test 3 Flashcards
Femoral neck fracture are common in______. Why? Laymans terms?
people over 60 years old especially women because of the angle of the femur
broken hip
Sacrotuberous ligament forms?
From the sciatic notch to the ischial tuberosity… forms the lesser sciatic notch
Sacrospinous ligament forms?
From the sacrum to the ischial spine… forms the greater sciatic foramen
The greater sciatic foramen is the passageway?
The greater sciatic foramen is the passageway for structures leaving the pelvis like the sciatic nerve
The lesser sciatic foramen is the passageway?
The passageway for structures leaving the perineum like the pudendal nerve
What are the muscles of the posterior abdominal wall?
Psoas major, Psoas minor, iliacus, quadratus lumborum
What is IT band syndrome?
Repetitive strain of IT band
Friction between the soft tissue and lateral epicondyle causes pain and inflammation
Name the artery pathway starting at common iliac artery?
internal Iliac artery and external iliac artery which changes to femoral artery when travelling under inguinal ligament
What are the borders/contents for the femoral triangle
Inguinal ligament, sartorius, and adductor longus
Floor: pectineus and iliopsoas
Contents: Femoral vein, artery, nerve
What are the contents of the adductor canal/ hiatus?
Saphoneous nerve
Femoral artery, vein, nerve
What are the 5 P’s of the compartment syndrome?
Pain, Pallor, Paresthesia, Pulselessness, Paralysis
Lumbosacral Plexus Big 5?
Obturator Nerve (L2-L4)
Femoral Nerve (L2-L4)
Sciatic Nerve (L4-S3)
Superior Gluteal Nerve (L4-S1)
Inferior Gluteal Nerve (L5-S2)
What travels through the fovea?
Obturator Artery
What kind of bone is the patella?
Sesamoid bone
What direction is most common in patellar dislocation?
Lateral
Knee Joint- Screw Home Mechanism?
Foot on surface (closed chain)
- to lock and straighten the knee, the knee locks by medially rotating the femur on the fixed tibia
- to unlock, the popliteus contracts, laterally rotates the femur on the fixed tibia
Foot off surface (open chain)
- to lock and straighten the knee, the knee locks by laterally rotating the tibia on the fixed femur
-to unlock the knee, the popliteus contracts, medially rotates the tibia on the fixed femur
When does the femoral artery become the popliteal artery?
After the adductor hiatus
What are the borders/ contents of the popliteal fossa?
Superolateral: Biceps femoris tendon
Superomedial: Semimembranosus and semitendinosus
Inferomedial: medial head of gastrocnemius
Inferolateral: Lateral head of gastrocnemius and plantaris
Contents: Politeal artery, politeal vein, Nerves
Bifurcation of sciatic nerve into tibial and common fibular nerve, sural nerve
Differences between Genu varum and genu valgum?
Genu varum- bow leg
Genu Valgum- KD shot, knocked knee
ACL Function?
Attaches to the posterior part of the medial side of the lateral condyle of the femur extending to the anterior intercondylar area of the tibia
Prevents anterior displacement of the tibia and hyperextension of the knee
PCL Function?
Attaches to the posterior part of the lateral side of the medial condyle of the femur to the posterior intercondylar area of the tibia
Prevents anterior displacement of femur on tibia or posterior displacement of the tibia on the femur and helps prevent hyperflexion of the knee joint
Medial Mensicus? Lateral meniscus?
C shaped and less mobile, more commonly injured
Circular, smaler, and more freely moveable than medial menisucus
What is the unhappy triad?
a ligament sprain injury involving the MCL, ACL, and medial meniscus
Lateral Collateral Ligament Location and function?
Extends from the lateral epicondyle to the lateral surface of the fibular head
Resists varus stress and tibial external rotation
Medial Collateral Ligament Location and function?
Extends from the medial epicondyle of the femur to the medial condyle and the superior part of the medial surface of the tibia
Valgus stress
Where is the proximal and distal tibiofibular joints?
Fibular head and Lateral mallelous on fibular notch
Responsible for IR and ER of the lower leg
Talocrural DF/PF
Name the 3 5th metatarsal injuries?
Avulsion fracture at base of 5th metatarsal
Jones fracture
Stress fracture
What is the most commonly injured ligament in the lateral ankle? 2nd most commonly injured?
Anterior talofibular ligament
Calcaneofibular ligament
Differences between high ankle sprain and lateral ankle sprain?
Inversion and involves the anterior talofibular ligament and calcaneofibular ligament
DF with lower leg external rotation and involves the tibiofibular syndesmosis and anterior tibiofibular ligament
What are the Ottawa ankle and Foot fracture rules?
A: Posterior edge of lateral malleolus
B: Posterior edge of medial malleolus
C: Base of 5th metatarsal
D: Navicular
Ankle X ray if pain in malleolar zone, tenderness at A and/or B, and inability to bear weight
Foot X Ray if pain in midfoot zone, tenderness at C and/ or D and inability to bear weight
What comprises the tarsal tunnel (medial malleolus)?
Tom DIck and Very Nervous harry
T: Tibalis Posterior
D: Flexor Digitorum Longus
A: Tibial Artery
V: Tibial Vein
N: Tibial Nerve
H: Flexor Hallucis Longus
What position is the great toe?
Adduction
What is a bunion?
1st ray is out of alignment
Hallux valgus
reduces medial longitudinal arch
What keeps the TOM DICK AND VERY NERVOUS HARRY in place?
Flexor retinaculum
What can also be injured in a lateral ankle sprain?
Fibular retinaculum
Superior fibular retinaculum
Inferior fibular retinaculum
What muscles/ ligaments make up the dynamic support/ passive support of the medial longitundal arch?
Dynamic:
Tib ant, tip post, flexor hallucis longus, fibularis longus, plantar intrinsic muscles
Passive support:
Plantar aponeurosis, long plantar ligament, short plantar ligament, plantar calcaneclavicular
What is in both the medial and lateral longitudnal arches?
Calcaneus
What muscles/ ligaments make up the lateral longitudnal arch?
Fibularis Longus, Flexor Digitorum Longus
What muscles and ligaments make up the transverse arch?
Artery network starting at the popliteal artery?
Popliteal artery at Adductor hiatus, Posterior tibial artery at soleal line, Anterior tibial artery branches off (Dorsalis pedis pulse), fibular artery branches off PTA too, posterior tibial artery goes through tarsal tunnel
Arterial supply on the dorsal surface?
Anterior tibial artery becomes dorsalis pedis artery, Lateral tarsal artery branches off ATA, Arcuate artery
Arterial supply on plantar surface?
Posterior tibial artery goes to lateral plantar artery, medial plantar artery branches off PTA, Plantar Arch
Muscles of the foot- first layer?
ABductor digiti minimi, Flexor digitorum brevis, Abductor hallucis
Muscles of the foot- second layer?
Quadratus plantae, lumbricals
Muscles of the foot- third layer?
Flexor digiti minimi, Adductor hallucis, flexor hallucis brevis
Muscles of the foot- fourth layer?
Pad, Dab
plantar interossei, dorsal interossei
The ____ divides the greater sciatic foramen into superior and inferior
Piriformis
Sciatica caused by____
Spondylosis and Spondylolisthesis
What is piriformis syndrome?
Part of sciatic nerve can pierce piriformis or piriformis can become chronically tight —- muscle contraction compresses nerve
Lateral femoral nerve entrapment (meralgia paresthetica)
Inguinal ligament - 2cm inf
Causes: tight clothing, obesity, trauma, pregnancy, diabetes
Where can the femoral nerve be trapped?
Beneath iliopsoas tendon
Inguinal ligament
Femoral triangle
Adductor canal
Obturator nerve entrapment? Caused by? Symptoms?
Injury to the nerve as it passes through the obturator canal
Caused by anterior dislocation of hip and prostrate surgery
Difficulty adducting thigh and decreased sensation over medial thigh
Superior gluteal nerve entrapment cause? Presents as?
Piriformis muscle compression
Achy type butt pain
Waddling gait
Tender to palpating
Common fibular nerve injury? Symptoms?
Most common nerve injured in the lower limb
Flaccid paralysis of all muscles in the anterior and lateral compartments of leg
The loss of dorsiflexion and eversion causes foot drop
Deep fibular nerve entrapment (ski boot syndrome)? Cause? Where does pain occur?
Excessive use of muscles supplied by the deep fibular nerve may result in muscle injury and edema in the anterior compartment
Pain occurs in the disruption of the foot and usually radiates to the web space of the 1st and 2nd toes
Superficial fibular nerve entrapment? Cause? Pain where?
Chronic ankle sprains may produce recurrent stretching of the superficial fibular nerve
Pain along the lateral side of the leg and the dorsum of the ankle and foot
Pudendal nerve entrapment? Found where?
Perineal pain while sitting
Travels over the sascrospimous ligament and through the pidendal canal formed by the obturator fascia and ST ligament, emerging inferior to pubic bone
To innervate perineum and genitalia
What is a popliteal cyst? Aka as?
Fluid filled growth behind the knee, common in children
Baker cyst
Tibial nerve at tarsal tunnel entrapment? Symptoms?
Posterior to medial mallelous, deep to the flexor retinaculum
Edema, synovial sheath tightness, heel pain
Sural nerve entrapment sites?
Fibrous arcade at lower lateral leg
Baker cyst
Gastric strains
Fx of 5th metatarsal
Tarsal tunnel syndrome? Can also cause problems where?
When the tibial nerve is compressed in the tarsal tunnel
Double crush causes back problems
What makes up the transverse tarsal joint? What is it’s other name?
Chopart joint
Calcaneocuboid joint
Talocalcaneonavicular joint
What makes up the talocalcaneonavicular joint?
Plantar Calcaneonavicular (Sprint ligament)
Plantar Calcaneocuboid (short plantar ligament)
Long plantar ligament
What is LisFranc Injury?
Injury to Lisfranc ligament, dislocation
Fracture of Metatarsal
Medial cuneiform to 2nd metatarsal ligament
Foot twisting
What is medial plantar nerve entrapment (Baxter’s neuropathy)? May occur when?
Also called?
Compressive irritation as it passes deep to the flexor retinaculum or curves deep to the abductor hallucis, in navicular tuberosity region
May occur during repetitive eversion of the foot
Jogger’s foot
Which joints participate in pronation of the foot?
What are its three movements?
Talocrural joint
Subtalar joint
Trantarsal joints
Tarsometatarsal
Ankle DF, hindfoot eversion, forefootabduction
Which joints participate in supination?
What are its three movements?
Talocrural joint
Subtalar joint
Trantarsal joints
Tarsometatarsal
Ankle PF, hindfoot inversion, forefoot adduction
What is a chopart injury?
dislocation of the midtarsal joints of the foot, often with associated fractures of the calcaneus, cuboid, and navicular bone and transverse tarsal joint
What is Charcot Marie tooth?
neurological disorder
high arch pes cavus or low arch pes planus
claw toes
What is mallet toe? What are some causes?
Flexion of the distal phalanx of the long toe
causes: bad fitting shoes, arthritis, trauma, neuromuscular and metabolic disease
What is hammer toe?
Which muscles are weak which would allow this?
Proximal phalanx hyperextended at MTP, middle phalanx flexed at PIP, DIP hyperextended
Lumbricals, PADs, and DABs
What is claw toe? Which toes?
Hyperextended at the MTP
Flexion of the DIP
Lateral 4 toes
What is Morton’s toe?
2nd toe extends more distal than the other digits
What is Morton’s neuroma?
inflammation nerve pain between 3rd and 4th toes
What are the anatomical borders/ surface borders of the urogenital triangle/ anal triangle?
Anterior border: pubic symphysis
Lateral border: ischiopubic rami and ST ligament
Inferior border: tip of coccyx
Anterior border: mons pubis
Lateral border: medial surface of thigh
Inferior border: intergluteal cleft
What are the 3 muscles of the perineum?
Bulbospongiosus, ischiocavernosus, superficial transverse perineal muscle
What is the false pelvis vs true pelvis?
False pelvis (greater pelvis) are the bones
True pelvis (lesser pelvis) is the inlet
Differences between male and female pelvis?
males is heavier with more attachment sites
sacral promontory more prominent
ischial spines more medial
heart shaped(males) vs oval shaped(females)
angle of pubic arch more narrow
5 S’s of Pelvic Floor Function
Support, Sphinteric, Sexual, Stability, Sump and Pump
