Ortho - lower limb

Question 1

how do you diagnose meniscal tears?

Answer 1

MRI

Question 2

popping sensation followed by pain in the knee - what injury is this?

Answer 2

meniscal tear

Question 3

mensical tear - symptoms + signs

Answer 3

pain + swelling

joint line tenderness (mainly lateral i think?)

Question 4

common peroneal lesion - features

Answer 4

loss of dorsiflexion (foot + toes) + eversion

impaired pinprick to lateral calf + dorsum of foot

painless
ankle reflex preserved

loss of movement + sensation to the side

hx kneeling

Question 5

common peroneal nerve lesion - investigations

Answer 5

nerve conduction studies (neurophysiology) - conduction block at fibular neck

Question 6

CPN lesion - management + prognosis

Answer 6

avoid precipitant
footdrop splint
referral to neuro to confirm
should semi/recover by a couple of months

demyelinating lesion → full recovery
axonal loss → slower, potentially incomplete recovery

Question 7

foot drop: differentials

Answer 7

CPN compression at fibular head - mononeuropathy

prolapsed disc compressing L4/L5 - radiculopathy. almost always involves S1 root

Question 8

prolapsed disc compressing L4/L5 root - features

Answer 8

footdrop with weakness of INVERSION as well as eversion
significant back pain
S1 root nearly always involved - loss of ipsilateral ankle reflex

Question 9

radial nerve palsy - features, diagnosis, management

Answer 9

wrist drop - sat night palsy
diagnosis - neurophysiology
management - wrist drop splint

Question 10

CPN anatomy - what are its nerve roots and what does it branch from? role?

Answer 10

L4-S3
branches from sciatic nerve
dorsiflexion of foot + toes, eversion of foot
sensation to lateral leg (generally speaking) + dorsum of foot

Question 11

which muscle do ankle dorsiflexion, inversion + eversion? nerves responsible?

Answer 11

dorsiflexion - tibialis anterior (think - anterior)

inversion - tibialis posterior

eversion - pEroneal muscles

Question 12

which nerve root is involved in ankle reflex?

Answer 12

S1

Question 13

nerves of the leg: branches

Answer 13

sciatic (L4-S3) →

1) tibial → plantar nerves
2) common peroneal → superficial + deep

femoral (L2-L4) →
sensory:
1) anterior cutaneous branches
2) saphenous
3) then has various motor branches to quads (knee extensors) + hip flexors

Question 14

motor functions of common peroneal nerve - leg compartments, muscles, roles

Answer 14

superficial peroneal - lateral compartment:
fibularis longus + brevis
→ evert foot

deep peroneal - anterior compartment:
tibialis anterior; extensor digitorum, extensor hallucis longus
→ dorsiflex floot; extend digits

Question 15

common peroneal nerve - sensation

Answer 15

lateral calf + dorsum of foot

common: upper lateral/posterior calf
superficial: lower lateral/anterior calf + dorsum of foot
deep: gap between big + 2nd toe

Question 16

femoral nerve - sensation

Answer 16

femoral - anteromedial thigh

saphenous branch - anteromedial calf + foot

Question 17

femoral nerve - sensation

Answer 17

femoral - anteromedial thigh

saphenous branch - anteromedial calf + foot

Question 18

tibial nerve - muscles innervated generally

Answer 18

posterior leg compartment - includes some foot muscles

Question 19

common peroneal nerve - muscles innervated (generally)

Answer 19

anterior leg, lateral leg + some foot

Question 20

sciatic nerve - muscles innervated

Answer 20

posterior thigh
entire lower leg
entire foot

Question 21

tibial nerve - sensation

Answer 21

lateral/posterior lower calf (eg around lateral malleolus) - sural nerve
lateral foot
sole of foot

Question 22

femoral nerve - muscles innervated

Answer 22

anterior thigh muscles that:
flex the hip (pectineus, iliacus, sartorius - PIS)
extend the knee (quads)

Question 23

femoral nerve - sensory function

Answer 23

anteromedial thigh (anterior cutaneous branches)

medial lower leg + foot (saphenous nerve)

Question 24

tibial nerve - motor function

Answer 24

plantar flexion of ankle + toes
inversion of foot (but tibials anterior (dCPN) also does this)
flexion of knee

Question 25

frozen shoulder - RF? features OE?

phases? management?

Answer 25

diabetes
active AND passive affected
freezing episode is painful

NSAIDs + physio
oral + IA steroids

Question 26

vit B12 deficiency - features

Answer 26

predominantly sensory neuropathy

peripheral
subacute combined degeneration of SC
posterior column usually affected first (prop + vib), then distal paraesthesia

Question 27

myasthenic crisis - management

Answer 27

plasmapheresis

IV Ig