Musculoskeletal Flashcards
Name the joint located between the head of the femur and the acetabulum. State the type of joint it is and its movements.
Hip joint
Ball-and-socket joint
Involved in flexion, extension, abduction, adduction, lateral roatation, medial rotation and circumduction of the hip
Name the joint located between the femur and tibia. State the type of joint it is and its movements.
Knee joint
Hinge joint
Flexion, extension, medial rotation and lateral rotation (only small amounts) of the leg
Name the joint located between the proximal end of the tibia and fibula. State the type of joint it is and its movements.
Proximal tibiofibular joint
Synovial joint
Very minimal movement
Which specific parts of the tibia and fibula form the proximal tibiofibular joint?
The head of fibula articulates with the fibular facet on the lateral tibial condyle
Name the joint located between the distal ends of the tibia and fibula. State the type of joint it is and its movements.
Distal tibiofibular joint
Fibrous joint
No movement
Name the joint located between the distal ends of the tibia and fibula which articulates with the talus. What type of joint is it and state its movement?
Ankle joint
Synovial hinge-type joint
Dorsiflexion (true extension)
Plantarflexsion (true flexion)
Small amounts of abduction and adduction and inversion and eversion
Which type of movement from the ankle joint is considered true extension?
Dorsalflexion
List all of the tarsal bones of the foot
Talus
Calcaneus
Cuneiforms (1-3)
Cuboid
Navicular
State the name of the joints between the tarsal bones. What is the role of these joints?
The intertarsal joints
The eversion (lifting of the lateral border of foot)
Inversion (lifting of the medial border of foot)
State the name of the joint located between the talus and calcaneal bone
Anatomical subtalar (talocalcaneal) joint.
State the name of the joint between the talus and navicular bone
Talonavicular joint
The talonavicular and talocalacneal joint are collectively known as?
talocalcaneonavicular joint complex.
In orthapaedics, the talocalcaneonavicular joint complex is known as? Describe the movement of this joint
Functional (clinical) subtalar joint
Involved in inversion and eversion of the foot
The proximal ends of the metatarsal bones articulate with the distal row of tarsal bones to form which joint? What type of joint is this and describe its movement.
Tarsometatarsal joints
Plane synovial joints
Limited sliding movements.
Name the ligaments which attaches all the metatarsal heads together and state its purpose.
Four deep transverse metatarsal ligmanets
Enable the metatarsals to move as a single unit
State the name of the joint which is located between the head of the metatarsals and the base of the proximal phalanges. What type of joint is this and state its function.
metatarsophalangeal joint
Elipsoid synovial joint
Flexion, extension , abduction and adduction of the digits
State the name of the joints located between the proximal and distal ends of the adjacent phalanges. What type of joints are they and state their function.
Interphalangeal joint
Hinge synovial joint
Only flexion and extension
What are the components of a lower limb examination
Look: Inspection
Feel: Palpation
Move
Measure degree of movement
Compare with opposite limb
Explain how you would inspect the lower limb
What useful mnemonic is used when inspecting the lower limb?
SWIFT
Scars
Wasting of muscles
Involuntary movements
Fasciculatons (muscle twitches)
Tremor
Explain how you would do a gait assesment
Ask if patient is able to walk unassisted
Tell person to cross arms over shoulder whilst sitting and then ask to stand up. (they can stop crossing arms after this)
Tell patient to walk towards an area of the room and then turn around (we will look for stance, stability, arm swing, steps, turning)
After turning as them to put one foot in front of the other to asses for tandem gait (should be able to do it without falling from side to side or losing balance)
Then ask them to walk on tip-toes and then heel (think this is optional?)
What clinical test is used to look for loss of proprioceptive and vestibular dysfunction? Explain how this test is performed
Romberg’s test
Ask patient to stand up with arms straight on their side and legs stright side by side and ask them to close their eyes (and not to worry if they feel unstable as you will support them).
Check if they lose balance
Assess the tone of the lower limb
Ask patient to go floppy and do a leg roll (rotate the knee so leg moves side to side)
Do a leg lift (grab under the knee, lift and let it fall)
Then test for ankle clonus
What is ankle clonus? How can we assess for ankle clonus?
series of involuntary rhythmic muscular contractions and relaxations of the ankle that is associated with upper motor neuron lesions of the descending motor pathways (e.g. stroke, multiple sclerosis, cerebral palsy).
Lift the leg and support it with left hand and with right
Rapidly dorsiflex the foot and partially evert the foot to relax gastrocnemius
Then keep the foot in a dorsiflex positon and observe for clonus (if more than 5 beats of clonus detected then this is abnormal)
Assess for muscle power of the lower limb
Ask patient to lift leg up and push down against them for both legs (tests for L1/L2 involved in hip flexion)
Ask patient to push leg down towards the bed (tests for L5/S1) involved in hip extension
Ask to push legs together (tests L2/L3 for hip adduction)
Ask to push legs apart (tests L4/L5 for hip abduction)
Ask the to try and pull their ankle towards their bottom and stop me from trying to straighten their leg (tests for knee flexion S1)
Bend their leg and ask them to straighten it (tests for knee extension L3/L4)
Ask to push their feet towards them and stop you from bringing them down (dorsalflexion L4)
Ask them to try and straighten their foot as you push against them (plantarflexion S1/S2)
Ask them to bring big toe towards you and use middle and index finger and thumb to try to straighten big toe (extensor hallucis L5)
Hip extensor muscle
Superficial gluteal muscles (Gluteus maximus)
Hip flexor muscles
Anterior thigh muscles.
Psoas major
psoas minor
Illiacus
Sartorius
Pectinius
Hip abductors + medial rotators
Supericial layer of gluteal muscles
Gluteus medius
Gluteus minimus
Tensor fasciae latea
Hip adductors
Deep gluteal muscles
Abductor longus
Abductor brevis
Abductor magnus
Gracilis
Hip lateral rotators
Piriformis
Gemelli
Obturator internus and externus
Qudratus femoris
