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Clin Med II > Pathologies Related to Pelvis and Hip I > Flashcards

Pathologies Related to Pelvis and Hip I Flashcards

1
Q

Pathological hip fracture overview:

________ femur fx; particularly the _____ due to what?

A

proximal

neck

disease

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2
Q

Pathological hip fracture

Etiology: Conditions with compromised ______

  • Osteoporosis and _________
  • _________ _______ : congenital and inherited brittle bone disease
  • ________ disease- chronic bone disorder with abnormal bone turnover that results in bigger but softer bones

May or may not involve a _______

A

bone

osteomalacia

Osteogenesis imperfecta

Paget’s

fall

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3
Q

Risk factors for Pathological hip fracture: _____ based on etiologies

A

vary

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4
Q

Incidence/Prevalence with pathological hip fracture:

mostly ______

_____ Americans

A

older

European

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5
Q

Pathogenesis of Pathological hip fracture: ______ _____ of bone resulting in fx

A

gradual weakening

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6
Q

Pathological hip fracture

S&S:

  • Painful ____ and possible _____ way
  • _____ and possibly _______ thigh P! and to the knee and lateral ______

Increased pain in ________ and decreased in _______ WB

A

snap; giving

Groin; anteromedial

hip

WB; non

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7
Q

With a Pathological hip fracture, you may observe…

_______ and excessively ______ rotated LE due to displacement and pull of ER’s

_______ and _______ gait

A

Shortened; externally

antalgic; asymmetrical

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8
Q

With a Pathological hip fracture, ROM will be in ______ directions but specifically _____

A

several; IR

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9
Q

With a Pathological hip fracture, what special test will be positive?

A

Patellar-pubic percussion

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10
Q

With a Pathological hip fracture, there could be a sign of the _______

A

buttock

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11
Q

The sign of the buttock is a collection of _____ indicating a ______ pathology

A

signs; serious

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12
Q

What is the etiology for sign of the buttock? (4)

A

Fx
Tumor
Infection
Hematoma

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13
Q

S&S for sign of the buttock

Hx- possible ______, infection, or ______ S&S

A

cancer
fracture

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14
Q

What would you observe with sign of the buttock?

A

gluteal swelling

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15
Q

ROM S&S with the sign of the buttock:

Hip _____ limitation the same no matter the ______ position with _____ end feels

Same degree of trunk ______ limitation in relation to the _____ and trunk position

A

FLX
knee
empty

flexion
femur

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16
Q

With sign of the buttock resisted/MMT: they will have _____ and ______ glutes

A

weak; painful

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17
Q

Sign of the buttock referral?

A

Urgent referral to MD but emergent if there is fx present

*due to possible displacement and vascular compromise

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18
Q

With a pathological hip fracture:

PT Implications- significant _____, _____, and health ______ arise from resulting sedentary situation

Ensure patients with risk factors of Osteoporosis had a ______ scan

A

morbidity; mortality; issues

DEXA (DXA)

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19
Q

Age group for DEXA scan:

Biological women at ____ years old

Biological men at _____ years old

A

65
70

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20
Q

Pathological hip fracture is a “Do Not Want To Miss” condition

You want to ______ with _______ referral due to possible displacement and potential vascular compromise

A

immobilize; emergent

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21
Q

________ is aka avascular necrosis or AVN of the femoral head

A

Osteonecrosis

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22
Q

With osteonecrosis incidence/prevalence:

May be ______ in _____% of cases

______> younger individuals

A

bilateral; 60

older

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23
Q

With osteonecrosis etiology and risk factors:

Insufficient _______ supply to _______ head

A

arterial; femoral

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24
Q

Two risk factors associated with trauma and osteonecrosis?

A

Fx/dislocation
Slipped femoral epiphysis or growth plate

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25
Q

With osteonecrosis etilogy which ligament is involved?

A

ligamentum teres- intracapsular ligament

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26
Q

Pertaining to osteonecrosis:

The ligamentum teres attaches proximally in the ________ is distally in the _______ of the femoral head

A

acetabulum; fovea

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27
Q

Pertaining to osteonecrosis: The ligamentum teres contains the _____ _____ artery to supply the head of the femur

Also plays a ________ role

A

medial epiphyseal

supportive

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28
Q

With osteonecrosis, the femoral head is also supplied by the _____ and ______ circumflex aa.

A

medial; lateral

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29
Q

Osteonecrosis etology and risk factors:

Insufficient ______ supply to ______ head

A

arterial; femoral

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30
Q

Osteonecrosis etology and risk factors:

Gradual onset with…
_______ abnomalities
________ (ex. radiation, smoking, alcoholism)
_____ ______ disease with a shortage of healthy carrying oxygen RBCs
Chronic _______ and oral _________ use
Bone _______ pathology
_______ syndrome

A

Vascular
Toxicity
Sickle cell
corticosteroid; contraceptive
Marrow
Metabolic

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31
Q

Osteonecrosis pathogenesis:

______ leading to death of bony tissue

Rapid progression to ____-_____ _____ _____

May involve ______ tears

A

Ischemia

age-related joint changes

labral

32
Q

Osteonecrosis S&S:
Hx of…
_____ and possibly _______ thigh P! and to the knee

_______ but worsening with _______ and unknown

Even occuring at rest due to ______

A

Groin; anteromedial

Intermittent; gradual

ischemia

33
Q

With osteonecrosis, you may observe ______ and ______ gait

A

antalgic; asymmetrical

34
Q

With osteonecrosis their ROM may be limited with _____, ______, and _______ due to greater contact

A

IR/ABD/FLX

35
Q

With osteonecrosis, there could S&S with what condition that involves changes?

A

Age-Related Joint Changes

36
Q

Osteonecrosis is a _______ referral to MD if _______ onset

A

urgent; gradual

37
Q

With osteonecrosis, if referred for PT proceed with ________

Should focus on _______ training with an _______ device to help protect the femur

PT directed primarily at ______ motion, improving ______, and for _____/______ integrity; like age-realted joint changes Rx

A

caution

gait; assistive

protection; circulation; bone; cartilage

38
Q

With osteonecrosis, the patient may end up having a ____-_______ or possibly a _____

A

Hemi- arthroplasty
THA

39
Q

______-_____-______ is aka as coxa plana or flat hip

A

Legg-Calve-Perthes

40
Q

Legg-Calve-Perthes is the AVN of the femoral head in _______

A

children

41
Q

Etiology for Legg-Calve-Perthes:

_______
Exposure to ______ ______ ______
_______ factors (ex. genetics, endocrine, nutritional, or socioeconomic conditions)
________ dysfunction of bone and vasculature

A

trauma

2nd hand smoke

Prenatal

Developmental

42
Q

With Legg-Calve-Perthes incidence/prevalence: it is MOST common in ____-_____ year old caucasian biological ______

A

5; 8
boys

43
Q

With Legg-Calve-Perthes pathogenesis- there is impaired vascular supply to ________ (med/lat _______ aa.) that changes the shape of the femoral _____ and ________

A

epiphyses; circumflex; head; acetabulum

44
Q

Legg-Calve-Perthes S&S:

Vary in _______
_______ and ______ onset primarily

If p!ful, ____ and possible ________ thigh p! and to the knee

A

magnitude

gradual; unknown

groin; anteromedial

45
Q

With Legg-Calve-Perthes S&S:
If p!ful, groin and possible anteromedial thigh p! and to the knee

it could _____ with activity
decrease with ______

A

increase
rest

46
Q

What might you observe with Legg-Calve-Perthes?

_______ and _______ gait
Muscle _______ if ______ standing

A

antalgic; asymmetrical

atrophy; long

47
Q

With Legg-Calve-Perthes, ROM will be limited with ______ and ______ due to greater bony contact

A

IR; ABD

48
Q

Legg-Calve-Perthes is a ____-_____ problem

A

long term

49
Q

Legg-Calve-Perthes is a _______ referral to MD if gradual; ______ referral to MD if trauma

A

urgent
emergent

50
Q

With Legg-Calve-Perthes, if referred for PT proceed with caution:

Should focus on _______ training with an _______ device to help protect the femur

PT directed primarily at ______ motion, improving ______, and for _____/______ integrity

A

gait; assistive

protected; circulation; bone; cartilage

51
Q

With Legg-Calve-Perthes, they present to the clinic periodically in a _______, ______, or ____ in a slight abducted position

A

splinted
braced
casted

52
Q

With Legg-Calve-Perthes, they present to the clinic periodically in a splinted, braced, or casted in a slight abducted position:

It allows better _______ head contact with acetabulum

Maintain and help better ______ femoral head in the acetabulum as ______ can occur

Complication: prone to _______

A

femoral

form

contractures

53
Q

With Legg-Calve-Perthes, possible age-related _____ changes in early _____ and ____% will develop age-related ______ disease before 50 yrs. old

A

joint; adulthood; 50; joint

54
Q

With Legg-Calve-Perthes, MOST will need ______ surgery and or early ______

A

corrective; THA

55
Q

With Legg-Calve-Perthes, there could be earlier ______ and _____ P! development in life due to ______ dysfunction

*kids tend to keep _____
*adults tend to _____ activity

A

LBP; knee

gait

moving

reduce

56
Q

_____ ______ ______ is the anterior displacement of femoral neck on femoral head

A

Slipped capital epiphysis

57
Q

Slipped capital epiphysis is aka as adolescent ____ ______

A

coxa vara

58
Q

_______ _______ ______ is the MOST significant epiphyseal plate disorder of the LE

A

Slipped capital epiphysis

59
Q

What is the etiology of slipped capital epiphysis?

Mostly _______
Association with _____ and _______ disorders and _____ _______

A

idiopathic

endocrine; renal

Down Syndrome

60
Q

What is the MOST common etiology for slipped capital epiphysis?

A

Hypothyroidism

61
Q

With slipped capital epiphysis, risk factors create increased _____ force across the _______ plate

A

shear; epiphyseal

62
Q

The single MOST common risk factor for slipped capital epiphysis is?

A

obesity

63
Q

Risk factors for slipped capital epiphysis:

Biological _____
Rapid _______
______ therapy
Femoral ______

A

males
growth
radiation
torsion

64
Q

With slipped capital epiphysis: Incidence/prevalence

MOST common in early _______
______ Americans and biological _____
Typically higher _____ in 75% of cases
Bilateral in up to ___/___ of patients

A

adolescence
African; boys
BMI
1/3

65
Q

The pathogenesis of _______ _______ _______- progressive displacement of femoral neck relative to the head through the growth plate due to shear forces and/or weakened epiphyseal plate

A

Slipped capital epiphysis

66
Q

Slipped capital epiphysis S&S

More likely ______ and ______ onset than trauma but could be sudden with ______ activity like rolling in bed

_______ and possibly _______ thigh P! and to the knee

A

gradual; unknown

benign

Groin; anteromedial

67
Q

With slipped capital epiphysis, you may observe it to be ______ and _________, ______ rotated hip, and muscle ______ if long standing

A

antalgic; asymmetrical
externally
atrophy

68
Q

With slipped capital epiphysis: ROM may be limited with

______/______/and ________ due to greater bony contact

Obligatory ______ during flexion

Possible sign of ______

A

IR/ABD/FLX

ER

buttock

69
Q

With slipped capital epiphysis: PT implications- should always be considered in ___-_______ with atraumatic ____ pain; particularly if associated with _____ gait

A

peri-adolescent

hip

antalgic

70
Q

Slipped capital epiphysis is a ______ referral to MD

A

urgent

71
Q

PT implications of slipped capital epiphysis:

If referred for PT proceed with caution-

If slip is __ 1 cm.
~ Splinted in an _____ position with non-WBing

A

<
ABDUCTED

72
Q

PT implications of slipped capital epiphysis:

Post-splinting

Should focus on _______ training with an _______ device to help protect the femur

PT directed primarily at ______ motion, improving ______, and for _____/______ integrity

A

gait; assistive

protected; circulation; bone; cartilage

73
Q

With slipped capital epiphysis:

Surgery is required if slip is ___ 1 cm.

A

>

74
Q

With slipped capital epiphysis: you need to avoid _____ or _______ (rapid loss of articular cartilage)

A

AVN; chondrolysis

75
Q

Vascular insufficiency S&S

_______
_______ or ______ discoloration
________ pulses
Impaired ______ refill with nail bed recovery
____ skin
____ loss

A

COLDNESS
blueish; pale
diminished
capillary
shiny
hair

76
Q

With vascular insufficiency: it is at least an ______ but possibly ______ referral depending on severity and if _______

A

urgent; emergent; traumatic

Clin Med II (7 decks)

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