Unit 3 Clinical Aspects Flashcards
What is chondromalacia?
Dull pain around the knee that gets worse with exercise or when going from a flexed to extended position at the knee joint
(like walking up and down stairs or standing from a sitting position)
What is patella emarginata?
A patella where the superior lateral portion of the bone is unossified
What is Bipartite/Tripartite Patella?
A patella where the superior lateral portion ossifies by itself. It occurs in about 3% of the population
What is iliotibial band syndrome?
Stinging pain on the lateral aspect of the knee where the distal end of the IT band repeatedly rubs on the lateral epicondyle of the femur
Weakness of the Psoas Major/iliacus will cause what?
Disability from climbing stairs, walking up hills, or getting up from a reclining position
Disease or inflammation of the kidneys, parts of the lower intestine, pancreas, and/or appendix may cause pain referred pain in what muscle?
Psoas Major/Iliacus
A patient with difficulty extending their leg against resistance, or if they have abnormal patellar movements, may have what?
Atrophy of the quadriceps
What term is used to indicate a cramping or spasm of the quadriceps?
Charley Horse
(it’s also used to indicate trauma to the muscles, which can cause a tearing of a muscle fiber and lead to a painful hematoma and bruising)
What term is used to indicate a painful overuse injury of the common tendon of insertion of the quadriceps and/or the patellar ligament?
Jumper’s Knee
A patient who complains of pain and soreness in the area of the common tendon of insertion of the quadriceps or the patellar ligament, and who’s pain is intensified with activity, may have what?
Jumper’s Knee
What is another term for Jumper’s Knee?
Patellar Tendonitits
The patellar reflex tests for the segmental innervation of what spinal nerves?
L2, L3, L4
Which bursae separates the superior part of the muscle (gluteus maximus) from the greater trochanter?
Trochanteric Bursae
Which bursae separates the inferior part of the muscle (gluteus maximus) from the ischial tuberosity?
Ischial Bursae
What do we call a common painful contusion injury of the soft tissue associated with the iliac crest?
Hip Pointers
(very common in contact sports and usually result in painful hematomas)
What is a normal angle of inclination at birth? What about an adult?
Birth: 145 degrees
Adult: 125 Degrees
An increase in the angle of inclination is what?
Coxa Valga
- Occurs with developmental hip dysplasia and congenital dislocation
An decrease in the angle of inclination is what?
Coxa Vara
- Occurs in a fracture to the proximal part of the femur and can cause rickets
Degeneration to the femoral head due to a lack of blood supply caused by a fracture is known as what?
Avascular Necrosis
What causes an indirect trauma fracture to the patella?
Sudden contraction of the quadriceps muscle, causing a transverse fracture to the patella
What are the different types of grades of a pulled groin?
Grade 1 - Micro tear of fibers
Grade 2 - Partial tear
Grade 3 - Complete tear
What is the term used to denounce an adductor muscle that stretches past its origin and beyond its tensile strength?
Pulled Groin
Weakness of this muscle causes patients to have difficulty getting from a sitting to a standing position, straightening from bending on a hill, and/or walking uphill or up stairs.
Weakness of the Gluteus Maximus
During an orthopedic exam on your patient you discover a positive Trendelenburg Sign, which nerve is not functioning properly?
Superior Gluteal Nerve of the gluteus medius and minimus muscles.
A patient shows a positive Trendelenburg Sign while lifting their left foot. Which muscles are atrophied, and what side of the body are they on?
Gluteus Medius & Minimus on the right side of the body.
Weakness of the right gluteus medius and minimus will give rise to a “C” curve on which side of the body?
Left “C” curve, with the opening of the C opening to the right side of the body where the muscles are weak.
An athlete who runs very hard with quick starts are at a greater disposition for developing what?
A pulled hamstring
What 4 factors contribute to a pulled hamstring?
- Running Style
- Over developed quadriceps
- Biomechanical factors
- Inadequate warm ups and stretches
Forcible flexion of the hip when the knee is extended may result in what?
Avulsion of the Ischial Tuberosity
The body may compensate for weak or tight hamstrings by changing the position of what bone?
The pelvic bone
Meralgia Paresthesia is compression neuropathy of what nerve?
The lateral cutaneous nerve as it leaves the pelvic cavity beneath the inguinal ligament
A patient comes into your office complaining of a burning and tingling sensation along the lateral aspect of the thigh. What condition might they have?
Meralgia Paresthesia
What are some common causes of Meralgia Paresthesia?
- Obesity
- Tight fit clothing
- Any activity which puts the femur in a flexed position for a long period of time
What happens when the motor supply of the femoral nerve is damaged?
- Quadriceps are involved and the leg cannot be extended
- Flexion at the hip joint is diminished
What areas are affected when the sensory supply of the femoral nerve is damaged?
- Medial and intermediate anterior aspect of the thigh
- Medial aspect of the leg and foot
What nerve can be damaged during a difficult birth or by an anterior dislocation of the hip joint?
Obturator Nerve
Adduction of the femur tests for which nerve?
Obturator Nerve
Which nerve can be damaged by fracturing the pelvis, a posterior dislocation of the hip joint, or a penetrating wound like an injection in the wrong spot?
Sciatic Nerve
What nerve is injured causing foot drop?
Motor part of the sciatic nerve
When the motor supply of the sciatic nerve is damaged, the foot falls into plantar flexion (foot drop) due to what?
Gravity
If the motor part of the sciatic nerve is damaged, hamstring muscles will be atrophied, but weak flexion of the leg is still possible due to which muscles?
Gracilis and Sartorius
Damage to what nerve can cause loss of sensation below the knee except for an area along the medial aspect of the leg and foot?
Sensory part of the sciatic nerve
