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SPOM > Radiology Lower Limb > Flashcards

Radiology Lower Limb Flashcards

1
Q

3 types of fractured hips?

A
  1. Intertrochanteric fracture: greater to lesser trochanter
  2. Femoral neck: below head of femur
  3. Subtrochanteric Fracture: below lesser trochanter, entire bone must be stabilized

-most fractured hips are externally rotated, muscles pull on broken bones, shorten and rotate leg

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2
Q

Blood supply to femoral head? Danger of fracturing it?

A
  • Medial Circumflex Femoral Artery comes off Deep Femoral and gives most blood supply to femoral head and neck
  • could cause death to head, or inability to fully heal
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3
Q

How to test for Gluteus Medius and joint stability?

A
  • stand on one leg, if there is a problem the hip will drop down (Trendelenberg Sign)
  • if the person is old, it might be because the articular cartilage is worn down
  • can happen if Superior Gluteal Nerve is damaged during surgery
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4
Q

Last bone to ossify? Clinical significance?

A
  • iliac crest

- get X-ray of hand and pelvis to determine how much more growth a child has, wait to treat scoliosis

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5
Q

Why do women generally have genu valgus?

A
  • women have wider pelvis
  • femur is more angled to compensate
  • affects knees over time
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6
Q

Hallux Valgus?

A
  • lateral deviation of big toe
  • medial deviation of 1st metatarsal
  • adductor muscles pull
  • develop exostoses (cartilage) or bunion on medial side of metatarsal head
  • also called metatarsus primus varus
  • surgery to correct: release adductors, take off exostoses, and realign bone
  • may require arthroplasty: surgical reconstruction of proximal MP joint
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7
Q

Spina bifida in infants and risk of hip dislocation? How to fix it?

A
  • posterior vertebrae don’t close during development, spinal cord is exposed
  • nerves don’t work properly and femoral head dislocates
  • Surgery to cut hole in pelvis and take Psoas Major and attach it to Greater Trochanter to prevent dislocation
  • it becomes an abductor muscle instead of flexor
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8
Q

Order of vessels from lateral to medial that go under inguinal ligament?

A
  • femoral nerve
  • artery
  • vein
  • lymphatic
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9
Q

Risk of clot in femoral vein?

A
  • Pulmonary Embolism
  • anticoagulants to help
  • put cage in there to prevent clot from reaching heart
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10
Q

Largest sesamoid bone in body? Function?

A
  • Patella

- used as fulcrum in leg to help the quads do their job of extending the knee

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11
Q

How do you check to see if a baby hip is dislocated?

A
  • femoral head not yet ossified so X-ray doesnt help
  • Barlow Test to check for dislocation
  • abduct too much and medial circumflex will be kinked and lead to necrosis of femoral head
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12
Q

Innervation of Pes Anserinus?

A
  • Sartorius: Femoral
  • Gracilis: Obturator
  • Semitendinosus: Tibial division of Sciatic

-they function to internally rotate knee

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13
Q

ACL surgery?

A
  • take Semitendinosus and Gracilis, cut the long tendon and fuse these muscles together
  • use tendon as new ACL, drill holes in femur to feed it through
  • bone fibers need to fuse into new tendon, could take one year
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14
Q

Osteochondritis desicans?

A

bone under cartilage dies due to lack of blood flow

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15
Q

Which direction does the patella want to dislocate?

A
  • laterally
  • valgus stance increases chance of patella moving laterally
  • strengthen Vastus Medialis to pull patella more medially
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16
Q

What imaging technique shows meniscal or ACL tears?

A

MRI

17
Q

How to test an achilles tendon tear?

A
  • lie on stomach
  • flex knee and squeeze gastrocnemius and soleus
  • if the foot moves, the tendon is not torn
  • if pain, could be plantaris tear
18
Q

Outcome of Tibial fracture?

A
  • hard to heal because superficial to skin, may lose leg
  • supports most body weight (Fibula is not weight bearing- can remove bone for graft)
  • if patient is smoker it may never heal
  • need long leg cast to immobilize knee and foot joints
  • if cannot fix with cast, put rod through medullary canal
19
Q

Mangled extremity index?

A
  • based on bone, muscle, skin lost and amount of contamination in wound
  • used to see if you can save leg or need to amputate
20
Q

What supports the lateral knee?

A
  • Biceps Femoris

- LCL

21
Q

Attachments of MCL?

A

adductor tubercle and goes deep to Pes Anserinus

22
Q

Function of Sartorius?

A

Sartorial Slender:

  • flex hip
  • externally rotate
  • abduct
23
Q

Ankle Mortise?

A
  • Medial Malleolus of Tibia and Lateral Malleolus of Fibula designed to keep Talus in place
  • allows ankle to dorsi and plantar flex
  • must be carefully fixed if fractured, lateral malleolus is more important
  • AP xray to see relationship
  • Fibula sits more posterior to Tibia, to really see relationship, need to internally rotate ankle to bring Fibula and malleoli into view
24
Q

What goes under sustentaculum tali of calcaneus?

A

Flexor Hallucis Longus

-holds talus up

25
Q

Fall from height, what’s fractured?

A
  • Calcaneus fractured
  • evaluate for compression fracture in thoracolumbar spine because they roll forward into flexion when they fall and compress vertebral bodies (lateral xray)
26
Q

Role of Navicular bone? What supports it

A
  • top of arch, supports arch

- Posterior Tibialis Tendon and Fibularis Longus

27
Q

Jones Fracture

A
  • Fibularis Brevis attaches to 5th metatarsal

- during ankle roll, can break tuberosity off

28
Q

March Fracture?

A
  • crack in 2nd or 3rd metatarsal

- stress fracture from jogging or marching

29
Q

Function of Quadratus Plantae?

A
  • Flexor Digitorum Longus comes around medial malleolus and attaches to toes at an angle
  • Quadratus plantae attaches to the tendons at an oblique angle to pull the digitorum straight
30
Q

Sesamoid bones in foot?

A
  • medial and lateral, or fibular and tibial
  • form under metatarsal head of big toe in the tendon of Flexor Hallucis Brevis
  • Flexor Hallucis Longus tendon runs through these bones
31
Q

Lisfranc Fracture?

A
  • injury at base of metatarsals where cuboid and cuneiforms are
  • difficult to diagnose because hard to get a lateral view
32
Q

How to see if problem with arch on xray?

A

must be weight bearing xray

33
Q

Pes planus?

A
  • flat arch
  • most are born with it, some athletes have it
  • can be pathological due to tearing of Tibialis Posterior or ligaments in foot
  • can be due to abnormal or fusion of tarsals
  • problem because you walk and put weight on inside of arch, pronating foot on navicular bone, will stretch ligament over time
34
Q

Plantar Fasciitis?

A
  • help support arch
  • need good arch support if on feet a lot
  • can cause bone spur off calcaneus
  • due to inflammation of fascia
35
Q

Foot deformities in babies?

A
  • Congenital club foot (Talipes Equinovarus)
  • Talus becomes vertical and toes go against Tibia
  • may need to cut ligaments and put them in place, put in a cast and change it every week
36
Q

Compartment Syndrome?

A
  • pressure within crural fascia compartments is high
  • bleeding and swelling will squeeze muscles
  • blood cannot leave, waste products remain, low O2
  • could be from severe crush injury or Tibial injury
  • could become necrotic and lose leg
  • need to release pressure with surgery, muscle squeezes through incisions
  • cover with skin grafts

SPOM (17 decks)

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