palpation at the hip joint
  • Coxalgic gait
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3
Q

Medications for management of AVN of the hip

A
  • Acetaminophen for pain
  • NSAIDs for pain and/or inflammation
  • Corticosteroids contraindicated since they may be a causative factor
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4
Q

What might cause coxa vara/valga

A
  • Coxa vara usually results for a defect in ossification of head of femur
  • Coxa vara/valga may result from necrosis of femoral head occurring with septic arthritis
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5
Q

MOI and common symptoms of greater trochanteric pain syndrome/gluteal tendinopathy/trochanteric bursitis

A
  • MOI: excessive hip adduction and IR with weight bearing tasks
  • Pain over greater trochanter that may extend down lateral thigh
  • Worsens with laying on side, prolonged standing/walking, and stairs
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6
Q

Pathology of IT band tightness/friction disorder

A
  • Tight ITB, abnormal gait
  • Results in inflammation of trochanteric bursa
  • Noble compression test and/or Ober’s test may be positive
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7
Q

Function of the Piriformis muscle

A
  • Hip ER at <60º hip flexion
  • Hip IR and abductor at 90º hip flexion
  • Tightness or spasm of piriformis muscle can result in compression of sciatic nerve and/or sacroiliac dysfunction
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8
Q

Signs and symptoms of Piriformis syndrome

A
  • Restriction in IR
  • Pain with palpation of piriformis muscle
  • Referral of pain to posterior thigh
  • Weakness in ER, [ositive piriformis test
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9
Q

What are the 2 types of FAI (femoroacetabular impingement)

A
  • CAM: impingement of a large aspherical femoral head in a constrained acetabulum
  • Pincer: over-coverage of the femoral head by a prominent acetabular rim
  • Frequently associated with acetabular labral tears
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10
Q

Pathology of groin pain in athletes (sports hernia)

A
  • Common in sports requiring kicking, rapid acceleration/deceleration, & sudden change of direction
  • May be related to pathology of adductor, iliopsoas, inguinal, or pubic
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11
Q

Signs and symptoms of a sports hernia

A
  • Acute or gradual onset
  • Symptoms and painful weakness localized to structures involved
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12
Q

What are the degree classifications for knee ligament injuries

A
  • 1st degree: little or no instability
  • 2nd degree: minimal to moderate instability
  • 3rd degree: extreme instability
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13
Q

What is the “unhappy triad” of the knee

A
  • Injury to the MCL, ACL, and medial meniscus resulting from a combination of valium, flexion, and ER forces at the knee while the foot is planted
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14
Q

MOI of meniscal and articular cartilage injuries

A
  • Result from a combination of forces to include tibiofemoral joint flexion, compression, & rotation which places abnormal shear stresses on the meniscus
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15
Q

Symptoms of a meniscus/articular cartilage injury

A
  • Lateral and/or medial joint pain
  • Effusion
  • Joint popping
  • Knee giving way
  • Limitations in movement
  • Joint locking
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16
Q

Describe patella alta

A
  • Malalignment in which patella tracks superiorly in femoral intercondylar notch
  • May result in chronic patellar subluxation and also possibly;y patellar tendon rupture
  • Positive camel back sign (2 bumps, one being the tibial tuberosity and the other being the patella)
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17
Q

Describe patella baja

A
  • Malalignment in which patella tracks inferiorly in femoral intercondylar notch
  • Results in restricted knee extension with abnormal cartilaginous wear, resulting in DJD and also possibly quadriceps tendon rupture
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18
Q

Pathology of patellofemoral pain syndrome (PFPS)

A
  • Common dysfunction that is the result of elevated patellofemoral joint loading caused by trauma, biomechanical factors, and/or muscle tightness & weakness
  • May be associated with patellar tendinopathy and/or chondromalacia patellae
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19
Q

Pathology of patellar tendinopathy/tendonosis (Jumper’s knee)

A
  • Degenerative condition of the patellar tendon typically of the deep aspect
  • May be related to overload and/or jumping activities
  • May also be interrelated to PFPS
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20
Q

What are the typical causes of pet anserine bursitis

A
  • Typically caused by overuse or a contusion
21
Q

Which femoral condyle is most often involved in a fracture due to it’s anatomical design

A
  • Medial femoral condyle
22
Q

Common MOI for a tibial plateau fracture

A
  • Combination of valgum & compression forces to knee when knee is flexed
  • Often occurs in conjunction with a medial collateral ligament injury
23
Q

MOI for an epiphyseal plate fracture in the knee

A
  • Frequently a weight bearing torsional stress
  • Presents more frequently in adolescents where an ACL injury would occur in an adult
24
Q

Most common MOI for a patella fracture

A
  • Direct blow to patella due to a fall
25
Q

Pathology of acute compartment syndrome

A
  • Elevated compartment (anterior, lateral, posterior) pressure that results in local ischemic condition
  • Usually the result of direct trauma and/or fracture
26
Q

What are the 6 P’s of compartment syndrome

A
  • Pain
  • Palpable tenderness
  • Paresthesia
  • Paresis
  • Pallor (unhealthy pale appearance)
  • Pulselessness
27
Q

What is chronic external compartment syndrome and its symptoms

A
  • Result of elevated compartment (anterior, lateral, posterior) pressure that restricts blood flow to muscles
  • Symptoms depend on compartment but anterior is most common resulting in pain in the anteriolateral leg region but may also present with paresthesia
28
Q

Pathology of medial tibial stress syndrome

A
  • Overuse injury of posterior tibialis and/or the medial soleus resulting in periostea inflammation at the muscular attachments
  • Etiology is thought to be excessive pronation
  • Pain elicited with palpation of the distal posteromedial border of the tibia
29
Q

What muscles make up the triceps surae

A
  • Soleus
  • Gastrocnemius
  • Plantaris muscles
30
Q

Pathology of lower leg stress fractures

A
  • Overuse injury resulting most often in micro fracture of tibia or fibula
  • Tibia is more commonly involved than fibula
  • 3 common etiologies: abnormal biomechanical alignment, poor conditioning, & improper training methods
31
Q

What is the grading system for ankle ligament sprains

A
  • Grade I: no loss of function, minimal tearing of the anterior talofibular ligament
  • Grade II: some loss of function, partial disruption of the anterior talofibular & calcaneofibular ligaments
  • Grade III: complete loss of function, complete tearing of anterior talofibular & calcaneofibular ligaments and partial tear of posterior talofibular ligament
32
Q

Pathology of Achilles tendonosis/tendonopathy

A
  • Degenerative condition of the Achilles tendon
  • Clinical examination including Thompson’s test helps to identify this condition
33
Q

What are the 3 fracture types of the ankle

A
  • Unimalleolar: involves the medial or lateral malleolus
  • Bimalleolar: involves the medial and lateral malleoli
  • Trimalleolar: involves the medial & lateral malleoli and the posterior tubercle of the distal tibia
34
Q

Pathology of tarsal tunnel syndrome

A
  • Entrapment of the posterior tibial nerve or one of its branches within the tarsal tunnel
  • Over/excessive pronation, overuse problems resulting in tendonitis of the long flexor & posterior tibialis tendon, & trauma may compromise space in the tarsal tunnel
35
Q

Symptoms of tarsal tunnel syndrome

A
  • Pain, numbness & paresthesias along the medial ankle to the plantar surface of the foot
36
Q

What population is flexor hallucis tendonopathy commonly seen in

A
  • Commonly seen in ballet performers
37
Q

How is a pes cavus (hollow foot) deformity observed

A
  • Increase height of longitudinal arches
  • Dropping of anterior arch
  • Metatarsal heads lower than hind foot
  • Plantar flexion and splaying of forefoot
  • Claw toes
38
Q

Pathology of equinus

A
  • Etiology can include congenital bone deformity, neurological disorders ( Cerebral palsy), contracture of gastrocnemius and/or soleus muscles, trauma, or inflammatory disease
  • Deformity observed is a PF foot
  • Compensation 2ndy to limited DF includes subtalar or midtarsal pronation
39
Q

Pathology of hallux valgus

A
  • Etiology is varied to include biomechancial malalignment (excessive pronation), ligamentous laxity, heredity, weak muscles, & footwear that is tight
  • Observed deformity: medial deviation of head of 1st metatarsal from midline; metatarsal & base of 1st phalanx move medially while distal phalanx then moves laterally
40
Q

What is a normal metatarsophalangeal angle

A
  • 8-20º
41
Q

What are the Sa;ter-Harris Fracture Classifications for the foot/ankle

A
  • Type I: entire epiphysis; very few complications to growth of bone
  • Type II: entire epiphysis & portion of metaphysis; may cause decreases bone growth but limited negative impact on long-term function
  • Type III: portion of the epiphysis; may lead to long-term problems 2ndy to fracture
  • Type IV: portion of epiphysis & portion of metaphysis; may lead to deformity of the joint
  • Type V: compression injury of the epiphyseal plate; poor functional prognosis
42
Q

Etiologies of metatarsalgia

A
  • Mechanical: tight triceps surae group and/or Achilles tendon, collapse of transverse arch, short 1st ray, pronation of forefoot
  • Structural changes in transverse arch possible leading to vascular and/or neural compromise in tissues of forefoot
  • Changes in footwear
43
Q

What is the frequently heard complaint with metatarsalgia

A
  • Pain at 1st and 2nd metatarsal heads after long periods of weight bearing
44
Q

Pathology of Charcot-Marie-Tooth disease

A
  • Slowly progressive disorder with varying degrees of involvement depending on degree of genetic dominance
  • Peroneal muscular atrophy that affects motor and sensory nerves
  • May begin in childhood or adulthood
  • Initially affects muscles in lower leg/foot and progresses to muscles of the hands/forearms
45
Q

Deformity observed with rear foot varus (subtalar varus, calcaneal varus)

A
  • Abnormal mechanical alignment of tibia, shortened rear foot soft tissues, or malunion of calcaneus
  • Rigid inversion of calcaneus when subtalar joint is in neutral position
46
Q

Pathology of rearfoot valgus

A
  • Abnormal mechanical alignment of the knee (genu varum)
  • Deformity observed: eversion of calcaneus with a neutral subtalar joint
  • Due to increased mobility of hind foot, fewer musculoskeletal problems develop form this deformity than with rear foot varus
47
Q

Pathology of forefoot varus

A
  • Congenital abnormal deviation of head and neck of talus
  • Deformity observed: inversion of forefoot when subtalar joint is in neutral
48
Q

Pathology of forefoot valgus

A
  • Congenital abnormal development of head and neck of talus
  • Deformity observed: eversion of forefoot when the subtalar joint is in neutral

NPTE Study Practice (17 decks)

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