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Sports injury anatomy > radiology 1 (leg) > Flashcards

radiology 1 (leg) Flashcards

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1
Q

In anatomy, what does the term leg refer to?

A

knee to ankle

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2
Q

in anatomy, what does the term lower limb refer to?

A

hip to ankle

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3
Q

in radiology, how would you describe the location of an injury on the bone

A

joint surface=articular, just below=metaphysis, middle portion=diaphysis. use proximal and distal

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4
Q

give the different fracture patterns and how they occur?

A

google picture
transverse, oblique, butterfly fragment, spiral, comminuted, segmental.
pattern determined by size of force: larger=bone more brittle=shatters e.g. comminuted fractures in motor sport.
oblique vs spiral: in tibia if close to fibular more likely to be oblique and spiral further away as is likely caused by twisting e.g. skiing

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5
Q

describe the terminology of fracture displacement

A

undisplaced=best
angulation: describe degree of rotation
translation=displacement: describe as a % of the bone that has displaced

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6
Q

what imaging tools are used to view fractures?

A

XR

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7
Q

when would you use a CT to view a fracture?

A

when the fracture location is articular or metaphyseal (shown by inital XR)

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8
Q

which bone in the lower limb is most likely to have an open fracture?

A

tibia as close to skin

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9
Q

what is internal fixation and when do you use it?

A

rod is inside the bone

if fracture is closed and clean

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10
Q

what is external fixation and when do you use it?

A

rod outside of bone

if fracture is open and potentially contaminated

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11
Q

what else must you do other than fixation for open fractures?

A

abx asap

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12
Q

what are the 2 causes of stress fractures?

A

bone is too weak for normal activity (osteoporosis)

normal bon ebut hight demand (long distance running)

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13
Q

how are stress fractues diagnosed?

A

can be hard
may need MRI (T2 weighted, water shows so get lots of bright white in affected area due to odema)
bone scan (use technetium 99 tracer which is taken up in areas of high bone turnover so affected area is dark)

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14
Q

what is a pathological fracture?

A

not due to trauma, tumour, osteoporitic stress fracture

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15
Q

what is the technical name for shin splints?

A

medial tibial stress syndrome

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16
Q

what is chronic exertional compartment syndrome and where is most commonly affected?

A

usually anterior compartment of leg
when running the front part of the leg begins to burn as the muscles are swelling due to blood flow but thick fascia blocks the muscles from swelling as they want to

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17
Q

draw and label the compartments of the lower leg

A

google https://www.google.com/imgres?imgurl=https%3A%2F%2Fupload.wikimedia.org%2Fwikipedia%2Fcommons%2F8%2F8f%2FGray440_-_Fascial_compartments_of_leg.svg&imgrefurl=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FFascial_compartments_of_leg&tbnid=hlBMxT2Ci9V9wM&vet=12ahUKEwiowKiq6LrzAhVUPhoKHS9kApQQMygAegUIARDNAQ..i&docid=8QeqWHOjpkGPvM&w=1200&h=875&q=compartments%20of%20leg&ved=2ahUKEwiowKiq6LrzAhVUPhoKHS9kApQQMygAegUIARDNAQ

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18
Q

which compartments of the leg are mirror images?

A

anterior and deep posterior. anterior deals with extension, posterior with flexion, both have 3 muscles separated by interosseus membrane

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19
Q

what is in the anterior compartment of the leg?

A

tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus tertius, deep peroneal nerve, anterior tibial vessels

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20
Q

what is in the lateral compartment of the leg?

A

peroneus longus, peroneus brevis, superficial peroneal nerve

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21
Q

what is in the superficial posterior compartment of the leg?

A

gastrocnemius, plantaris, soleus, sural nerve

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22
Q

what is in the deep posterior compartment of the leg?

A

tibialis posterior, flexor hallucis longus, flexor digitorum longus, popliteus, tibial nerve, posterior tibial vessels

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23
Q

which nerve in the leg is most likely to be damaged?

A

superficial peroneal nerve

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24
Q

what is the origin of tibialis anterior?

A

upper 1/2 or 2/3 of lateral surface of tibia and adjacent interosseous membrane

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25
Q

where is the insertion of tibialis anterior?

A

medial cuneiform and the base of the 1st metatarsal bone of the foot

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26
Q

which nerve supplies tibialis anterior?

A

deep fibular (peroneal), L5

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27
Q

what are the actions of tibialis anterior?

A

dorsiflexion and inversion of foot

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28
Q

where is the origin of tibialis posterior?

A

tibia and fibula

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29
Q

where is the insertion of tibialis posterior?

A

navicular and medial cuneoform bone

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30
Q

which nerve supplies tibialis posterior?

A

tibial

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31
Q

what are the actions of tibialis posterior?

A

inversion of foot and plantar flexion of foot at the ankle

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32
Q

where is the origin of peroneus longues?

A

proximal part of shaft of fibula

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33
Q

where is the insertion of peroneus longus?

A

first metatarsal, medial cuneiform

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34
Q

which nerve supplies peroneus longus?

A

superficial fibular (peroneal)

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35
Q

what are the actions of peroneus longus?

A

plantarflexion, eversion, support arches

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36
Q

where is the origin of peroneus brevis?

A

lower 2/3 lateral fibula

37
Q

where is the insertion peroneus brevis?

A

5th metatarsal

38
Q

which nerve supplies peroneus brevis?

A

superficial fibular

39
Q

what are the actions of peroneus brevis?

A

plantarflexion, eversion

40
Q

where is the origin of extensor hallucis longus?

A

middle portion of fibula on the anterior surface ad interosseous membrance

41
Q

where is the insertion of extensor hallucis longus?

A

dorsal side of base of distal phalanx of big toe

42
Q

which nerve supplies extensor halllucis longus?

A

deep fibular (L5)

43
Q

what is the action of extensor hallucis longus?

A

extends big toe and assists in dorsiflexion of foot and ankle

44
Q

where is the origin of extensor digitorum longus?

A

anterior lateral condyle of tibia, anterior shaft of fibula and superior 3/4 of interosseous membrane

45
Q

where is the insertion of externsor digitorum longus?

A

dorsal surface, middle and distal

46
Q

which nerve supplies extensor digitorum longus?

A

deep fibular (L5)

47
Q

what are the actions of extensor digitorum longus?

A

extension of toes and dorsiflexion of ankle

48
Q

where is the origin of the achilles (calcaneal) tendon?

A

gastrocnemius and soleus

49
Q

where does the calcaneal tendon insert?

A

calcaneal tuberosity

50
Q

what is the action of the calcaneal tendon?

A

plantar flexion of foot

51
Q

what causes achilles tendon rupture and what will it look like?

A

inability to disepate heat from stretching, unravelling of type 1 collagen. loss of tendon definiton, bruisng, swelling

52
Q

what is the clinical test for achilles tendon rupture?

A

Thompson/simmonds

squeeze the calf while patient laying on front, should be plantar flexion, if not then complete rupture

53
Q

give some rf for achilles tendone rupture

A

ageing, fluoroquinolone abx, steroid injectins, male, increased BMI, smoking, peripheral vascular disease, diabetes

54
Q

what is achilles tendonitis?

A

chronic, thickens and degenerated tendon

55
Q

what imaging is used for tendons?

A

MRI and US(good as can see while moving)

56
Q

why are medial ankle sprains less common?

A

length of fibula acts as buffering

57
Q

what causes a high ankle sprain?

A

forced external rotation of foot and dorsiflexion

posterior inferior tibiofibular ligament, anterior inferior tibiofibular ligament

58
Q

what causes a low ankle sprain?

A

supination and adduction

posterior talofibular ligament, calcaneofibular ligament, anterior talofibular ligament

59
Q

describe the grades of ankle sprains

A

grade1=minimal tissue damage, tx rice, usually resolves within a week
2= 1+ ligaments damaged, more swelling and brusing, healing can take 2-6 weeks
3=ligament torn, often popping sound, inability to weight bare, 6-12 weeks to recover

60
Q

what are the Ottawa ankle XR rules?

A

if have 1 of these then need an XR:
bone tenderness at posterior edge or tip of lateral malleolus
bone tenderness at posterior edge or tip of medial malleolus
inability to weight bare for 4 steps immediatelt and at the emergency department

61
Q

why do ankle fractures often have to be operated on?

A

need to restore full anatomy to prevent arthtiris

62
Q

what is the classification for ankle fracturs?

A

Weber A: rare but best
Weber B: tibia and fibula still well connected
Weber C: tibia and fibula not connected

63
Q

name and draw the bones of the foot

A

calcaneus, talus, navicular, cuboid, cuneiforms
https://www.google.com/imgres?imgurl=https%3A%2F%2Fi.pinimg.com%2Foriginals%2Fd1%2F3d%2F3d%2Fd13d3d674d99b39b41334102720b1475.jpg&imgrefurl=https%3A%2F%2Fwww.pinterest.com%2Fpin%2F202450945722792046%2F&tbnid=RQUHLWwUdYBavM&vet=12ahUKEwjWvd-R7rrzAhVF0RoKHUwiBlUQMygOegUIARDwAQ..i&docid=frvDmopuPgUISM&w=1118&h=1398&q=foot%20bones%20anatomy&ved=2ahUKEwjWvd-R7rrzAhVF0RoKHUwiBlUQMygOegUIARDwAQ

64
Q

describe the surface abatomy of the cuboid.

A

lateral (proximal and superior to 5th MT)

65
Q

describe the surface anatomy of the 5th metatarsal.

A

lateral, midfoor inferior prominance

66
Q

describe the surface anatomy of the navicular

A

medial, 2cm anterior to sustentaculum tail

67
Q

describe the surface anatomy of sustentaculum tail.

A

medial, 2cm inferior to MM

68
Q

when is the calcaneus often broken?

A

when fall from a hight

69
Q

what are the important ligaments in the foot?

A

spring/calcaneonavicular: holds the arch together

plantar, tibialis posterior

70
Q

what are the brevis toe extendors?

A

extensor hallucis brevis, extensor digitorum brevis

71
Q

what is the origin of the extensor hallucis brevis?

A

calcaneus

72
Q

where is the insertion of the extensor hallucis brevis?

A

proximal phalanx of hallux

73
Q

which nerve supplies extensot hallucis brevis?

A

deep fibular

74
Q

what is the action of extensor hallucis brevis?

A

extend hallux

75
Q

where is the origin of extensor digitorum brevis?

A

dorsal surface of calcaneus

76
Q

where is the insertion of extensor digitorum brevis?

A

proximal dorsal region of middle phalanges 2,3 amd 4

77
Q

what are the actions of extensor digitorum brevis?

A

extends digits 2,3,4

78
Q

which nerve supplies the extensor digitorum brevis?

A

deep fibular

79
Q

where is the origine of the tibialis posterior tendon?

A

tibia and fibula

80
Q

where does the tibialis posterior tendon insert?

A

navicular and medial cuneiform

81
Q

which nerve supplies the tibialis posterior tendon?

A

tibial

82
Q

what are the actions of the tibialis posterior tendon?

A

inversion of foot and plantar flexion of ankle

83
Q

what is the medial longitudinal arch formed and supported by?

A

formed by: calcaneus, talus, navicular, 3 cuneiforms, 1st 3 metatarsal bones
supported by: muscles ( tibialis anterior and posterior, fibularis longus, flexor digitorum longus, flexor hallucis, intrinsic foot muscles), ligaments (plantar, medical ligament of ankle joint), shape of bones, plantar aponeurosis

84
Q

what is the function of the medial longitudinal arch of the foot

A

distribute force

85
Q

what is plantar fascitis and how is it treated?

A

lots of pain, plantar fascia becomes tight, bulls bone and creastes calcification at insertion , causes bone spur (shown on XR)
need US/MRI to look at fascia
tx: stretching, rest, ice, arch supports, steroid injections, surgery to release plantar fascia

86
Q

is peroneus brevis associated with base of 5th metatarsal avulsion fracture due to inversion injury to ankle

A

yes

87
Q

what can stress fractures to metatarsals be called?

A

march fractures

88
Q

what is mortons neuroma?

A

soft tissue between 3rd and 4th toes, get stabbing/burning pain, need MRI

Sports injury anatomy (8 decks)

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